Aspects on dental hard tissues in primary teeth from patients with Ehlers-Danlos syndrome

Int J Paediatr Dent. 2009 Jul;19(4):282-90. doi: 10.1111/j.1365-263X.2009.00970.x. Epub 2009 Mar 30.


Background: Ehlers-Danlos syndrome (EDS) is a rare hereditary condition affecting connective tissues and dental hard tissues.

Hypotheses: Primary enamel and dentine from EDS patients were expected to differ from those of healthy subjects regarding morphology and chemical composition.

Design: Forty-seven exfoliated primary teeth from 25 patients with EDS were investigated. Morphology was studied using a polarized light microscope, scanning electron microscope, and X-ray microanalysis. Comparisons were made with 36 primary teeth from 36 healthy patients.

Results: Morphological analysis of enamel in EDS teeth showed a high frequency of postnatally hypomineralized enamel and postnatally located incremental lines, whereas dentine was normal in all patients. Chemical analysis could not reveal any differences between EDS and control patients except for lower content of C and a higher Ca/P ratio in the enamel in the EDS teeth, indicating porous enamel. Regarding dentine, EDS teeth had a lower content of C, and a higher content of Ca, P, and O. Ratios for Ca/C and Ca/O were also higher compared with controls.

Conclusions: There are several aberrations of booth enamel and dentine in primary teeth from patients with EDS. These could explain the occurrence of both more dental caries and tooth fractures in patients with EDS.

MeSH terms

  • Calcium / analysis
  • Case-Control Studies
  • Dental Enamel / chemistry
  • Dental Enamel / pathology*
  • Dental Enamel / ultrastructure
  • Dentin / chemistry
  • Dentin / ultrastructure*
  • Ehlers-Danlos Syndrome / complications
  • Ehlers-Danlos Syndrome / pathology*
  • Female
  • Humans
  • Male
  • Phosphates / analysis
  • Reference Values
  • Statistics, Nonparametric
  • Tooth Abnormalities / complications
  • Tooth Abnormalities / pathology
  • Tooth Demineralization / complications
  • Tooth Demineralization / pathology*
  • Tooth, Deciduous / chemistry
  • Tooth, Deciduous / pathology*
  • Tooth, Deciduous / ultrastructure


  • Phosphates
  • Calcium