The spectrum of dental manifestations in vitamin D-resistant rickets: implications for management.

Vitamin D-resistant rickets (VDRR), usually inherited in X-linked dominant manner, is the most common type of rickets in developed countries today. This analysis of 13 patients affected by the disease indicates that dental manifestations occur in a wide spectrum of severity which is determined by several factors including heredity, sex, and medical treatment. The spectrum of severity of dental manifestations can be classified into Grades IIII in order of increasing severity. Grade I severity includes near normal dentition while Grade II indicates involvement of only a few teeth. Grade III includes greatly enlarged pulp chambers, multiple dental abscesses, and poorly calcified dentin. Strategies for the prevention of dental abscesses in each grade of severity should be used appropriately. The most common form of rickets in developed countries today is an inherited form of rickets known as vitamin D-resistant rickets (VDRR). 1 This condition, first described by Albright et al., 2 also is known by various other names such as familial hypophosphatemia, vitamin D-refractory rickets, and phosphate diabetes. The disease usually is inherited in an X-linked dominant manner, 3 with an affected male passing the defective gene to all his daughters and none of his sons. In contrast, an affected female will pass the gene to half of the daughters and half of the