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Vitamin D has an important role in bone-metabolism (and its deficiency can cause preterm osteopenia, craniotabe and rickets), but it has also non-calcitropic functions. In fact, vitamin D deficiency is correlated to chronic kidney disease, respiratory infections, type 1 diabetes, psoriasis, Crohn disease and neonatal hypocalcemia. Because of the vitamin D deficiency is a global problem, its role as a drug is fundamental for the human health in all ages.

This investigation was undertaken to study the clinical and histologic appearance of deciduous enamel from 11 infants who were subjected to blood exchange transfusions (ET) during the first days of life. As a result of the treatment they had a mean of 3 consecutive hypocalcemic days. At the age of 5 years a dental examination of their primary teeth was performed. Four of the children had clinically recorded enamel aberrations correlated with the neonatal period. Exfoliated teeth were then examined histologically. All had a normal major enamel morphology, and the neonatal line was present in all teeth. Histologically investigated teeth with enamel hypoplasia had the aberrations located close to the neonatal line. The conclusions drawn from this study are that hypocalcemia caused by ET in the newborn period did not affect the width of the neonatal line or the major enamel morphology to any extent. Enamel aberrations occurred only when four or more ETs were performed.

The various definitions of neonatal hypocalcemia (NHC) are critically examined. The authors review the known and less known complications of NHC and of its treatment. They emphasize the need for a definition of NHC in terms of serum ionized rather than total calcium concentrations, the rationale for treating symptomatic NHC, as well as the need for further research in infants with asymptomatic NHC.