牙本质发育异常分类方法进展及相应临床管理策略

Progress in the classification of hereditary dentin disorders and clinical management strategies

位于第4常染色体的牙本质涎磷蛋白(dentin sialophosphoprotein,DSPP)基因是迄今发现的遗传性牙本质发育异常的主要致病基因。根据de La Dure-Molla等提出的新分类,将由DSPP基因突变引起的主要表现为牙本质发育异常的疾病统称为牙本质发育不全(dentinogenesis imperfecta,DI),包括Shields分类法的牙本质发育不良Ⅱ型(dentin dysplasia type-Ⅱ,DD-Ⅱ)、牙本质发育不全Ⅱ型(dentinogenesis imperfecta type-Ⅱ,DGI-Ⅱ)和牙本质发育不全Ⅲ型(dentinogenesis imperfecta type-Ⅲ,DGI-Ⅲ)3种疾病。将Shields分类的牙本质发育不良Ⅰ型(dentin dysplasia type-Ⅰ,DD-Ⅰ)称为根部牙本质发育不良(radicular dentin displasia)。本文对遗传性牙本质发育异常的分类方法、临床特征、致病基因的研究进展进行阐述,根据不同阶段的临床特征,提出相应的临床管理和治疗策略。

Heterogeneous mutations in dentin sialophosphoprotein(DSPP)gene,which is located on autosome 4,are associated with hereditary dentin developmental disorders.According to the new classification proposed by de La Dure-Molla et al,diseases caused by DSPP gene mutations mainly manifested as abnormal dentin development are collectively referred to as dentinogenesis imperfecta(DI),including dentin dysplasia typeⅡ(DD-Ⅱ),dentinogenesis imperfecta typeⅡ(DGI-Ⅱ)and dentinogenesis imperfecta typeⅢ(DGI-Ⅲ)in Shields classification.And dentin dysplasia typeⅠ(DD-Ⅰ)in Shields classification is redesignated as radicular dentin dysplasia.In this paper,progress in the classification,clinical characteristics and genetic mechanisms of DI are reviewed.This paper also provides clinical management and treatment strategies for patients suffering DI.