10. Dental Anomalies Flashcards
Anatomic Anomalies
n Developmental
n Changes during the formation of teeth
n Initiation to ____ week in utero
n Acquired
n Changes initiated after ____
6th
tooth formation
Supernumerary teeth
n Teeth that develop in addition to the normal complement
n 1-4% of population
n 2:1 ____ to female
n Greater incidence in ____ and Native Americans
male
asians
Supernumerary teeth
n Radiographic features
n Normal looking to ____ form, may be grossly deformed
n Size varies, but generally ____
n Easily identified by ____ the number of teeth
conical
smaller
counting
Supernumerary teeth n Mesiodens n \_\_\_\_ region, \_\_\_\_ more common than mandible n Distodens, distomolar teeth n \_\_\_\_ n Para...molars n \_\_\_\_ region n Peridens n \_\_\_\_ or \_\_\_\_ to normal arch
anterior maxilla distal to third molar buccal lingual
Supernumerary teeth
n Differential diagnosis
n ____
n Aplasia or hypoplasia of clavicles
n Craniofacial abnormalities
n Multiple supernumerary and unerupted teeth
n \_\_\_\_ n Intestinal polyposis n Osteomas and odontomas n Skin fibromas n Epidermal cysts n Impacted and supernumery teeth
cleidocranial dysplasia
gardner’s syndrome
Missing teeth
n Result of pathologic mechanisms n Disruption of formation of \_\_\_\_ n Failure of \_\_\_\_ development n Lack of space in \_\_\_\_ n Genetics
lamina dura
tooth germ
malformed jaw
Missing teeth n Hypodontia n Absence of one or a few \_\_\_\_ n Oligodontia n Absence of \_\_\_\_ teeth n Anodontia n Absence of all \_\_\_\_
teeth
numerous
teeth
Missing teeth Anodontia, Oligodontia
n Ectodermal Dysplasia
n ____ disorder
n missing two ____ derived structures (sweat glands, hair, skin, nails, teeth)
n Severity variable
n number of missing teeth, malformed teeth (usually ____ and ____)
inherited
ectoermally
conical
smaller
Macrodontia
n ____ than normal teeth
n Relative macrodontia
n Normal size teeth in ____ than normal jaw
n Usually affect ____ of teeth rather than entire dentition
larger
smaller
group
Macrodontia
n ____ may cause increase in size or advanced development of adjacent teeth
n Hemihypertrophy
n Pituitary ____
hemangioma
gigantism
Macrodontia
Differential diagnosis n Gemination
n Evidence of a cleft on ____ or root segment
n Fusion
n There will be a ____ tooth
coronal
missing
Microdontia n \_\_\_\_ than normal teeth n Altered morphology n Extra \_\_\_\_ on molars n Peg \_\_\_\_ n Relative \_\_\_\_ n Usually affect \_\_\_\_ of teeth rather than entire dentition
smaller cusps lateral microdontia group
Microdontia
n Consider syndromes such as ____ or progeria
n Generalized microdontia rare, but may occur in ____
congenital heart disease
pituitary dwarfism
Transposition
n Two teeth have exchanged ____
n ____ dentition
n ____ and ____ most common
positions
permanent
canine
first premolar
Fusion
n Union of developing teeth, adjacent tooth germs combined
n Deciduous and permanent
n ____ more common
n ____ fusion more common in both
n 1:1 ____ to female
n Higher incidence in ____ and Native Americans
deciduous
anterior
male
asians
Fusion
n Total or partial depending on stage of odontogenesis
n Size varies from normal to ____ the size
n Bifid crown
n Two teeth joined by ____ or dentin
n Crowns can also be ____ and single, or have an ____ groove
twice
enamel
large
incisocervical
Fusion Differential diagnosis n \_\_\_\_ n \_\_\_\_ In fusion, there are \_\_\_\_ teeth
gemination
macrodontia
fewer
Concrescence
n Two or more teeth united by \_\_\_\_ n Deciduous and permanent teeth n \_\_\_\_ most common n (\_\_\_\_ molar and supernumerary) n 1:1 \_\_\_\_ to female
cementum
maxillary molars
third molar
male
Concrescence
n Differential diagnosis
n Radiographically difficult to determine, roots may be ____
n If treatment necessary, take radiographs from different ____
n Check if PDL space ____ around tooth
superimposed
angles
continuous
Gemination
n Rare, ____ attempts to divide
n Common in ____, but may occur in permanent
n ____ most common
n 1:1 ____ to female
n Enamel or dentin may be ____ or hypocalcified
