title: Tooth pigmentation caused by bilirubin: a case report and histological evaluation.
abstract: Systemic disorders in pediatric patients, such as congenital biliary atresia, acute liver failure, and biliary hypoplasia, may be the indications for a need of liver transplantation. One of the manifestations of these disorders is the elevated serum levels of bilirubin (hyperbiliru-binemia), a product of hemoglobin degradation, which is deposited in different tissues, including mineralized and soft tissues. When hyperbilirubinemia occurs during the period of dental development, these teeth can develop a green coloration, which remains permanently, because, after maturation, these tissues loose their metabolic activity. This case report describes a 9-year-old girl who required a liver transplant due to biliary atresia when she was three years old. Some of her pigmented teeth needed extraction and afterwards were submitted for histological analysis and compared with sound teeth.
authors.affiliation: Department of Pediatric Clinics, Preventive and Social Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Thais Helena Andreolli do
authors.initials: TH
authors.lastname: Amaral
authors.forename: Carolina de Souza
authors.initials: Cde S
authors.lastname: Guerra
authors.forename: Karina Fittipaldi
authors.initials: KF
authors.lastname: Bombonato-Prado
authors.forename: Francisco Wanderley
authors.initials: FW
authors.lastname: Garcia de Paula E Silva
authors.forename: Alexandra Mussolino
authors.initials: AM
authors.lastname: de Queiroz
mesh_terms: D001656:Biliary Atresia / Q000150:complications; D001663:Bilirubin / Q000032:analysis; D002648:Child; D003481:Cuspid / Q000473:pathology; D003743:Dental Enamel / Q000473:pathology; D003804:Dentin / Q000473:pathology; D005260:Female; D006801:Humans; D006932:Hyperbilirubinemia / Q000150:complications*; D016031:Liver Transplantation; D014075:Tooth Discoloration / Q000209:etiology* / Q000473:pathology; D014094:Tooth, Deciduous / Q000473:pathology
chemical_list: D001663:Bilirubin