Enamel hypoplasia of primary teeth in chronic renal failure

Chronic renal failure (CRF) in the first years of life is associated with d evelopmental defects of enamel in the permanent dentition. We investigated if CRF also affects the primary (deciduous) dentition. Thirty-one children with CRF on conservative treatment (n=12) or on renal replacement therapy ( n=19) underwent dental inspection. In addition. 18 CRF children provided an exfoliated deciduous tooth for microscopic examination. Enamel defects wer e detected in a total of 12 children (31%), either clinically or microscopi cally. Of the 7 children affected clinically, 6 (19% of all examined) prese nted localized hypoplasia of the primary canines, which was found only in 3 % of healthy control children: 1 patient had generalized pitted enamel hypo plasia. By microscopy, 5 of 10 primary canines examined showed enamel hypop lasia localized exclusively in enamel formed after birth. The "birth line," a visible structure within the primary enamel, was always present, which e xcludes a prenatal onset of the defects. Of the 12 patients with an enamel defect, 9 had a documented onset of CRF within the first 7 weeks of life. W e conclude that renal disease leading to CRF may affect enamel formation of primary teeth in early postnatal life, resulting in lesions different from those observed in the secondary dentition.