tooth bud deciduous incisors male hypoplastic
Gemination
n Invagination of crown with \_\_\_\_ n Rarely, \_\_\_\_ division n Radiographic features n Cleft and \_\_\_\_ in crown n Enlarged or partially divided \_\_\_\_
partial division
complete
invaginations
pulp chamber
Gemination
Differential diagnosis
n ____
(less teeth in fusion)
fusion
Taurodontism n \_\_\_\_ enlarged pulp chambers n Crown normal shape and size n \_\_\_\_ and permanent n More common in \_\_\_\_ n Single or \_\_\_\_ teeth
longitudinally
deciduous
molars
multiple
Taurodontism n Radiographic finding, clinically normal n Extension of \_\_\_\_ into elongated body of tooth n Associated with \_\_\_\_
rectangular pulp chamber
trisomy 21 syndrome
Dilaceration
n Disturbance in tooth formation that results in ____ or sharp ____ in tooth
n May occur in ____ or root
curve
bend
crown
Dilaceration n Differential diagnosis n \_\_\_\_ roots n Condensing \_\_\_\_ n \_\_\_\_
Radiograph from different ____
fused
osteitis
enostoses
angles
Dens in dente (invaginatus)
n Infolding of the ____ surface into the interior of the tooth
n Occurs in ____ or root, may involve ____ or root canal
n Most common in ____
n 1:1 ____ to female
outer crown pulp chamber crown male
Dens in dente n Coronal invaginations n anomalous infolding of enamel organ into \_\_\_\_ n \_\_\_\_ lining in fold
dental papilla
enamel
Dens in dente
n Root invaginations (radicular dens invaginatus)
n Invaginations of ____
n Lined with ____
n Can retract and cut off leaving remnants of
____ in canal
n Mandibular first and second ____
hertwig’s epithelial
cementum
PDL
premolars
Coronal dens in dente
n Clinically- pit at incisal edge or ____
n Prominent ____ and cingulum
n ____ >maxillary centrals > premolars > canines
n Rare on ____
cingulum
lingual ridges
maxillary lateral
mandibulars
Dens in dente
n Clinically
n Risk of ____ disease
n Pit difficult to clean, prone to caries
n Difficult to detect, may quickly involve ____
n ____ restoration
pulpal
pulp
prophylactic
Dens evaginatus
n Outfolding of the ____ organ
n Enamel-covered tubercle on occlusal surface of ____, less commonly molar
n Higher frequency in ____ and Native Americans
enamel
premolar
asians
Dens evaginatus n Tubercle of enamel on \_\_\_\_ surface n Usually in \_\_\_\_, may be bilateral n Tubercle has \_\_\_\_, slender pulp horn n If worn by \_\_\_\_ teeth, appears as \_\_\_\_ facet with black pit
occlusal mandible dentin core opposing circular
Dens evaginatus n Occlusal interference or marked abrasion n Remove \_\_\_\_ n Pulp \_\_\_\_ n (prevent \_\_\_\_)
aseptically
capped
infection
Amelogenesis Imperfecta
n Developmental disturbance that interferes with ____ formation
n Enamel lacks normal pristine structure
n ____ and root form usually normal
n 14 or more variants, 4 general types
enamel
dentin
Amelogenesis imperfecta n Hypoplasia n Defect in \_\_\_\_ n Thin enamel, \_\_\_\_ shows through n \_\_\_\_ color n Undersized n No \_\_\_\_ contact n Low, flat cusps n \_\_\_\_ common
ameloblasts dentin yellowish-brown interproximal anterior open bite
Amelogenesis imperfecta
n Hypomaturation n Enamel has normal \_\_\_\_ with mottled appearance n Enamel soft (similar to dentin) n Radiopacity of enamel same as \_\_\_\_ n Enamel may crack away n Clear to \_\_\_\_, yellow or brown
thickness
dentin
cloudy white
Amelogenesis imperfecta
n Hypocalcification
n Enamel normal thickness
n Enamel poorly ____ (less dense than dentin)
n Fractures as soon as in ____
n Enamel and dentin abrade rapidly, often to
____ level
n Enamel ____, tends to stain dark brown
n ____ not common
mineralized function gingival permeable caries
Amelogenesis imperfecta
n Hypomaturation/ hypocalcification n Dominant defect is ____
n Mottled enamel, yellow/brown teeth
n Hypocalcification/hypomaturation n Dominant defect is ____
n ____ enamel
hypomaturation
hypocalcification
thin
Amelogenesis imperfecta
n Diagnosis primarily ____
n Radiographic features
n Hypoplastic
n ____ crown
n Thin opaque layer of enamel n Low or absent ____
