Neonatal Enamel Hypoplasia — ORE Part 1 MCQ

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ModeratePaediatric DentistryNeonatal Enamel HypoplasiaORE Part 1

A 4-year-old child has symmetrical pits and grooves with reduced enamel thickness on the labial surfaces of the upper primary incisors. Similar defects are present on the first primary molars. The permanent tooth germs appear unaffected radiographically. Which cause is most likely?

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Correct answer: E — Perinatal systemic disturbance during enamel formation

Explanation lettering: C = shown as A · E = shown as C · A = shown as E

A is correct. Pits, grooves and reduced enamel thickness are quantitative defects, therefore enamel hypoplasia. A perinatal or neonatal systemic insult, such as prematurity or serious neonatal illness, can disrupt primary-tooth enamel formation; maxillary primary incisors, with or without primary molars, are a recognised pattern. The normal permanent tooth germs favour an insult confined to the early developmental period. Fluorosis usually produces diffuse, bilateral opacities in teeth mineralising during sustained fluoride exposure rather than this localised hypoplastic pattern. Amelogenesis imperfecta is inherited and typically generalised, affecting both dentitions. Molar-incisor hypomineralisation affects first permanent molars and often permanent incisors, and is a qualitative hypomineralisation defect. Congenital syphilis classically affects permanent teeth, producing Hutchinson incisors and mulberry molars.

Reference: Mendoza-Mendoza A, et al. Relationship between preterm birth and developmental defects of enamel: A systematic review and meta-analysis. International Journal of Paediatric Dentistry, 2020. https://pubmed.ncbi.nlm.nih.gov/32243004/