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GOODMORNIN
G
Dr Sanjana Ravindra
Post graduate Student
Oral Medicine and
Radiology
Amelogenesis Imperfecta, Hypoplastic Type
Associated with Some Dental Abnormalities:
A Case Report
Canger EM, Celenk P, Ye...
Introduction
DEVELOPMENTAL
DISTURBANCES
an abnormality where the
pathology starts in the
embryonic stage of human
life , b...
Introduction
DEVELOPMENTAL TOOTH
ANOMALIES
SIZE
• Microdontia
• Macrodontia
NUMBER
• Anodontia
• Supernumerary
teeth
• Pre...
encompasses a
complicated
group of conditions
that demonstrate
developmental
alterations in the
structure of the
enamel in...
Case report
Canger EM, Celenk P, Yenísey M, Odyakmaz SZ. Amelogenesis Imperfecta, Hypoplastic
Type, Associated with Some D...
Case reportBIODATA
A 26-year-old
female
CHIEFCOMPLAINT
discolored teeth
MEDICALHISTORY
noncontributory.
FAMILY
HISTORY
Non...
GINGIVA
Hyperemic and edematous gingiva.
No gingival enlargement
ORAL HYGIENE
Poor
Clinical crown length
Adequate
Case rep...
17 16 55 14 13 52 11 21 22 24 25 26
46 85 44 83 42 41 31 32 73 44 75 36
Clinically short
Yellow-brown
coloured
Loss of con...
Panoramic
view
Intraoral
periapical
radiographs
Periodontal therapy
Oral hygiene instructions, scaling, and root
planning.
Prosthodontic rehabilitation
Full-mouth metal r...
DISCUSSION
Introduction
 Tooth enamel consists mainly of inorganic material (96%) and oraganic
substance and water(4%)
 Physical pr...
SYNONYMS
Hereditary enamel dysplasia
 Hereditary brown enamel
Hereditary brown opalescent teeth
 “AI encompasses a complicated group of conditions that demonstrate
developmental alterations in structure of the enamel ...
Historical background
Spokes in 1890,
described "brown
teeth" with a familial
history.
In 1907 Turner described
some cases...
ETIOLOGY
 Dental enamel is a highly mineralised tissue
 Derived through the synthesis and secretion of proteins
 Format...
Development of normal enamel occurs in three stages
1. Formative stage – deposition of organic matrix – Hypoplastic AI
2. ...
Genes and phenotypes
Proteins/ enzymes
forming enamel
Type of AI Inheritance
1 Amelogenin Diffuse smooth
hypoplastic &
hyp...
Modes of Mendelian Inheritance Associated with AI
https://www.google.co.in/search?q+phenotype
CLASSIFICATION
Sekar B, Dominic Augustine, Murali S.
Amelogenesis Imperfecta - A Case Report with
Genetic Transmission. IJ...
Hypoplastic
Hypocalcified
By Weinnman et al (1945)
BASED ON CLINICAL, MICRORADIOGRAPHIC
AND HISTOPATHOLOGICAL FINDINGS BY
Darling (1956)
Hypoplastic
Group 1 – gen pitting
Gr...
By Witkop
(1957)
 Hypoplastic
 Hypocalcification
 Hypomaturation Pigmented
hypomaturation
 Local hypoplasia
By Schulze
(1970)
Type 1 hypoplastic Specific features , inheritance
1A Hypoplastic, pitted AD
1B Hypoplastic, local AD
1C...
Prevalence range from 1 in 718 to 1 in 14,000, depending on the
population studied.
 Hypoplastic AI represents 60 – 73% o...
Clinical features
Hypoplastic type
Gen.
pitted
Localized
pitted
Diffuse
smooth
Diffuse
rough
AD
Localized
pitted
Enamel
Agenesis
AR
Males
Fe...
Hypoplastic type – autosomal dominant
GENERALIZED
PITTED
• Thin enamel
• Open contact
• Pinpoint to pinhead
pits
• Newly e...
Localized
pitted
Severe form of AD
Enamel
agenesis
Yellow colour like normal
dentition
Surface is rough & granular-
ground...
