Structural and ultrastructural study of the teeth in a suspected case of pseudohypoparathyroidism

Two premolars removed from a 14 year old girl, with suspicion of pseudohypoparathyroidism (PHP) have been studied, using several of the correlated techniques applied to the study of calcified tissues (light microscopy, microradiography and scanning electron microscopy). Enamel gross and micro hypoplasia, hypomineralization of the enamel surface and dentin hypocalcification were similar to dental abnormalities observed in pseudohypoparathyroidism. Microradiography showed for the first time calcifications present in blood vessels of the dental pulp. Light microscopy and SEM revealed dystrophic globular calcifications within enamel hypoplastic pits. Cemental changes consisting of hypoplasia, aplasia, localized hyperplasia and cementicules were described for the first time. It is suggested that enamel, dentine and pulp abnormalities observed in the present case might be pathognomonic of PHP.