OWN - Quintessenz Verlags-GmbH CI - Copyright Quintessenz Verlags-GmbH OCI - Copyright Quintessenz Verlags-GmbH TA - Int Poster J Dent Oral Med JT - International Poster Journal of Dentistry and Oral Medicine IS - 1612-7749 (Electronic) IP - 3 VI - 21 PST - ppublish DP - 2019 PG - 0-0 LA - en TI - Acne Therapy as a Trigger for the Discoloration of the Roots of Third Molars? FAU - Künzlberger, Andreas AU - Künzlberger A FAU - Benz, Korbinian AU - Benz K FAU - Hassfeld, Stefan AU - Hassfeld S FAU - Jackowski, Jochen AU - Jackowski J CN - OT - tooth discolouration OT - acne therapy OT - long-term consequences AB - In addition to the typical, often amber-coloured changes of the enamel and dentin dysplasias and the primary or secondary pigmented hypoplasias, tooth discoloration may also develop which is not directly associated with structural changes. These are medicinal deposits or pigment surpluses that are stored in the tooth structure during tooth development. Sole root discolorations are rare. In the third molars, crown formation is completed between the ages of 12 and 14. The formation of the roots can only be completed between the ages of 19 and 21. Case report: In a 14.5-year-old patient with heterozygous Factor V mutation at the time of surgery, the four third molars were surgically removed. They were inconspicuously shaped and structurally intact with incomplete root growth. All roots showed a homogeneous, brown-yellow discoloration almost throughout. The colour of the four crowns differed from the regular tooth colour. Growth lines (retzius stripes) were macroscopically recognisable e in the enamel. The preoperative panoramic view showed no evidence of structural changes (e.g. hypodense compartments). The postoperative course had no complications. The patient reported that she had received antibiotics several times during infancy for the treatment of otitis media. For about two years she had been taking SKID® (minocycline, 50 mg/day) for the treatment of acne. In addition, a current long-term medication with Androcur® (cyproterone acetate antiandrogen) was available. Literature review: Tooth discoloration can occur both as a result of changes in the structural composition of the hard tooth substance and as a result of colour deposits during or after the process of ontogenetic tooth development. Biliverdin can lead to a discoloration of the tooth structure in the case of hyperbilirubinemia or incompatibility of the blood groups between mother and child in the context of haemolyticus neonatorum disease. This also applies to supplementation with iron preparations for the therapy of anaemia in children with chronic kidney failure. In erythropoietic congenital porphyria, discoloration by porphyrin may occur. There are occasional case reports of greyish-brown to yellowish discoloration of teeth with anamnestically confirmed intake of tetracycline or its semi-synthetic derivatives such as minocycline. These publications mainly describe discolorations of the coronal tooth segments. After an extensive literature research, only four publications on discoloration of third molars (12 patients / 28 teeth) have appeared in the last 20 years. Discolorations of the permanent dentition occur in 3 to 6% of cases with long-term administration of minocycline. The intensity of staining seems to depend on the duration of administration and the stage of odontogenesis. In addition to the discoloration of the tooth structure, tetracyclines and their derivatives were found in a few cases in the adjacent bone of third molars. Various mechanisms for the incorporation of minocycline into the tooth structure are discussed. Besides intrinsic and extrinsic hypotheses, an irreversible complex formation within the tooth structure is assumed to be probable. Minocycline differs from other tetracyclines in that it is well absorbed from the gastrointestinal tract, chelated with iron to insoluble complexes and may lead to tooth discoloration. The exact mechanisms are not fully understood. AID - 857778