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Enamel hypocalcification is a defect of tooth enamel in which normal amounts of enamel are produced but are hypomineralized. [ 1 ] [ 2 ] In this defect the enamel is softer than normal. Some areas in enamel are hypocalcified: enamel spindles, enamel tufts, and enamel lamellae.
Enamel spindles are often confused with two other entities: enamel lamellae and enamel tufts. Lamellae are linear enamel defects that extend from the surface of the enamel towards the DEJ, or vice versa. Enamel tufts are "small, branching defects that are found only at the DEJ, protruding into the enamel towards the enamel surface.
Enamel mineralization only occurs once (as ameloblasts are lost with eruption within the reduced enamel epithelium); therefore after amelogenesis, enamel production has been finalized. [4] This is in contrast to dentin formation which occurs throughout life (secondary dentin production).
Hypomineralization or hypocalcification, as opposed to hypoplasia, refers to a decrease in the mineral content of the enamel, not the total amount present. It can vary in its presentation, and teeth may appear visually normal or highly translucent. Affected enamel is softer and more susceptible to acid, wear and decay.
The hypocalcification type, which is the most common, is an autosomal dominant condition that results in enamel that is not completely mineralized. [51] Consequently, enamel easily flakes off the teeth, which appear yellow because of the revealed dentin.
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The enamel represents the usual translucent semivitriform (glass-like) type of structure. The surface is smooth, glossy and usually of pale creamy white color Questionable: 1: The enamel discloses slight aberrations from the translucency of normal enamel, ranging from a few white flecks to occasional white spots.