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[Amelogenesis imperfecta. Description of a clinical case].

A family of five was examined. Four of them presented with enamel alteration including changes in colour and loss of enamel surface. A genetic study was undertaken which revealed an autosomal dominant inheritance with complete penetration and variable expressivity. This is reflected in shape, number, extension and depth of the affected areas. Amelogénesis Imperfecta type IV was diagnosed using Shields classification.

Adolescent↗

[Relevance of histopathologic diagnosis in amelogenesis imperfecta].

The aim of the study was the determination of the correlation between the morphostructural aspects of the enamel defects and the clinical diagnostic and the nosologic kinds of these diseases. The research was made on 600 children from Iassy between 7-11 years old, who were examined in natural light. The index used for the systematization of the data was EDS. We used 21 temporary teeth and we examined these teeth on an optic microscope. The study show that there is no absolute correlation between the morphostructural aspects of the enamel defects and the clinical aspects of the lesions, and the clinical defect may not be always associate to the dysplasia from the imperfect amelogenesis.

Amelogenesis Imperfecta↗

Kohlschütter-Tönz syndrome: epilepsy, dementia, and amelogenesis imperfecta.

Kohlschütter-Tönz syndrome is a central nervous system (CNS) degenerative disease with convulsions and mental regression in which the affected children present with yellow teeth due to defective enamel. We present a family in which 2 affected children (a boy and a girl) were born to consanguineous parents. This report confirms the autosomal recessive inheritance of the disorder. The combination of a CNS and an enamel defect may represent pleiotropy or a contiguous gene syndrome.

Abnormalities, Multiple↗

Amelogenesis imperfecta and nephrocalcinosis: a new case of this rare syndrome.

This article describes a new case of a rare syndrome including enamel agenesis of the primary and permanent dentition, delayed or absent eruption of the permanent dentition, coronal intra-alveolar resorption and gingival enlargement. Renal symptoms include medullary nephrocalcinosis without any apparent cause, and evolution to a renal failure. The early diagnosis provided by the oral symptoms leads to a better renal prognosis. As a consequence, pediatric dentists should be aware of this pathology.

Adolescent↗

The use of animal models to explore amelogenin variants in amelogenesis imperfecta.

Amelogenin proteins are secreted by ameloblast cells during tooth development. Because of extensive alternative splicing of the amelogenin primary RNA transcript, and because systematic proteolysis results in many additional peptides during enamel maturation, it has been difficult to assign function to individual amelogenins. Targeted deletions and transgenic mice have been generated in order to better understand amelogenin protein function in vivo. From these murine models, we have determined that amelogenins are responsible for normal enamel thickness and structure, but not for initiation of enamel mineral formation at the dentin-enamel junction. Although it is now clear that the amelogenin (AmelX) gene exists in a nested orientation and that AmelX is expressed at a low level in various developing tissues, the significance of these findings is incompletely understood. Future studies are expected to answer remaining questions concerning structure/function relationships among these 'enamel proteins'.

Amelogenesis Imperfecta↗

Enamelysin (matrix metalloproteinase 20)-deficient mice display an amelogenesis imperfecta phenotype.

Enamelysin is a tooth-specific matrix metalloproteinase that is expressed during the early through middle stages of enamel development. The enamel matrix proteins amelogenin, ameloblastin, and enamelin are also expressed during this same approximate developmental time period, suggesting that enamelysin may play a role in their hydrolysis. In support of this interpretation, recombinant enamelysin was previously demonstrated to cleave recombinant amelogenin at virtually all of the precise sites known to occur in vivo. Thus, enamelysin is likely an important amelogenin-processing enzyme. To characterize the in vivo biological role of enamelysin during tooth development, we generated an enamelysin-deficient mouse by gene targeting. Although mice heterozygous for the mutation have no apparent phenotype, the enamelysin null mouse has a severe and profound tooth phenotype. Specifically, the null mouse does not process amelogenin properly, possesses an altered enamel matrix and rod pattern, has hypoplastic enamel that delaminates from the dentin, and has a deteriorating enamel organ morphology as development progresses. Our findings demonstrate that enamelysin activity is essential for proper enamel development.

Amelogenesis Imperfecta↗

Human enamel phenotype associated with amelogenesis imperfecta and a kallikrein-4 (g.2142G>A) proteinase mutation.

Kallikrein-4 is known to be highly expressed during the maturation stage of enamel formation and is thought to be critical for the final phase of crystallite growth. The purpose of this study was to evaluate the enamel phenotype in humans with a known KLK-4 mutation (g.2142G>A). Primary teeth from two individuals with a known KLK-4 mutation were evaluated using amino acid analysis and light and electron microscopy. Light microscopy showed the enamel was of normal thickness but opaque throughout its width compared with normal enamel. Electron microscopy showed enamel affected by the KLK-4 mutation had a normal prismatic structure and generally had a well-organized and discernable crystallite composition. In some areas, globular structures were present where crystallites were not discernable or appeared to have an altered morphology. The KLK-4 mutant enamel had an increased protein content compared with normal enamel. Human enamel formed with a lack of functioning KLK-4 proteinase is altered primarily in the completeness of crystallite growth, while enamel thickness and prism structure remains essentially normal. Collectively, these studies suggest that the KLK-4 proteinase is essential for the final crystallite growth of enamel but is not critical for crystallite orientation, prism formation or enamel thickness.