n Enamel density normal
n ____ mottled density in enamel (pitted enamel)
clinical
square
cusps
localized
Amelogenesis imperfecta
n Radiographic features
n Hypomaturation
n ____ enamel thickness
n Enamel density same as ____
n Hypocalcified
n ____ enamel thickness
n Enamel density more ____ than dentin
normal
dentin
normal
radiolucent
Amelogenesis imperfecta
n Differential diagnosis
n Dentinogenesis imperfecta
n Advance abrasion with secondary dentin obliterating ____, AI similar to DI
n Dentinogenesis imperfecta n \_\_\_\_ crowns n Narrow roots n \_\_\_\_ density of remaining enamel n Obliteration of \_\_\_\_ and root canals
pulp chambers
bulbous
normal
pulp chambers
Dentinogenesis imperfecta n Developmental disturbance primarily in \_\_\_\_ n Autosomal \_\_\_\_ n 1:1 \_\_\_\_ to female n Enamel may be \_\_\_\_
dentin
dominant
male
thinner
Dentinogenesis imperfecta n Type I n Associated with \_\_\_\_ n Pulp chambers and roots small and \_\_\_\_ n \_\_\_\_ affected more severely than permanent
n Type II
n Similar to Type I but no ____ defects
n Expression ____
osteogenesis imperfecta underdeveloped deciduous skeletal variable
Dentinogenesis imperfecta
n Teeth have ____ translucency
n Yellow to blue-gray
n Enamel ____ easily
n Crowns wear down easily, often to level of gingiva
n Exposed ____ stains easily, dark brown to black
amber-like
fractures
dentin
Dentinogenesis imperfecta
n Radiographic features
n Crowns normal ____
n Cervical constriction gives bulbous appearance to crown
n Slight to marked ____
n Roots short and slender
n Initially normal ____, eventually obliterated or threadlike by secondary dentin
size
attrition
pulp chambers
Osteogenesis imperfecta
n Hereditary, autosomal ____
n Inborn error in ____ collagen, “brittle bones” n 25% have dentinogenesis imperfecta
n Clinical findings n \_\_\_\_ sclera n Skeletal deformities n Progressive \_\_\_\_ n Class III malocclusion n Increased incidence \_\_\_\_
dominant
type I
blue
osteopenia
impacted first and second molars
Dentin dysplasia
n Clinically similar to DI, but is more rare
n Type I (radicular)
n Normal ____ and shape, sometimes ____
n Often ____, drifting teeth
n Exfoliate with little ____
n Type II (coronal)
n ____ teeth similar to DI
size
bluish-brown
misaligned
trauma
deciduous
Dentin dysplasia
n Radiographic features n Type I n Roots \_\_\_\_, abnormally shaped n \_\_\_\_ obliterated prior to eruption n 20% have associated \_\_\_\_ n \_\_\_\_ of residual pulp n \_\_\_\_ on noncarious teeth a distinguishing feature
short pulp chambers periapical pathology microcommunication PAP
Dentin dysplasia
n Type II
n Pulp chambers ____ after eruption
n Pulp chambers appear ____-shaped due to hypertrophic dentin
n Pulp stones
n ____ shaped pulp chambers on anterior and premolar teeth
obliterated
flame-shaped
thistle-tube
Dentin dysplasia
n Differential diagnosis n Need to distinguish from DI n \_\_\_\_ shape pulp chambers n Generally \_\_\_\_ morphology n Normal or no \_\_\_\_ n \_\_\_\_ on noncarious teeth
thistle-tube
normal
roots
apical rarefying osteitis
Odontodysplasia
n Rare condition, typically localized to adjacent teeth in quadrant
n Enamel and dentin hypoplastic and ____
n Clinically
n ____
n Mottled brown due to staining
n ____
n Susceptible to ____, fractures, and pulpal infections
hypocalcified
small
brittle
caries
Odontodysplasia n Radiographic features n \_\_\_\_ appearance n Pulp chambers and root canals large due to thin \_\_\_\_ layer n Poorly outlined \_\_\_\_, short roots n Enamel \_\_\_\_, or absent
ghostlike
dentin
roots
thin
Odontodysplasia n Differential diagnosis n Distinguish from DI n Not \_\_\_\_ n Enamel is hypoplastic n Usually only \_\_\_\_ of arch affected
hereditary
segment
Enamel pearl
n Small globule of enamel, usually on ____ of molars
n 3% population
n From ____
prior to losing enamel forming potential
n Core of ____, rarely pulp horn
roots
hertwig’s epithelial root sheath
dentin
Enamel pearl
n Trifurcation of ____ and bifurcation of mandibular molars
n Apical to CEJ
