PATHOHISTOLOGY OF UNDECALCIFIED PRIMARY TEETH IN VITAMIN-D-RESISTANT RICKETS - REVIEW AND REPORT OF 2 CASES

The basic dental defects in vitamin D-resistant rickets seem to be man ifested in dentin. Enamel is usually reported to be normal. This histo logic examination showed the penetration of microorganisms through the calcified structures of the enamel layer without visible caries. The microorganisms passed through the dentinoenamel junction and invaded d entin, which was characterized by calcospherites and large amounts of interglobular dentin. Furthermore, microorganisms could be detected in dentinal tubules, which were exposed to the oral cavity when enamel w as removed. However, large areas of tertiary dentin extended between s uch tubules and the pulp. These light microscopic results suggest that clinical manifestations, such as, pulp recrosis and periapical lesion s (without carious defects) may be caused by the penetration of microo rganisms through microclefts of the enamel layer as well as pathologic ally altered enamel microstructures of affected teeth.