Decreased dentin tubules density and reduced thickness of peritubular dentin in hyperbilirubinemia-related green teeth

BACKGROUND: It is stated anecdotally that patients with liver diseases in childhood who develop green teeth have increased risk for rampant caries, which may be secondary to changes in dental structure. The aim of this study was to test the hypothesis that hyperbilirubinemia affects the dentin morphology of green teeth. MATERIAL AND METHODS: Sixteen primary teeth were prepared and divided into two groups (green teeth, n = 8 and control, n = 8), which were transversely fractured across the cervical third of the dental crowns; dentin was prepared and sputter-coated with gold, and examined under a scanning electron microscope. The mean density and mean diameter of dentin tubules, as well as the thickness of peritubular dentin, were compared. RESULTS: Hyperbilirubinemia was associated with a decrease in the density of the dentin tubules (p< .01) and the thickness of peritubular dentin of green teeth (p< .01). CONCLUSIONS: There was a correlation between childhood hyperbilirubinemia and changes in the dentin morphology, including a decrease in the density of the dentin tubules and a reduction in the thickness of peritubular dentin in green teeth. Key words:Hyperbilirubinemia, liver disease, childhood, dentin tubules, human teeth, scanning electron microscopy.