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Enamel dysplasia with hamartomatous atypical follicular hyperplasia (EDHFH) syndrome: suggested pathogenic mechanisms.

Abstract
The syndrome of enamel dysplasia with hamartomatous atypical follicular hyperplasia (EDHFH) is an unusual syndrome and is unique to black South Africans. Major criteria for the syndrome are enamel dysplasia with generalized amelogenesis imperfecta-like features and atypical hyperplastic dental follicles with microscopic features of central odontogenic fibroma WHO-type (follicle analogue) attached to the crowns of multiple impacted teeth. Minor features of some cases are anterior open-bite malocclusion, supernumerary teeth, pulpal calcification, aberrant roots with hypercementosis, and hypodontia. The pathogenic mechanisms that lead to the development of EDHFH are unknown. We speculate that faulty synthesis of enamel matrix proteins may interfere with enamel formation and play a role in the generalized enamel hypoplasia described in this syndrome. Alterations in inductive signalling by the odontogenic epithelium mediated by enamel matrix proteins may explain the development of the follicle analogues, the root hypercementosis and the presence of dysplastic cementum deposition juxtaposed to odontogenic epithelium in the gingival overgrowth. Thus, alterations in the function of enamel matrix protein function, may be the common denominator responsible for the development of the EDHFH phenotype.
AuthorsL Feller, B Kramer, E J Raubenheimer, J Lemmer
JournalSADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging (SADJ) Vol. 63 Issue 2 Pg. 102-5 (Mar 2008) ISSN: 1029-4864 [Print] South Africa
PMID18561809 (Publication Type: Journal Article)
Chemical References
  • Dental Enamel Proteins
Topics
  • Ameloblasts (metabolism)
  • Dental Enamel Hypoplasia (etiology)
  • Dental Enamel Proteins (biosynthesis, physiology)
  • Dental Pulp Calcification (etiology)
  • Dental Sac (pathology)
  • Epithelial Cells (metabolism)
  • Hamartoma (etiology)
  • Humans
  • Hypercementosis (etiology)
  • Hyperplasia
  • Odontogenesis
  • Signal Transduction
  • South Africa
  • Syndrome
  • Tooth, Impacted (etiology)

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