Tetracycline teeth are a type of systemic hypoplasia that occurs as a result of taking tetracycline antibiotics by a pregnant woman or child. The main complaints are reduced to the appearance of an aesthetic defect. Discoloritis is observed – the color of the teeth varies from lemon yellow to dark brown. Pathology are also characterized by a violation of the enamel structure. Diagnostics includes anamnesis collection, physical examination, radiography. When disease are detected, remineralizing therapy is performed. The main methods of eliminating the aesthetic defect are whitening, restoration, lamination of teeth with ceramic veneers.
Meaning
Tetracycline teeth are persistent discoloritis, which occurs as a result of the deposition of complex compounds of tetracycline with calcium in the hard tissues of the tooth and is accompanied by a violation of the processes of histogenesis. Currently, systemic hypoplasia of drug origin is being diagnosed less and less often. Among the total number of non-carious lesions, the prevalence of tetracycline teeth is 9%. The appearance of tooth pigmentation due to tetracycline intake is equally susceptible to representatives of both sexes. Due to the fact that disease are inherently irreversible persistent discoloritis, antibiotics of this group should be prescribed to pregnant women and children under 12 years of age only if absolutely necessary.
Causes
The main cause of tetracycline teeth is the use of tetracycline group antibiotics during the formation, mineralization of enamel and dentin. Medical discoloritis of temporary teeth in a child may occur if a woman took tetracyclines in the second and third trimesters of pregnancy. At the same time, the cutting edges of the incisors, the chewing surfaces of the molars are colored. If tetracycline intake coincided with the 9th month of fetal development, the first permanent molars are most susceptible to color change. The appointment of tetracyclines in childhood leads to staining of permanent teeth.
Tetracycline has the property of binding to calcium, forming persistent compounds, and being deposited at those points where mineralization processes occur at the time of taking the drug. Enamel, dentin, and skeletal bones are most susceptible to toxic effects. Along with pigmentation in tetracycline teeth, there is a violation of histogenesis processes. This is due to the fact that tetracyclines form a close bond with the 30S subunit of the ribosome and block the subsequent attachment of aminoacyl-tRNA to the A-center of the ribosome, which leads to a violation of the elongation of the polypeptide chain. Failure at the stage of protein synthesis alters the formation of primary hydroxyapatite crystals in the hard tissues of the tooth.
Symptoms
Tetracycline teeth are characterized by persistent discoloration. As a result of taking tetracycline, the crowns acquire a lemon-yellow or gray-yellow hue. The severity of staining of tetracycline teeth is in direct correlation with the type of drug, the total dosage. After two days of taking tetracycline antibiotics, a yellow strip 1 mm thick may appear on the teeth. It has also been proven that drugs based on dimethyl chlorotetracycline have a more aggressive effect on hard tissues, causing dark brown or brown irreversible pigmentation. Oxytetracycline is less toxic.
When examining pathology, transverse stripes are revealed. As a result of the violation of histogenesis processes, signs of systemic hypoplasia are observed. The enamel of tetracycline teeth is thin and brittle, quickly chipped. Due to the imperfect structure, tetracycline teeth are more vulnerable to the carious process. Under the influence of ultraviolet rays, the buccal surfaces of tetracycline teeth darken, while the degree of staining of oral and chewing surfaces remains unchanged.
Diagnostics
The diagnosis of tetracycline teeth is based on the analysis of anamnesis data, clinical examination, and the results of additional research methods. During the survey, it is possible to find out when and in what dosage tetracyclines were prescribed. During the examination, the dentist reveals the teeth crowns changed in color. There are signs of enamel hypoplasia. When probing tetracycline teeth, the enamel is rough, pigmented areas are painless. When ultraviolet rays are directed at the crowns of pathology, a positive symptom of fluorescence is noted. Over time, under the influence of light, discoloritis becomes more pronounced, and teeth lose their ability to glow.
When applying tetracycline teeth pigmentation to the surface, methylene blue staining is not observed. There are no pathological changes on the orthopantomogram. Tetracycline teeth are differentiated with fluorosis, congenital discoloritis as a result of Rh conflict, as well as with hereditary malformations of enamel and dentin (imperfect amelogenesis, Stanton-Capdepon syndrome, dentin dysplasia). Physical examination is performed by a pediatric dentist-therapist.
Treatment
The main directions of treatment of tetracycline teeth are remineralizing therapy in combination with subsequent restoration with glass ionomer cements, compomers or composites, bleaching, prosthetics. In order to replenish the mineral composition of the enamel, applications of calcium- and fluorine-containing preparations are shown. Also, remtherapy can be performed by electro- and phonophoresis. Of the medicines in dentistry, calcium gluconate and sodium fluoride are most often used. In childhood, to eliminate an aesthetic defect, the buccal surfaces of tetracycline teeth are restored with glass ionomer cement. The advantages of this material are the absence of the need for acid etching (which in patients with tetracycline teeth can lead to even greater demineralization of hard tissues), good adhesion to dentin and enamel, a caries-protective effect achieved by the release of fluoride ions.
In older children, to eliminate discoloritis, laminating of the cheek surfaces of teeth along the smile line is carried out by direct veneering with composites. Combined whitening of tetracycline teeth turns out to be ineffective, since only a year after the procedure, the teeth acquire the same color. Among orthopedic methods of color correction of tetracycline teeth, microprosthetics are most often used. To this end, ceramic veneers are fixed to eliminate discoloritis or the affected teeth are covered with crowns.
Since tetracycline teeth belong to persistent irreversible discoloritis, bleaching does not bring the desired results, relapse is observed within the shortest period of time. The optimal method of eliminating an aesthetic defect is prosthetics.
