Review Article

Tricho-Dento-Osseous Syndrome: Diagnosis and Dental Management

Table 1

Characteristic defects in TDO.

DefectReported expression of defect/featuresReference

(1) Hair defectsKinky or tightly curled hair at birth[13, 1619]
Wavy hair[7, 18]
Curly hair at birth that straightened out a few years later[6]

(2) Dental defectsYellow-brown discolored teeth [16, 9, 1618]
Thin enamel associated with hypocalcification or hypomaturation defects and enamel hypoplasia [18, 12, 1619]
Severe attrition of enamel [1, 2, 5, 8, 16, 17, 19]
Dental abscesses [14]
Taurodontism in both the primary and permanent dentitions[13]
Taurodontism in the first permanent molar (key tooth)[20]
Histologic sections show:
(i) hypocalcified enamel that is decreased in thickness with enlarged pulp chambers [2, 3, 7]
(ii) small amounts of interglobular dentin have been noted in a few teeth[6]

(3) Bone changesSclerosis may be a variable feature.
It is commonly reported in the following areas: base of the skull, mastoids and zones of provisional calcification in the long bones
[13, 22]

(4) Nail defectsSplitting of the superficial layers of the nails[13, 7, 8]
Sometimes, only some toenails may be affected[21]

(5) Craniofacial defectsFrontal bossing [1, 7]
Square jaw[1]
Mandibular prognathism[2]
Maxillary retrusion[29]
Dolichocephaly[1, 9]

(6) Other reported abnormalitiesImpacted teeth[4, 7]
Clinodactyly[1]
Skin lesions[2]