Males
– Thin, hard, glossy
– Like crown preparations, open bite
– Opaque white to brown
Females
– Alternating vertical b...
Hypoplastic amelogenesis
imperfecta, gen pitted pattern .
Note the numerous pinpoint pits
scattered across the surface of
...
Autosomal dominant
Autosomal recessive
Hypocalcific type
Thickness of enamel
Normal- hypoplasia( middle 3rd of labial surface)
Consistency of enamel
Soft – lost after eruption- sc...
Dentition exhibiting diffuse
yellow-brown discoloration .
Note numerous teeth with loss
of coronal enamel except for
the c...
Autosomal dominant X linked recessiveAutosomal recessive
Hypomaturative type
Commonly in males
Both in primary and permanent dentition
Primary teeth: ground glass opaque white
appearance
Permanent te...
Both in primary and
permanent dentition
Enamel has milky to
shiny, agar brown
deeply stained on
contact with
exogenous age...
 Snow capped
 Zone of white opaque enamel on incisal
and
occlusal surface (1/4 to 1/3 of the surface)
 Looks like fluor...
 Predominant defect – enamel hypomaturation
 Enamel appears – mottled yellow-white to yellow brown
 Pits are seen frequ...
Predominant defect – enamel hypoplasia in which enamel is thin
but also hypomature
Radiographically-
Similar to hypomatura...
Radiographic features
Squarish type of crown
being devoid of the normal
mesial and distal contours
Normal enamel cap is
mi...
TYPE CLINICAL
APPEARANCE
ENAMEL
THICKNESS
HYPOPLASTIC
(TYPE I)
Crowns size : small to
normal, lack proxmal
contacts, color...
Histopathological examination
 Very thin enamel, voids within enamel & composed of laminations of
irregularly arranged en...
Syndromes associated
 Amelogenesi
s imperfect
with
taurodontism
 Trichodentoo
sseous
syndrome
Tricho-dento-osseous syndr...
Cone rod dystrophy
Kohlschutter-Tonz syndrome
Usher syndrome
Other syndromes
Non enamel anomalies seen
in Amelogenesis Imperfecta
 Delayed tooth eruption
 Congenitally missing
teeth
 Anterior open...
Diagnosis
Clinical diagnosis
Cheesy consistency of
enamel with loss of
enamel
Radiographic diagnosis
Missing enamel cap wi...
Differential diagnosis
Dental fluorosis Dentinogenesis imperfecta
Management
Cosmetic
improvement Desensitizing
agent
Prosthetic
rehabilitation
https://www.google.co.in/search?q=amelogenes...
Reason for choosing this article
Developmental disorder presents with severe dental anomalies. Its
important to diagnose t...
Reference
1. www.merriam-webster.com
2. Neville BW, Douglass DD, Allen CM, Bouquot JE. Abnormalities of teeth. In: Oral and Maxillof...
13. Santos MCLG, Line SRP. The genetics of amelogenesis imperfecta: a review of the literature. J Appl Oral
Sci 2005;13:21...
