Pre and Post Natal Enamel Mineralization in Primary Teeth from Children with Congenital Insensitivity to Pain with Anhidrosis (CIPA)

Enamel mineralization is affected by genetic disorders like Down syndrome and familial dysautonomia (FD). Congenital Insensitivity to Pain with Anhidrosis (CIPA) is associated with decreased sensation and autonomic dysfunction, somehow similar to FD. In this study we examined the effect of CIPA on pre and post-natal enamel mineralization of 9 primary extracted teeth and matchpaired normal teeth. Slices of 200 microns were performed, the neonatal line was marked using a light microscope and pre and post natal enamel mineral content was determined using SEM-EDS program. The results showed marked disturbance of mineralization in relation to the severity of clinical signs in the CIPA children. In the severe case pre and post natal enamel mineralization was affected, in the moderate case only the prenatal enamel was affected while in the mild cases there was no differences in mineralization in comparison with normal teeth. Post natal traumatic lines were observed in 4 out of 9 of CIPA teeth in the children with severe and moderate clinical signs. In comparison to FD, in CIPA the effect on mineralization was observed in both pre and post natal enamel and related to the severity of clinical signs, and less post-traumatic lines were observed.