[Histophysiopathological aspects of the life cycle of the tooth. Clinical considerations].
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A case of malformation of five permanent teeth in the right maxilla is described. The asymmetrical malformations were probably caused by an early local trauma of the right maxilla. This trauma led to defective mineralization of the deciduous tooth germs, which was verified roentgenologically. The resulting early osteitic process caused injury to the permanent germs at a sensitive mineralization period. Mineralization disturbances of 13, 14, 15, 16 and 17 were established roentgenologically. In the other halves of the jaws the development was entirely normal. Endocrinological examination showed normal values and there were no signs of hypothyreosis or Turner's syndrome. Acute symptoms in the right maxilla at the age of 9 necessitated extraction of germs 14 and 16. As subsequent roentgenograms showed that 13 and 15 were not developing normally in respect of mineralization, these were extracted at, respectively, 12 and 13 years of age. For the same reason 17 was extracted two years later. The histopathological examination showed in all involved teeth a pronounced malformation with disturbances both of the morpho- and histodifferentiation of the various dental tissues.
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In human premolars with posteruptive ages varying from 6 months to 4 years demineralized enamel was remineralized for 3 days at 37 degrees C in a recalcifying medium containing 2 mM Ca2+, 1.2 mM phosphate, 0.05 mMF- and 150 mM NaCl (pH = 7). The Ca, P and Ca/P molar ratio of the mineral gained were determined at various distances from the enamel surface. Whereas, particularly at 30 micrometers from the surface remineralization was higher and more extensive in young demineralized enamel, no difference could be found in Ca/P molar ratio, suggesting precipitation of an apatitic mineral in both young and old demineralized human enamel. The probable nature of the precipitate is that of a fluoridated hydroxyapatite.
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