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case report on amelogenesis imperfecta

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Amelogenesis imperfecta, hypoplastic type - Dr Sanjana Ravindra

  1. 1. GOODMORNIN G Dr Sanjana Ravindra Post graduate Student Oral Medicine and Radiology
  2. 2. Amelogenesis Imperfecta, Hypoplastic Type Associated with Some Dental Abnormalities: A Case Report Canger EM, Celenk P, Yenísey M, Odyakmaz SZ. Braz Dent J (2010) 21(2): 170-174. JOURNAL CLUB: 3
  3. 3. Introduction DEVELOPMENTAL DISTURBANCES an abnormality where the pathology starts in the embryonic stage of human life , before the formation of the dentition Orban’s Oral Histology and Embryology, 12th editio
  4. 4. Introduction DEVELOPMENTAL TOOTH ANOMALIES SIZE • Microdontia • Macrodontia NUMBER • Anodontia • Supernumerary teeth • Pre-deciduous dentition STRUCTURE • AMELOGENESIS IMPERFECTA • Dentinogenesis imperfecta • Dentin dysplasia • Regional odontodysplasia • Dentin hypocalcification SHAPE • Gemination • Twinning • Fusion • Concrescence • Talon cusp • Dilaceration • Dens in dente • Dens evaginatus • Enamel pearl • Globodontia • Mulberry molar • Moon’s molar • Hutchinson incisor • Carabelli cusp • Shovel shaped incisor
  5. 5. encompasses a complicated group of conditions that demonstrate developmental alterations in the structure of the enamel in the absence of a systemic disorder. AMELOGENESIS IMPERFECTA AMELOGENES IS ?IMPERFECT A  Hereditary enamel dysplasia  Hereditary brown enamel  Hereditary brown opalescent teeth Shafer’s textbook of Oral Pathology. 6th ed. Elsevier; 2009 www.merriam-webster.comIntroduction
  6. 6. Case report Canger EM, Celenk P, Yenísey M, Odyakmaz SZ. Amelogenesis Imperfecta, Hypoplastic Type, Associated with Some Dental Abnormalities: A Case Report: Braz Dent J (2010) 21(2): 170-174.
  7. 7. Case reportBIODATA A 26-year-old female CHIEFCOMPLAINT discolored teeth MEDICALHISTORY noncontributory. FAMILY HISTORY None had similar problem
  8. 8. GINGIVA Hyperemic and edematous gingiva. No gingival enlargement ORAL HYGIENE Poor Clinical crown length Adequate Case report
  9. 9. 17 16 55 14 13 52 11 21 22 24 25 26 46 85 44 83 42 41 31 32 73 44 75 36 Clinically short Yellow-brown coloured Loss of contact • CROWNS Decreased – vertical dimension Case report
  10. 10. Panoramic view Intraoral periapical radiographs
  11. 11. Periodontal therapy Oral hygiene instructions, scaling, and root planning. Prosthodontic rehabilitation Full-mouth metal reinforced porcelain fixed bridge restoration Advised and motivated for maintenance of proper oral hygiene & Repeated follow ups 2 WEEKS - NORMAL GINGIVA VERTICAL DIMENSION NORMAL ESTHETIC OR FUNCTIONAL PROBLEMS Case report
  12. 12. DISCUSSION
  13. 13. Introduction  Tooth enamel consists mainly of inorganic material (96%) and oraganic substance and water(4%)  Physical properties and physiological function of enamel – directly related to composition, orientation, disposition and morphology of mineral components within tissue  During organogenesis, enamel transitions from soft to pliable tissue to its final form- is devoid of protein  Final composition is reflection of unique molecular and cellular activities that take place during its genesis  Deviation from this pattern lead – AMELOGENESIS IMPERFECTA
  14. 14. SYNONYMS Hereditary enamel dysplasia  Hereditary brown enamel Hereditary brown opalescent teeth
  15. 15.  “AI encompasses a complicated group of conditions that demonstrate developmental alterations in structure of the enamel in the absence of a systemic disorder”  “AI represents a group of conditions, genomic in origin, which affect the structure and clinical appearance of the enamel of all or nearly all the teeth in a more or less equal manner, and which may be associated with morphologic or biochemical changes elsewhere in the body” Orphanet Journal of Rare Diseases 2007, 2:17 Definition
  16. 16. Historical background Spokes in 1890, described "brown teeth" with a familial history. In 1907 Turner described some cases of hereditary hypoplasia of teeth in five generations of same family Weinmann & associates in 1945 – introduced term “AMELOGENESIS IMPERFECTA” – it is an ectodermal disturbance, mesodermal components are normal
  17. 17. ETIOLOGY  Dental enamel is a highly mineralised tissue  Derived through the synthesis and secretion of proteins  Formation of this highly organised and unusual structure is controlled in ameloblasts through interaction of a number of organic matrix molecules
  18. 18. Development of normal enamel occurs in three stages 1. Formative stage – deposition of organic matrix – Hypoplastic AI 2. Calcification stage – matrix is mineralized –Hypocalcified AI 3. Maturation stage – crystallites enlarge and mature – Hypomaturative AI ETIOLOGY
  19. 19. Genes and phenotypes Proteins/ enzymes forming enamel Type of AI Inheritance 1 Amelogenin Diffuse smooth hypoplastic & hypomaturation X linked 2 Ameloblastin Hypocalcified AD 3 Enamelin Hypoplastic AD, AR 4 Tuftelin hypoplastic AD,AR 5 Kallikrein Hypomaturation AR 6 Matrix metalloproteinase Pigmented hypomaturation AR
  20. 20. Modes of Mendelian Inheritance Associated with AI https://www.google.co.in/search?q+phenotype
  21. 21. CLASSIFICATION Sekar B, Dominic Augustine, Murali S. Amelogenesis Imperfecta - A Case Report with Genetic Transmission. IJDA, 2(4), October- December, 2010 395.
