584H
Fig. 10.22 (a) A 16-year-old boy with
marked tooth surface loss of lower
permanent molars. Note the perimolysis
of the first molars. (b) Postcementation of
gold onlays on the permanent molars.10.5 INHERITED ANOMALIES OF ENAMEL AND DENTINE
585HChapter 13 covers the whole range of dental anomalies; however, the treatment of
amelogenesis imperfecta and dentinogenesis imperfecta poses specific challenges to
the dentist. In view of the wide variety of presentations and degree to which each
individual case is affected, it is difficult to make generalizations. Early diagnosis of
these conditions is important to their long-term prognosis; parents need to be educated
as to the implications of the condition; monitoring of the amount of tooth wear can
start, and, where necessary, teeth can be protected. There are four main clinical
problems associated with inherited enamel and dentine defects:
(1) poor aesthetics;
(2) chipping and attrition of the enamel;
(3) exposure and attrition of the dentine causing sensitivity; and
(4) poor oral hygiene, gingivitis, and caries.
While it is impossible to draw up a definitive treatment plan for all cases, it is possible
to define the principles of treatment planning for this group of patients. It is important
to realize that not all children with amelogenesis imperfecta or dentino- genesis
imperfecta are affected equally. Many will not have marked tooth wear or symptoms,
and will not require advanced intervention. 586HTable 10.9 describes the principles of
treatment in terms of the age of the child/adolescent and with regard to the three
aspects of care: prevention, restoration, and aesthetics.
Key Points