 Hello everyone, welcome back to a new session on dentistry and more. Today's topic is dentinogenesis imperfecta As we have seen amylogenesis imperfecta just like the same way it was interpreted We need to interpret dentinogenesis imperfecta the imperfect formation of dentin or the problem with Ordinal blast. So, let's see the details of dentinogenesis imperfecta Dentinogenesis is a formation of dentin which starts even before amylogenesis So the first tooth element is forming is dentin only after that enamel forms So dentinogenesis is the first process happening while tooth formation and it was Ordinal blast which creates dentin so basically two phases of dentinogenesis is there the first one is Organic collagen matrix formation later there will be deposition of hydroxy appetite crystals So the collagen matrix will be laid out first after that there will be Nenalyzation or hydroxy appetite crystals will be deposited. So it is an autosomal dominant condition That is dentinogenesis imperfecta and it affects both deciduous and permanent teeth So now we'll move on to the classification So the most common classification is shields classification. Then we have a revised classification and with cop classification So the shields classification is most commonly accepted and commonly used one He classified dentinogenesis imperfecta into three types type one two and three Type one is dentinogenesis imperfecta with osteogenesis imperfecta Type two is Dentinogenesis imperfecta without osteogenesis imperfecta. I just made it as oh I And type three is a Brandy wine type which is a rare form with multiple pulp exposure and periapical lesions in deciduous teeth and Why it got this brandy wine name? It is because Brandy wine is a place in Maryland, USA So that place has reported these type of Dentinogenesis imperfecta for the first time and there were many cases reported in that area So that particular dentinogenesis imperfecta with multiple Pulp exposure and periapical lesions in deciduous teeth named after the particular place So brandy wine is a place in Maryland, USA. That is a type three classification in shield in revised classification dentinogenesis imperfecta one is type two of shield classification and In revised classification dentinogenesis imperfecta two is type three shield classification And in revised classification, there is no substitute for type one shield classification. So don't get confused So we have only two types in revised classification. That is dentinogenesis imperfecta one and two which corresponds with Shields classification type two and type three Now, let's see. What is dentinogenesis imperfecta one? Which is Shield type two or a palestin dendin are also known as cap tipon teeth In etiology, it is a mutation which causing this dentinogenesis imperfecta one That is dspp gene the gene which is for dentin silo force for protein So the mutation in that gene causing dentinogenesis imperfecta one dentinogenesis imperfecta one is type two shield classification it is without osteogenesis imperfecta So it can be distinct from osteogenesis imperfecta with palestin teeth and affects only the teeth not bones So there will be no increased bone fracture So when you get this type one never get confused with shield type one, this is actually shield type two This is a revised classification And incidences one needs to 6000 or 8000 While moving on to the type two that is dentinogenesis imperfecta two Which is shield type three or brandy wine type So it is the mutation is not same as type two that is dspp it is different from This dentinogen imperfecta one But the difference is there will be enlarged pulp chamber and pulp exposure which is not present in This type one of dentinogenesis imperfecta in clinical features The gender prediction is almost same males and females are equally affected There will be blue gray or amber brown and opalescent tooth Few days after eruption teeth may achieve a normal color following which they become translucent And finally become gray or brown with bluish reflection from enamel The enamel may easily split readily from dentin when subjected to occlusion stress So the first part is saying about the color change. Normally it is when it erupts it is having normal color later. It's Getting changed to the blueish or palescent one and the second part about the Occlusion stress and it easily chips off that enamel And there will be severe attrition and obliterated pulp chamber Teeth are not very sensitive and dentin is basically soft and easily penetrable but Cary's incidences is very less because of the structural change in dentin even though it has Very soft dentin and it is easily penetrable. Cary's is not very much present in dentinogenesis imperfecta two So that is shield type two and shield type three In radiographic features There will be bulb shaped or bell shaped crown with constriction at the cervical areas. So the cervical areas will be constricted So it will be a bulb shaped or a bell shaped So, you know how a bulb or bell looks like at the top or end Or the bottom end if it is keeping in upright or In the opposite direction The tip will be constricted. So like why is the cervical areas will be constricted? And there will be thin and spiked roots Obliteration of coronal and radical pulp chamber is a unique feature of dentinogenesis imperfecta But the cementum alveolar bone and periodontal ligament are perfectly normal So the type two that is shield type three Brandy wine type which has large pulp chamber with Very thin enamel and dentin will give a peculiar appearance which is known as shell teeth So it is Shield type three and revised classification type two So that is shell teeth which is commonly asked question shell teeth Which is a radiographic feature with large pulp chamber with thin shell of dentin and enamel In histopathology, the enamel is normal The mantle dentin that is a narrow zone of dentin below enamel also normal The remaining dentin will be severely dysplastic with vast area of amorphous matrix with globular or inter globular foci of mineralization And there will be reduced number of dentinal tubules And the tubules are distorted irregular in shape widely spaced and larger in size And there will be absence of odendoblastic processes And degenerating cellular debris and there will be large areas of tubular dentin DJ will be smooth and flatten instead of scalloped nature So which is actually responsible for early chipping of enamel if it is scalloped there will be a Interlocking between enamel and dentin since it is very smooth or flattened the enamel will be easily chipped off and in chemical or Physical features there will be increased water content around 60 percentage more water content than normal And there will be decreased mineral content and micro hardness is near to cementum So while moving on to the treatment part The main goal is to prevent the loss of enamel and dentin through attrition So in mild to moderate cases we can go for veneering bleaching restorative procedures like composites and amalgam amalgam in posterior and composites in anterior teeth In severe case cases it mostly we should do processes that is crown placement and always we should keep a Importance in maintaining the vertical dimension because the vertical dimension will be lost because of the attrition So that's all about dentinogenesis imperfecta the takeaway points are retina type So this is type one and this is type two that is revised classification and shell teeth is a radiographic appearance of type two that is Mostly you get confused between these two. This is shield classification and revised classification So this is what we follow revised classification, but we corresponded with our shield classification So this type one is type two of shield and this type two is type three of shield So that's all about dentinogenesis imperfecta. It is a developmental anomaly involving the dentin or the amul that odendoblast So we had seen amulogenesis imperfecta, which is amuloblast and enamel formation Related problem and dentinogenesis is something related to odendoblast and dentin formation So I'll come up with a new topic in dentistry and more. Thank you