  22. 22. Hypoplastic Hypocalcified By Weinnman et al (1945)
  23. 23. BASED ON CLINICAL, MICRORADIOGRAPHIC AND HISTOPATHOLOGICAL FINDINGS BY Darling (1956) Hypoplastic Group 1 – gen pitting Group 2- vertical grooves Group 3- gen hypoplasia Hypocalcified Type 4A- chalky, yellow, brown enamel Type 4B- marked enamel discolouration 7 softness with post eruptive loss of enamel Type 5- gen/ localized discolouration and chipping of enamel
  24. 24. By Witkop (1957)  Hypoplastic  Hypocalcification  Hypomaturation Pigmented hypomaturation  Local hypoplasia
  25. 25. By Schulze (1970) Type 1 hypoplastic Specific features , inheritance 1A Hypoplastic, pitted AD 1B Hypoplastic, local AD 1C Hypoplastic, local AR 1D Hypoplastic, smooth AD 1E Hypoplastic, smooth x-linked D 1F Hypoplastic, rough AD Typw 2 hypomaturation 2A hypomaturation 2B hypomaturation 2C Snow capped teeth, x linked 2D AD Type 3 hypocalcification 3A AD 3B AR Type 4 Hypomaturation- hypoplastic with taurodontismType 4A Hypomaturation- hypoplastic with taurodontism AD Type 4B Hypoplastic- hypomaturation with taurodontism AD Neville BW, Douglass DD, Allen CM, Bouquot JE. Abnormalities of teeth. In: Oral and Maxillofacial Pathology. 2nd ed.. Pennsylvania:Elsevier;200
  26. 26. Prevalence range from 1 in 718 to 1 in 14,000, depending on the population studied.  Hypoplastic AI represents 60 – 73% of all cases,  Hypomaturation AI represents 20 – 40%, and  Hypocalcification AI represents 7% Prevalence
  27. 27. Clinical features
  28. 28. Hypoplastic type Gen. pitted Localized pitted Diffuse smooth Diffuse rough AD Localized pitted Enamel Agenesis AR Males Females X- linked
  29. 29. Hypoplastic type – autosomal dominant GENERALIZED PITTED • Thin enamel • Open contact • Pinpoint to pinhead pits • Newly erupted teeth: hard with normal yellow-white colour • Staining of teeth- exposure to oral environment- black appearance LOCALIZED PITTED • Linear depression/ large area of hypoplasia • Prominent on buccal surface DIFFUSE SMOOTH • Thin, glossy with smooth surface • ¼ to 1/8 of normal thickness • Yellow color – opaque to translucent brown • Delayed eruption with alveolar resorption DIFFUSE ROUGH Hard with rough granular surface White to yellowish white Thicker enamel at cervical areas https://www.google.co.in/search?q=amelogenesis+hypoplas
  30. 30. Localized pitted Severe form of AD Enamel agenesis Yellow colour like normal dentition Surface is rough & granular- ground glass Complete lack of enamel formation Multiple missing teeth https://www.google.co.in/search?q=amelogenesis+hypoplastic Hypoplastic type – autosomal recessive
  31. 31. Males – Thin, hard, glossy – Like crown preparations, open bite – Opaque white to brown Females – Alternating vertical bands of normal and abnormal enamel https://www.google.co.in/search?q=amelogenesis+hypoplastic Hypoplastic type – x-linked dominant
  32. 32. Hypoplastic amelogenesis imperfecta, gen pitted pattern . Note the numerous pinpoint pits scattered across the surface of the teeth. The enamel between the pits is of normal thickness. hardness. and coloration. Hypoplastic amelogenesis imperfecta, autosomal dominant smooth pattern. Small. yellowish teeth exhibiting hard, glossy enamel with open contact Points and anterior open bite. Neville BW, Douglass DD, Allen CM, Bouquot JE. Abnormalities of teeth. In: Oral and Maxillofacial Pathology. 2nd ed.. Pennsylvania:Elsevier;2004. 89
  33. 33. Autosomal dominant Autosomal recessive Hypocalcific type
