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Hereditary dentin defects.
[dentin dysplasia]
By
the
Shields
classification
,
articulated
over
30
years
ago
,
inherited
dentin
defects
are
divided
into
5
types
:
3
types
of
dentinogenesis
imperfecta
(
DGI
)
,
and
2
types
of
dentin
dysplasia
(
DD
)
.
DGI
type
I
is
osteogenesis
imperfecta
(
OI
)
with
DGI
.
OI
with
DGI
is
caused
,
in
most
cases
,
by
mutations
in
the
2
genes
encoding
type
I
collagen
.
Many
genes
are
required
to
generate
the
enzymes
that
catalyze
collagen
's
diverse
post-translational
modifications
and
its
assembly
into
fibers
,
fibrils
,
bundles
,
and
networks
.
Rare
inherited
diseases
of
bone
are
caused
by
defects
in
these
genes
,
and
some
are
occasionally
found
to
include
DGI
as
a
feature
.
Appreciation
of
the
complicated
genetic
etiology
of
DGI
associated
with
bony
defects
splintered
the
DGI
type
I
description
into
a
multitude
of
more
precisely
defined
entities
,
all
with
their
own
designations
.
In
contrast
,
DD-
II
,
DGI
-
II
,
and
DGI
-
III
,
each
with
its
own
pattern
of
inherited
defects
limited
to
the
dentition
,
have
been
found
to
be
caused
by
various
defects
in
DSPP
(
dentin
sialophosphoprotein
)
,
a
gene
encoding
the
major
non-collagenous
proteins
of
dentin
.
Only
DD-
I
,
an
exceedingly
rare
condition
featuring
short
,
blunt
roots
with
obliterated
pulp
chambers
,
remains
untouched
by
the
revolution
in
genetics
,
and
its
etiology
is
still
a
mystery
.
A
major
surprise
in
the
characterization
of
genes
underlying
inherited
dentin
defects
is
the
apparent
lack
of
roles
played
by
the
genes
encoding
the
less-abundant
non-collagenous
proteins
in
dentin
,
such
as
dentin
matrix
protein
1
(
DMP
1
)
,
integrin-binding
sialoprotein
(
IBSP
)
,
matrix
extracellular
phosphoglycoprotein
(
MEPE
)
,
and
secreted
phosphoprotein-
1
,
or
osteopontin
(
SPP
1
,
OPN
)
.
This
review
discusses
the
development
of
the
dentin
extracellular
matrix
in
the
context
of
its
evolution
,
and
discusses
the
phenotypes
and
clinical
classifications
of
isolated
hereditary
defects
of
tooth
dentin
in
the
context
of
recent
genetic
data
respecting
their
genetic
etiologies
.
Diseases
Validation
Diseases presenting
"inherited diseases of bone are caused by defects in these genes"
symptom
dentin dysplasia
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