X-ray photography of unerupted permanent teeth in congenital syphilis.

Changes in the permanent upper central incisors (Hutchinsonian teeth) and in the permanent first molars (Moon, 1877, 1884; Pfluger, 1924) are two of the most important stigmata of late congenital syphilis. These stigmata are not seen until the second dentition, in the incisors after about 7 years of age and in the molars after the 6th year. In radiographs however, Stokes and Gardner (1923) demonstrated in a child aged 5 years the changes, described by Hutchinson, in unerupted permanent upper central incisors and Pincherle (1937) noted changes in the permanent first molars. Further reports of such observations have also been published (Quinlan, 1927; Pitts, 1927; Meyer-Buley, 1930; etc.), but a search ofthe literature revealed only one case (Sarnat, Schour, and Heupel, 1941) in which the x-ray findings had been checked after the second dentition; in this case the syphilitic changes were associated with enamel hypoplasia. The interpretation of x-ray findings in the case of unerupted teeth is frequently difficult, and for this reason our experience based on x-ray examination of the unerupted teeth of patients with congenital syphilis and on follow-up examinations after eruption of the teeth, may be of interest.