Kim J-W, Simmer J P
Seoul National University, School of Dentistry Department of Pediatric Dentistry & Dental Research Institute, 28-2 Yongon-dong, Chongno-gu, Seoul, Korea 110-749.
J Dent Res. 2007 May;86(5):392-9. doi: 10.1177/154405910708600502.
By the Shields classification, articulated over 30 years ago, inherited dentin defects are divided into 5 types: 3 types of dentinogenesis imperfecta (DGI), and 2 types of dentin dysplasia (DD). DGI type I is osteogenesis imperfecta (OI) with DGI. OI with DGI is caused, in most cases, by mutations in the 2 genes encoding type I collagen. Many genes are required to generate the enzymes that catalyze collagen's diverse post-translational modifications and its assembly into fibers, fibrils, bundles, and networks. Rare inherited diseases of bone are caused by defects in these genes, and some are occasionally found to include DGI as a feature. Appreciation of the complicated genetic etiology of DGI associated with bony defects splintered the DGI type I description into a multitude of more precisely defined entities, all with their own designations. In contrast, DD-II, DGI-II, and DGI-III, each with its own pattern of inherited defects limited to the dentition, have been found to be caused by various defects in DSPP (dentin sialophosphoprotein), a gene encoding the major non-collagenous proteins of dentin. Only DD-I, an exceedingly rare condition featuring short, blunt roots with obliterated pulp chambers, remains untouched by the revolution in genetics, and its etiology is still a mystery. A major surprise in the characterization of genes underlying inherited dentin defects is the apparent lack of roles played by the genes encoding the less-abundant non-collagenous proteins in dentin, such as dentin matrix protein 1 (DMP1), integrin-binding sialoprotein (IBSP), matrix extracellular phosphoglycoprotein (MEPE), and secreted phosphoprotein-1, or osteopontin (SPP1, OPN). This review discusses the development of the dentin extracellular matrix in the context of its evolution, and discusses the phenotypes and clinical classifications of isolated hereditary defects of tooth dentin in the context of recent genetic data respecting their genetic etiologies.
根据30多年前提出的希尔兹分类法,遗传性牙本质缺陷可分为5种类型:3种牙本质发育不全(DGI)和2种牙本质发育异常(DD)。I型牙本质发育不全(DGI-I)是伴有牙本质发育不全的成骨不全(OI)。多数情况下,伴有牙本质发育不全的成骨不全是由编码I型胶原的2个基因突变引起的。生成催化胶原多种翻译后修饰及其组装成纤维、原纤维、束和网络的酶需要许多基因。罕见的骨遗传性疾病是由这些基因的缺陷引起的,偶尔会发现其中一些疾病伴有牙本质发育不全。认识到与骨缺陷相关的牙本质发育不全复杂的遗传病因后,I型牙本质发育不全的描述被细分为多个定义更精确的实体,每个实体都有自己的名称。相比之下,已发现II型牙本质发育异常(DD-II)、II型牙本质发育不全(DGI-II)和III型牙本质发育不全(DGI-III)各自具有仅限于牙列的遗传缺陷模式,是由牙本质涎磷蛋白(DSPP)的各种缺陷引起的,DSPP是一种编码牙本质主要非胶原蛋白的基因。只有I型牙本质发育异常(DD-I),一种极为罕见的疾病,表现为牙根短而钝,髓腔闭塞,在遗传学变革中未受影响,其病因仍是个谜。遗传性牙本质缺陷相关基因特征的一个重大意外是,编码牙本质中含量较少的非胶原蛋白的基因,如牙本质基质蛋白1(DMP1)、整合素结合涎蛋白(IBSP)、基质细胞外磷酸糖蛋白(MEPE)和分泌性磷蛋白1或骨桥蛋白(SPP1,OPN),显然没有发挥作用。本综述在牙本质细胞外基质进化的背景下讨论其发育,并结合近期关于遗传性牙本质孤立缺陷遗传病因的基因数据,讨论其表型和临床分类。
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