Regional odontodysplasia (ROD) is a relatively rare localized developmental anomaly of the dental tissues with specific clinical, radiographic, and histologic characteristics.
Crawford ascribed the first report of ROD to Hitchin in 1934, while others suggested that McCall and Wald were the first to describe this condition in 1947.
It was not until 1963, however, that Zegarelli et al coined the term “odontodysplasia” and Pindborg added the prefix “regional” in 1970.
In an extensive review of ROD in 1989, Crawford and Aldred stated females are more often affected than males (1.4:1) and that there was no association with race.
These authors listed several etiological factors such as local circulatory disorders, viral infections, pharmacotherapy during pregnancy, facial asymmetry, local trauma, metabolic disturbances, somatic and neural mutations, and syndromal involvement.
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They also suggested that a combination of factors might be involved. In spite of this, ROD’s etiology remains undetermined.
The criteria for ROD diagnosis are based on clinical, radiographic, and histologic findings. The maxilla is typically affected twice as often as the mandible.
Clinically, the condition is usually unilateral and rarely crosses the midline; exceptions are, however, occasionally found. In most cases in which the damage crosses the midline, only the central incisor on the opposite side is affected.
The teeth are likely to be small, brown, grooved, and hypoplastic. Eruption failure or delay is frequently seen as well as abscesses or fistulae in the absence of caries.
Radiographically, there is a lack of contrast between the enamel and dentin, both of which are less radiopaque than unaffected counterparts.
Moreover, enamel and dentin layers are thin, giving the teeth a “ghost like” appearance. The pulp chambers are large, and usually present areas of relatively radiodense tissue (pulp stones or denticles). The follicles of unerupted teeth are enlarged.
Abel Cahuana, PhD, MD, DDS Yndira González, DDS Camila Palma, DDS