  34. 34. Thickness of enamel Normal- hypoplasia( middle 3rd of labial surface) Consistency of enamel Soft – lost after eruption- scrapped with instrument Colour of enamel Newly erupted teeth- dull lustreless opaque, white, honey coloured or yellowish orange or brown Significance : Exposed dentin- hypersensitive anterior opn bite Rapid calculus formation Hypocalcified type – aD & AR Neville BW, Douglass DD, Allen CM, Bouquot JE. Abnormalities of teeth. In: Oral and Maxillofacial Pathology. 2nd ed.. Pennsylvania:Elsevier;2004. 89
  35. 35. Dentition exhibiting diffuse yellow-brown discoloration . Note numerous teeth with loss of coronal enamel except for the cervical portion. Hypocalcified type – aD & AR Extensive loss of coronal enamel and the similar density of enamel and dentin. Neville BW, Douglass DD, Allen CM, Bouquot JE. Abnormalities of teeth. In: Oral and Maxillofacial Pathology. 2nd ed.. Pennsylvania:Elsevier;2004. 89
  36. 36. Autosomal dominant X linked recessiveAutosomal recessive Hypomaturative type
  37. 37. Commonly in males Both in primary and permanent dentition Primary teeth: ground glass opaque white appearance Permanent teeth :mottled yellow white, may be darkened with absorption of stains Tight contact point Enamel approaches normal thickness. Point of explorer can be forced into enamel Hypomaturative type – autosomal dominant
  38. 38. Both in primary and permanent dentition Enamel has milky to shiny, agar brown deeply stained on contact with exogenous agents Normal thickness. Chips away around restoration Forms large amount of calculus which may contain pigment forming agents Teeth may resorb within alveolus https://www.google.co.in/search?q=amelogenesis+hypomaturativ Hypomaturative type – autosomal recessive
  39. 39.  Snow capped  Zone of white opaque enamel on incisal and occlusal surface (1/4 to 1/3 of the surface)  Looks like fluorosis  Anteriors, premolars/molars  Both dentitions https://www.google.co.in/search?q=snow+capped Hypomaturative type – x linked recessive
  40. 40.  Predominant defect – enamel hypomaturation  Enamel appears – mottled yellow-white to yellow brown  Pits are seen frequently on buccal surface of teeth Radiographically – enamel appears similar to dentin  Large pulp chambers may be seen in single rooted teeth in addition to varying degrees of taurodontism Hypomaturation- hypoplastic with taurodontism – Autosomal dominant https://www.google.co.in/search?q=amelogenesis+hypomatu+tauro
  41. 41. Predominant defect – enamel hypoplasia in which enamel is thin but also hypomature Radiographically- Similar to hypomaturation-hypoplastic variant, except decrease in thickness of enamel https://www.google.co.in/search?q=amelogenesis+hypomatu+tauro Hypoplastic - hypomaturation with taurodontism – Autosomal dominant
  42. 42. Radiographic features Squarish type of crown being devoid of the normal mesial and distal contours Normal enamel cap is missing and in its place a thin and opaque layer of enamel Low or absent cusps, with serrations of varying sharpness Lack of contrast between enamel and dentin Obliteration of pulp chamber Loss of contour Enamel Pulp chamber https://www.google.co.in/search?q=amelogenesis+tauro
