From Volume 45, Issue 10, November 2018 | Pages 961-972
Developmental defects of enamel (DDE) are not uncommon in both the primary and permanent dentition. This article presents a review of the current literature and describes the definition, prevalence, aetiology, diagnosis and management of primary molars affected by DDE.
CPD/Clinical Relevance: This article describes the diagnosis and management of DDE in practice to aid treatment planning in children with primary molars affected by DDE.
Historically, a collection of terms and definitions have been used to describe various developmental defects of the enamel (DDEs). DDEs are classified as demarcated opacities, diffuse opacities and hypoplasia.1 Clinicians have intermixed these terms in attempting to describe the clinical findings.
Hypoplasia is a quantitative defect of enamel caused by disturbances in the secretory phase of amelogenesis. During the secretory phase, enamel crystals grow in length creating the enamel thickness.2 Hypoplasia presents clinically as pitting, grooving or absence of enamel.
Hypomineralization, by contrast, is a qualitative defect of enamel and occurs due to disturbances in the maturation phase of amelogenesis. Enamel maturation is a slow developmental process, with two-thirds of the time needed for crown formation being used for this phase.3 During this phase, proteases remove the organic material as mineralization continues.4 Hypomineralization presents as enamel with a soft, chalky or cheesy appearance and can vary in colour from white to yellow or brown. A clear demarcation can usually be seen between the affected and non-affected enamel.5
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