Regional Odontodysplasia in Primary Teeth: A Case Report

Abstract

Regional odontodysplasia (RO) is a rare dental anomaly that affects the development of dental tissues, resulting in amorphous, hypocalcified, hypoplastic teeth with the characteristic radiographic appearance of "ghost teeth." This study aims to report the clinical case of a patient diagnosed with RO in primary teeth. A two-year-old boy was brought to a private clinic with complaints of delayed eruption and anomalies in the upper right primary teeth. Intraoral examination revealed significant changes in the shape, color, and structure of all upper right primary teeth, including enamel hypoplasia, conoid and flattened teeth, yellowish/brownish coloration, and associated gingival inflammation. Radiographic examination revealed a thin layer of enamel and dentin, with no contrast between them, a pattern characteristic of "ghost teeth." A conservative approach was adopted, including prophylaxis, application of fluoride varnish, guidance, and regular clinical and radiographic follow-up, aiming to maintain the health of the affected tissues and monitor the development of the permanent dentition. This case highlights the importance of early recognition of RO, which enabled an individualized treatment plan focused on preserving the affected teeth and promoting oral health.

Keywords: child oral health; conservative treatment; deciduous dentition; developmental disorders; odontodysplasia; pediatric dentistry; tooth abnormalities.

Figure 1. Intraoral view showing the dental arches. (A) Frontal view highlighting tooth 51 with a reduced crown, yellow-brown enamel, irregular surface, and associated gingival inflammation; tooth 52 with a short crown, yellow enamel with hypoplasia, and an ulcerated lesion on the adjacent gingiva; tooth 53 partially erupted with an irregular, shortened, flattened, and conoid crown, enamel hypoplasia, and yellow-brown discoloration; teeth 54 and 55 partially erupted, with undefined contours, amorphous appearance, opaque enamel, and enamel absence in some areas. (B) Occlusal view of the maxillary arch showing structural alterations in the right-sided teeth, with enamel hypoplasia, irregular crown contours, and yellow to brown discoloration. The left-sided teeth have preserved shape, contour, and color, with an eruption pattern consistent with the patient’s age. The clinical features are compatible with a diagnosis of regional odontodysplasia

Figure 2. Panoramic radiograph showing the involvement of the upper right primary teeth, with reduced radiopacity, poorly defined crown contours, enlarged pulp chambers, and short or absent roots, consistent with the “ghost tooth” pattern. The germs of the upper right permanent teeth are either absent or show underdevelopment. In contrast, the upper left and lower primary teeth exhibit root and crown development appropriate for the patient’s age