  43. 43. TYPE CLINICAL APPEARANCE ENAMEL THICKNESS HYPOPLASTIC (TYPE I) Crowns size : small to normal, lack proxmal contacts, color varies from normal to opaque white – yellow brown Varies from thin and smooth to normal thickness with grooves, furrows and/or pits HYPOMATURATIO N (TYPE II) Varies from creamy opaque to marked yellow/brown, surface of teeth soft and rough, dental sensitivity and open bite common Normal thickness with enamel that often chips and abrades easily around restoration HYPOCALCIFIE D (TYPE III) Opaque white to yellow-brown, soft rough enamel surface, dental sensitivity and open bite common, heavy calculus formation common Normal thickness with enamel that often chips and abrades easily HYPOMATURATIO N/ HYPOPLASIA/ TAURODONTISM (TYPE IV) White/Yellow- Brown mottled, teeth can appear small and lack proximal contact Reduced, hypomineralized areas and pits RADIOGRAPHIC APPEARANCE INHERITANCE Enamel has normal to slightly reduced contrast/ thin Autosomal dominant, recessive, or X- linked Enamel has contrast similar to or > than dentin, unerupted crowns have normal morphology Autosomal dominant, recessive, or X- linked Enamel has contrast similar to or < dentin, unerupted crowns have normal morphology Autosomal dominant, recessive Enamel contrast normal to slightly > dentin, large pulp chambers Autosomal dominant Neville BW, Douglass DD, Allen CM, Bouquot JE. Abnormalities of teeth. In: Oral and Maxillofacial Pathology. 2nd ed.. Pennsylvania:Elsevier;2004. 89
  44. 44. Histopathological examination  Very thin enamel, voids within enamel & composed of laminations of irregularly arranged enamel prisms  Enamel-dentin junction, show some exaggerated scalloping.  Areas of homogeneous aprismatic enamel or fused indistinct prisms, with “a reduction in distance between enamel rod incremental lines” https://www.google.co.in/search?q=amelogenesis+slides
  45. 45. Syndromes associated  Amelogenesi s imperfect with taurodontism  Trichodentoo sseous syndrome Tricho-dento-osseous syndrome. Dentition exhibiting diffuse enamel hypop lasia and hypomaturat ion. At birth, the patient exhibit kinky "steel wool" hair texture with time, the hair gets straightened. Taurodontism of the first molar and the enamel. which is thin and similar in density to the dentin. Neville BW, Douglass DD, Allen CM, Bouquot JE. Abnormalities of teeth. In: Oral and Maxillofacial Pathology. 2nd ed.. Pennsylvania:Elsevier;2004. 89
  46. 46. Cone rod dystrophy Kohlschutter-Tonz syndrome Usher syndrome Other syndromes
  47. 47. Non enamel anomalies seen in Amelogenesis Imperfecta  Delayed tooth eruption  Congenitally missing teeth  Anterior open bite  Taurodontism  Pulpal calcification  Root and crown resorption  Hypercementosis  Root malformations  Malocclusion  Gingivitis
  48. 48. Diagnosis Clinical diagnosis Cheesy consistency of enamel with loss of enamel Radiographic diagnosis Missing enamel cap with low or absent cusp
  49. 49. Differential diagnosis Dental fluorosis Dentinogenesis imperfecta
  50. 50. Management Cosmetic improvement Desensitizing agent Prosthetic rehabilitation https://www.google.co.in/search?q=amelogenesis+treat+crowns
  51. 51. Reason for choosing this article Developmental disorder presents with severe dental anomalies. Its important to diagnose the condition as early as possible to balance the decision for early intervention and long-term survival of the restorations. Also consider the social implications for these patients and intervene to relieve their suffering. Thus, this article is an attempt to improve the clinician’s knowledge about the clinical & radiographic diagnosis as well as intervention required for such a condition.