n (below gingival crest, not detected clinically) n Radiographically- ____, round radiopacity
n Differential diagnosis n \_\_\_\_ (detected clinically) n Pulp stone (change vertical angulation) n Superimposition of molar roots at \_\_\_\_ (change \_\_\_\_ angulation)
maxillary molars smooth calculus furcation horizontal
Talon cusp n Hyperplasia of \_\_\_\_ of incisor n Supernumerary cusp n \_\_\_\_ are caries prone n Radiographically, cusp superimposed over crown
n Differential diagnosis
n May simulate a ____ tooth
n Use ____ object technique to distinguish
cingulum
grooves
supernumerary
buccal
Turner’s hypoplasia
n Term to describe a permanent tooth with a localized ____ defect on crown
n Caused by ____ (deciduous) or trauma
n Severity depends on severity of insult
n Affects developing ____
n Disturbs matrix formation and calcification
n Hypocalcified with ____ to pitting and changes in morphology of crown
hypoplastic
infection
ameloblasts
staining
Congenital syphilis
n 30% of patients with congenital syphilis
n Direct infection of developing tooth,
n Dental hypoplasia (permanent)
n Hutchinson’s teeth- incisors
n ____ shaped crown
n Incisal edge no wider than ____ portion of tooth
n Mulberry molars
Constricted ____ third of crown, occlusal no wider than ____ portion of tooth
n Cusps ____ and poorly formed
n Enamel ____, globular- like a mulberry
screwdriver
cervical
occlusal
cervical
small
hypoplastic
Acquired anomalies n \_\_\_\_ n Abrasion n \_\_\_\_ n Resorption n Secondary \_\_\_\_ n Pulp stones n Pulpal \_\_\_\_ n Hypercementosis
attrition
erosion
dentin
sclerosis
Attrition
n Physiologic wear of dentition n Wear ____
n Dentinal exposure- staining
n ____ as dentin wears faster than enamel
facets
cupping
Abrasion n Non-\_\_\_\_ wear of teeth due to contact with foreign substances n Tooth \_\_\_\_ n Dental floss n Pipe \_\_\_\_ n Denture clasps
physiologic
brushing
smoking
Erosion
n Teeth are eroded by a ____, commonly an acid
n Chronic vomiting or acid reflux
n Acidic diet
n ____ defects on crown
n Diagnosis by history and clinical exam
n Edges of defect more ____ than abrasion defects
chemical
radiolucent
rounded
Resorption
n Removal of tooth structure by ____
n Possible sequelae of infection, excessive ____ or function, local tumors or cysts
odontclasts
pressure
Internal resorption
n Resorption within pulp chamber/canal of the surrounding dentin
n ____ trauma, direct/indirect pulp cap, pulpotomy, enamel invagination
n ____ radiolucent lesion in crown or root
n Differential
n ____
n External resorption
Distinguish by ____ exam, changing horizontal angulation of beam
acute
homogenous
caries
clinical
External resorption
n Resorption of ____ surface of tooth
n Possible sequelae of infection, reimplanted ____, excessive ____ or occlusal forces, impacted teeth
outer
teeth
orthodontic
External resorption
n Apical region
n ____ resorption
n ____ roots
n Pulp canal visible at apex, wide
n Cervical region
n Commonly caused by ____ adjacent tooth
n Differential
n ____
n ____
External resorption- normal intact pulp chamber/canal
smooth blunted unerupted caries internal resorption
Secondary dentin
n Dentin deposited in \_\_\_\_ after primary dentin formation completed n Normal aging process- stimuli such as \_\_\_\_ or minor trauma n (Tertiary) due to pathology n \_\_\_\_ n Trauma n \_\_\_\_ n Erosion n Dental \_\_\_\_
pulp chamber chewing caries abrasion restorations
Pulp stones n Foci of \_\_\_\_ in dental pulp n Radiographic finding n Microscopically apparent after \_\_\_\_yo n Vary in size and shape
____- amorphous and unorganized form of calcification
calcification
50
pulpal sclerosis
Hypercementosis
n Excessive deposition of ____ on tooth roots
n Radiographically see irregular enlargement of roots, more evident on apically
n ____
n Hyperocclusion
n ____
n Hyperpituitarism- gigantism, acromegaly
n Differential diagnosis
n Other radiopacities near ____
n Distinguishing feature- presence of ____ in hypercementosis
cementum inflammation paget's disease root PDL space