Adenine↗

Molecular biology of hereditary enamel defects.

Amelogenesis imperfecta is a disfiguring inherited condition affecting tooth enamel. X-Linked and autosomal dominant and recessive inheritance patterns occur. X-Linked amelogenesis imperfecta has been studied extensively at the molecular level. Linkage analysis has shown that there is genetic hetetogeneity in X-linked amelogenesis imperfecta with two identified loci: AIH1 and AIH3. The AIH1 locus corresponds to the location of the amelogenin gene on the distal short arm of the X chromosome; various mutations in the amelogenin gene have been found in families with X-linked amelogenesis imperfecta. The AIH3 locus maps to the Xq24-q27.1 region on the long arm of the X chromosome. Linkage to the long arm of chromosome 4 has been established in three families with autosomal dominant amelogenesis imperfecta. There is as yet no published evidence for genetic heterogeneity in autosomal dominant amelogenesis imperfecta as in X-linked amelogenesis imperfecta. Candidate genes for autosomal dominant amelogenesis imperfecta include tuftelin (1q), albumin (4q) and ameloblastin (4q) but the involvement of these genes in the disease has yet to be demonstrated. In view of the variable clinical appearances within families with autosomal dominant amelogenesis imperfecta and X-linked amelogenesis imperfecta, together with the finding that different X-linked amelogenesis imperfecta phenotypes result from mutations within the same gene, an alternative classification based on the molecular defect and mode of inheritance rather than phenotype has been proposed.

Amelogenesis Imperfecta↗

Cloning, characterization and immunolocalization of human ameloblastin.

Amelogenesis imperfecta is a broad classification of hereditary enamel defects, exhibiting both genetic and clinical diversity. Most amelogenesis imperfecta cases are autosomal dominant disorders, yet only the local hypoplastic form has been mapped to human chromosome 4q between D4S242 1 and the albumin gene. An enamel protein cDNA, termed ameloblastin (also known as amelin and sheathlin), has been isolated from rat, mouse and pig. Its human homolog has been mapped to chromosome 4q21 between markers D4S409 and D4S400, flanking the local hypoplastic amelogenesis imperfecta critical region. Therefore, ameloblastin is a strong candidate gene for this form of amelogenesis imperfecta. To facilitate genetic studies related to this dental disease, we isolated and characterized a human ameloblastin cDNA. A human third molar cDNA library was screened and two ameloblastin clones identified. Nucleotide sequencing of these cDNAs indicated alternative splicing of the putative open reading frame, use of different polyadenylation signals, and a high degree of similarity to reported rat, mouse and porcine cDNAs. Immunohistochemistry studies on embryonic human teeth using an antibody to recombinant ameloblastin indicated ameloblastin expression by ameloblasts with localization in the enamel matrix associated with the sheath structures.

Alternative Splicing↗

Analysis of self-assembly and apatite binding properties of amelogenin proteins lacking the hydrophilic C-terminal.

Amelogenins, the major protein component of the mineralizing enamel extracellular matrix, are critical for normal enamel formation as documented in the linkage studies of a group of inherited disorders, with defective enamel formation, called Amelogenesis imperfecta. Recent cases of Amelogenesis imperfecta include mutations that resulted in truncated amelogenin protein lacking the hydrophilic C-terminal amino acids. Current advances in knowledge on amelogenin structure, nanospheres assembly and their effects on crystal growth have supported the hypothesis that amelogenin nanospheres provide the organized microstructure for the initiation and modulated growth of enamel apatite crystals. In order to evaluate the function of the conserved hydrophilic C-terminal telopeptide during enamel biomineralization, the present study was designed to analyze the self-assembly and apatite binding behavior of amelogenin proteins and their isoforms lacking the hydrophilic C-terminal. We applied dynamic light scattering to investigate the size distribution of amelogenin nanospheres formed by a series of native and recombinant proteins. In addition, the apatite binding properties of these amelogenins were examined using commercially available hydroxyapatite crystals. Amelogenins lacking the carboxy-terminal (native P161 and recombinant rM166) formed larger nanospheres than those formed by their full-length precursors: native P173 and recombinant rM179. These data suggest that after removal of the hydrophilic carboxy-terminal segment further association of the nanospheres takes place through hydrophobic interactions. The affinity of amelogenins lacking the carboxy-terminal regions to apatite crystals was significantly lower than their parent amelogenins. These structure-functional analyses suggest that the hydrophilic carboxy-terminal plays critical functional roles in mineralization of enamel and that the lack of this segment causes abnormal mineralization.

Amelogenin↗

Inherited enamel defects.

This paper describes the clinical, histological and genetic findings in individuals with amelogenesis imperfecta diagnosed in more than 50 families in the county of Västerbotten, northern Sweden. Using pedigree analysis, families with autosomal and X-linked inheritance as well as sporadic cases of amelogenesis imperfecta have been recognized. A clinical subclassification in eight different variants of amelogenesis imperfecta has been made. The gene defects have been identified for two of these variants and the chromosomal location has been established for a third variant.

Amelogenesis Imperfecta↗

[An enamel disorder in two siblings].

Two sisters exhibit a similar enamel disorder. It is a hereditary developmental disorder, diagnosed as amelogenesis imperfecta. In this article the various types of amelogenesis imperfecta are discussed and the clinical consequences, genetic aspects, and basic guidelines for treatment are addressed.

Amelogenesis Imperfecta↗