Skip to main content

Dental Aspects of Epidermolysis Bullosa

  • Chapter
Epidermolysis Bullosa

Abstract

Because the skin and teeth are both ectodermal in origin, it is not surprising they are similarly affected in many pathologic processes. This is well illustrated in epidermolysis bullosa (EB), a heterogeneous group of genetic disorders in which blistering of the skin and mucosa occur as a result of minor trauma.1–4 In many patients, chewing and eating may cause formation of painful oral blisters that severely compromise nutritional intake. In addition, primary dental abnormalities such as enamel defects predispose patients to caries development. In severely affected patients crippling deformities of the hands make it almost impossible to maintain adequate oral hygeine. In this chapter, we review the unique spectrum of intraoral problems faced by EB patients and discuss management guidelines.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Gorlin RJ. Epidermolysis bullosa. Oral Surg. 1971;32:760–766.

    Article  PubMed  CAS  Google Scholar 

  2. Gedde-Dahl Jr T, Anton-Lamprecht I. Epidermolysis bullosa. In: Emery AEH, Rimion DL, eds. Principles and Practice of Medical Genetics. Edinburgh: Churchill-Livingstone; 1983:672–687.

    Google Scholar 

  3. Lin AN, Carter DM. Epidermolysis bullosa: when the skin falls apart. J Pediatr. 1989;114:349–355.

    Article  PubMed  CAS  Google Scholar 

  4. Crawford EG, Burkes Jr EJ, Briggaman RA. Hereditary epidermolysis bullosa: oral manifestations and dental therapy. Oral Surg. 1976;42:490–500.

    Article  PubMed  Google Scholar 

  5. Sharawy M, Bhussrt RB. Development and growth of teeth. In: Bhaskar SN, eds. Orban’s Oral Histology and Embryology. St. Louis: CV Mosby; 1986:24–36.

    Google Scholar 

  6. Mathiessen ME, Molloary K. Cell junctions of the human enamel organ. Z Zeilforsch Mikrosk Anat. 1973; 146:69–81.

    Article  Google Scholar 

  7. Pannese E. Observation on the ultrastructure of the enamel organ III. Internal and external enamel epithelium. J Ultrastruct Res. 1962;6:186–204.

    Article  PubMed  CAS  Google Scholar 

  8. Reith EJ. The stages of amelogenesis as observed in molar teeth of young rats. J Ultrastruct Res. 1970;30:111–151.

    Article  PubMed  CAS  Google Scholar 

  9. Preis FG. Epidermolysis bullosa simplex: a case in which tooth re-implantation was unsuccessful. Birth Defects: Original Article Series. 1971; VII: 276.

    Google Scholar 

  10. Noble HW. Electron microscopy of human developing dentin. Arch Oral Biol. 1962;7:395–399.

    Article  PubMed  CAS  Google Scholar 

  11. Sharawy M, Jaeger JA. Enamel. In: Bhaskar SN, eds. Orban’s Oral Histology and Embryology. St. Louis: CV Mosby; 1986:71–100.

    Google Scholar 

  12. Arwill T, Bergenholtz A, Thilander H. Epidermolysis bullosa hereditaria. V: The ultrastructure of oral mucsoa and skin in four cases of the letalis form. Acta Pathol Microbiol Scand. 1968; 74:311–324.

    Article  PubMed  CAS  Google Scholar 

  13. Stern IB. Oral mucous membrane. In: Bhaskar SN, eds. Orban’s Oral Histology and Embryology. St. Louis: CV Mosby; 1986:253–293.

    Google Scholar 

  14. Boyer EH, Owens RH. Epidermolysis bullosa: a rare disease of dental interest. Oral Surg Oral Med Oral Pathol. 1961; 14:1170–1177.

    Article  PubMed  CAS  Google Scholar 

  15. Howden EF, Oldenburg TR. Epidermolysis bullosa dystrophica: report of two cases. J Am Dental Assoc. 1972; 85:1113–1118.

    CAS  Google Scholar 

  16. Gormley JW, Schow CE. Epidermolysis bullosa and associated problems in surgical treatment. J Oral Surg. 1976; 34:45–52.

    PubMed  CAS  Google Scholar 

  17. Cooper, TW, Bauer EA. Epidermolysis bullosa: a review. Pediatr Dermatol. 1984; 1:181–188.

    Article  PubMed  CAS  Google Scholar 

  18. Koshiba H, Kimura O., Nakata M. A clinical and histologic observation of enamel hypoplasia in a case of epidermolysis bullosa hereditaria. Oral Surg. 1977;43:585–590.

    Article  PubMed  CAS  Google Scholar 

  19. Arwill T, Bergenholtz A, Olsson O. Epidermolysis bullosa hereditaria. III. A histologica study of changes in teeth in the polydysplastic dystrophic and lethal forms. Oral Surg Oral Med Oral Pathol. 1965; 19:723–744.

    Article  PubMed  CAS  Google Scholar 

  20. Brain EB, Wigglesworth JS. Developing teeth in epidermolysis bullosa hereditaria letalis: a histological study. Br Dental J. 1968; 124:255–260.