  52. 52. Reference
  53. 53. 1. www.merriam-webster.com 2. Neville BW, Douglass DD, Allen CM, Bouquot JE. Abnormalities of teeth. In: Oral and Maxillofacial Pathology. 2nd ed.. Pennsylvania:Elsevier;2004. 89-94. 3. Regezi J, Sciubba JJ. Oral Pathology- Clinical Pathologic Correlations. 3rd ed. WB Saunders Company; 1999. 4. Rajendran R, Sivapathasundaram. Shafer’s textbook of Oral Pathology. 6th ed. India: Elsevier; 2009. 5. Kumar GS. Orban’s Oral histology and embryology. 12th ed. Elsevier; 2009. 6. White SC, Pharaoh MJ editors. Normal Radiographic Anatomy. In: Oral Radiology- Principles and Interpretation 5th edition. St.Louis (US): Mosby/Elsevier; 2004. 7. Bailleul-Forestier I, Molla M, Verloes A, Berdal A. The genetic basis of inherited anomalies of the teeth. Part 1: clinical and molecular aspects of non-syndromic dental disorders. Eur J Med Genet 2008;51:273-291. 8. Mehta DN, Shah J, Thakkar B. Amelogenesis imperfecta: Four case reports. J Nat Sc Biol Med 2013;4:462- 5. 9. Seow WK. Dental development in amelogenesis imperfecta: a controlled study. Pediatr Dent 1995;17:26-30. 10. Gökçe K, Canpolat C, Özel E. Restoring function and esthetics in a patient with amelogenesis imperfecta: a case report. J Contemp Dent Pract 2007;8:90-101. 11. Siadat H, Alikashi M, Mirfazaelian A. Rehabilitation of a patient with amelogenesis imperfect using all- ceramic crowns: a clinical report. J Prosthet Dent 2007;98:85-88. 12. Toksavul S, Ulusoy M, Türkün M, Kümbüloğlu Ö. Amelogenesis imperfecta: the multidisciplinary approach: a case report. Quintessence Int 2004;35:11-14.
  54. 54. 13. Santos MCLG, Line SRP. The genetics of amelogenesis imperfecta: a review of the literature. J Appl Oral Sci 2005;13:212-217. 14. Begum N, Bhandarkar GP, Kini R, Naik V, Rashmi K, D Souza LC. Amelogenesis Imperfecta: A Series of Case Report.Int J Adv Health Sci 2015;2(1):17-21. 15. Crawford PJM, Aldred M, Bloch-Zupan A. Amelogenesis imperfecta. Orphanet J Rare Dis 2007;2:17-27. 16. Poulsen S, Gjqrup H, Haubek D, Haukali G, Hintze H, Lqvschall H, et al.. Amelogenesis imperfecta - a systematic literature review of associated dental and oro-facial abnormalities and their impact on patients. Acta Odontol Scand 2008;66:193-199. 17. Nigam P, Singh VP, Prasad KD, Tak J. Amelogenesis Imperfecta: A Case Report and Review of Literature. Int J Sci Stud 2015;2(10):146-149. 18. Jan C.-C. Hu Yong-Hee P, Hazzazzi AC, Simmer JP. Enamel Formation and Amelogenesis Imperfecta. Cells Tissues Organs 2007;186:78–85. 19. Sunil RP, Agarwal A. Hypoplastic amelogenesis imperfecta. Journal of Dental Sciences & Oral Rehabilitation. 2008. 20. Chhaparwal Y, Jhawar A, Lele A, Rathi S. Case Report on hypoplastic amelogenesis imperfecta with multiple impacted teeth. Journal of Dental and Medical Sciences. 2279-0861.Volume 13, Issue 5 Ver. V. (May. 2014), PP 79-82. 21. Chengappa, Murali.R, Sivagami.N. Rehabilitation of Mutilated Natural Dentition associated with Amelogenesis Imperfecta – A Case Report. INT J OF DENTAL CLINICS 2010:2(4): 77-79. 22. Sekar B, Dominic Augustine, Murali S. Amelogenesis Imperfecta - A Case Report with Genetic Transmission. IJDA, 2(4), October-December, 2010 395.

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