Generalized Developmental Enamel Hypoplasia of the Permanent Dentition Associated with Early Childhood Vitamin D Deficiency Rickets: A Case Report
Abstract
Background: Vitamin D deficiency rickets is a metabolic bone disorder caused by impaired calcium and phosphate homeostasis resulting from insufficient vitamin D. In children, severe vitamin D deficiency can disturb the mineralization of growing bones and teeth. Although the skeletal manifestations are well recognized, reports describing generalized developmental enamel defects affecting nearly all permanent teeth remain limited. Methods: A 6-year-9-month-old Japanese boy with a history of vitamin D deficiency rickets diagnosed at 2 years 5 months of age was referred to our department for evaluation of generalized discoloration and morphological abnormalities affecting multiple permanent teeth. Clinical, radiographic, and medical findings were reviewed. Results: Laboratory examination at diagnosis revealed severe vitamin D deficiency with elevated intact parathyroid hormone levels. Possible contributing factors included exclusive breastfeeding, delayed weaning, avoidance of fish and dairy products, and limited outdoor activity. Following oral alfacalcidol supplementation, skeletal and biochemical findings gradually normalized. However, clinical examination revealed generalized enamel hypoplasia affecting the permanent incisors and first molars, characterized by yellow-brown discoloration, rough enamel surfaces, morphological irregularities, and attrition, whereas the primary dentition showed no obvious abnormalities. Panoramic radiography demonstrated generalized crown…
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