    CAS  Google Scholar 

  21. Gardner DG, Hudson CD. The disturbances in odontogenesis in epidermolysis bullosa hereditaria letalis. Oral Surg. 1975;40:483–493.

    Article  PubMed  CAS  Google Scholar 

  22. Arwill T, Bergenholtz A. Epidermolysis bullosa hereditaria. VIII. Growth rate of the dentin in deciduous teeth in epidermolysis bullosa revealed by tetracycline lines. Arch Oral Biol. 1968; 13:819–822.

    Article  PubMed  CAS  Google Scholar 

  23. Pearson RW. Studies of the pathogenesis of epidermolysis bullosa. J Invest Dermatol. 1962;39:551–575.

    Article  PubMed  CAS  Google Scholar 

  24. Hashimoto I, Gedde-Dahl Jr T, Schnyder UW, Anton-Lamprecht I. Ultrastructural studies in epidermolysis bullosa hereditaria IV. Recessive dystrophic types with junctional blistering (Infantile or Herlitz-Pearson type and adult type). Arch Dermatol Res. 1976; 257:17–32.

    Article  PubMed  CAS  Google Scholar 

  25. Haas CD. Epidermolysis bullosa dystrophica: report of a case. Oral Surg Oral Med Oral Pathol. 1968; 26:291–295.

    Article  PubMed  CAS  Google Scholar 

  26. Gisanti JS. Oral nodular excrescences in epidermolysis bullosa. Oral Surg. 1975; 40:385–390.

    Article  Google Scholar 

  27. Morgan WC. Dental and anesthetic management of epidermolysis bullosa: a new approach. Oral Surg. 1975;40:732–735.

    Article  PubMed  CAS  Google Scholar 

  28. Haber RM, Hana W, Ramsay CA, Boxall LBH. Hereditary epidermolysis bullosa. J Am Acad Dermatol. 1985; 13:252–278.

    Article  PubMed  CAS  Google Scholar 

  29. Fine J-D. Epidermolysis bullosa: clinical aspects, pathology, and recent advances in research. Int J Dermatol. 1986;25:143–157.

    Article  PubMed  CAS  Google Scholar 

  30. Wright JT. Epidermolysis bullosa: dental and anesthetic management of two cases. Oral Surg Oral Med Oral Pathol. 1984; 57:155–157.

    Article  PubMed  CAS  Google Scholar 

  31. Tabas M, Gibbons S, Bauer EA. The mechanobullous diseases. Dermatol Clin. 1987;5:123–136.

    Article  PubMed  CAS  Google Scholar 

  32. Hashimoto I, Anton-Lamprecht I, Gedde-Dahl Jr T, Schnyder UW Ultrastructural studies in epidermolysis bullosa hereditaria. I. Dominant dystrophic type of Pasini. Arch Dermatol Res. 1975;252:167–178.

    Article  CAS  Google Scholar 

  33. Hashimoto I, Gedde-Dahl Jr T, Schnyder UW, Anton-Lamprecht I. Ultrastructural studies in epidermolysis bullosa hereditaria. II. Dominant dystrophic type of Cockayne and Touraine. Arch Dermatol Res. 1976;255:285–295.

    Article  PubMed  CAS  Google Scholar 

  34. Valle K-J, Bauer EA. Enhanced biosynthesis of human skin collagenase in fibroblast cultures from recessive dystrophic epidermolysis bullosa. J Clin Invest. 1980; 66:176.

    Article  PubMed  CAS  Google Scholar 

  35. Hashimoto I, Schnyder UW, Anton-Lamprecht I, Gedde-Dahl Jr T, Ward S. Ultrastructural studies in epidermolysis bullosa hereditaria III. Recessive dystrophic types with dermolytic blistering (Hallopeau-Siemens types and inverse type). Arch Dermatol Res. 1976; 256:137–150.

    Article  PubMed  CAS  Google Scholar 

  36. Hitchin AD. The defects of cementum in epidermolysis bullosa dystrophica. Br Dental J. 1973; 135:437–442.

    Article  CAS  Google Scholar 

  37. Block MS, Gross BD. Epidermolysis bullosa dystrophica recessive: oral surgery and anesthetic considerations. J. Oral Maxillofacial Surg. 1982;40:753–758.

    Article  CAS  Google Scholar 

  38. Wright JT, et al. Salivary gland function of persons with hereditary epidermolysis bullosa. Oral Surg Oral Med Oral Pathol. 1991; 71:553–554.

    Article  PubMed  CAS  Google Scholar 

  39. Putnam JJ, Sferra G, Lin AN, Carter DM. Junctional epidermolysis bullosa: report of a case with treatment considerations. Submitted.

    Google Scholar 

  40. Winstock D. Oral aspects of epidermolysis bullosa. Br J Dermatol. 1962; 74:431–438.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1992 Springer-Verlag New York, Inc.

About this chapter

Cite this chapter

Putnam, J.J., Sferra, G.W. (1992). Dental Aspects of Epidermolysis Bullosa. In: Lin, A.N., Carter, D.M. (eds) Epidermolysis Bullosa. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-2914-8_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-2914-8_14

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7717-0

  • Online ISBN: 978-1-4612-2914-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics