2 dental anomalies Flashcards
causes of environmental enamel defects
hypoplasia/diffuse and demarcated opacities; Turner hypoplasia; molar-incisor hypomineralization; RT effects; fluorosis
exanthamatous fevers of childhood + teeth
if before 2yo, enamel of anterior teeth and 1st molars
if ~4-5yo – cuspids, bicuspids, 2nd molars
turner teeth
periapical inflammation/trauma/caries of overlying primary tooth -> hypoplasia
periapical inflammation/trauma/caries of primary tooth risk of what
turner hypoplasia/turner teeth
cheese molars
molar incisor hypomineralization – northern europe
RT in childhood dental effects
hypodontia, microdontia, enamel/radicular/mandibular hypoplasia
fluorosis look
white challky hypomineralized/mottled enamel
can stain yellow/brown
white challky hypomineralized/mottled enamel
can stain yellow/brown
fluorosis
tooth/tooth contact –>
attrition (eg bruxism)
mechanical external agent on tooth –>
abrasion (toothbrush)
chemical agent on tooth –>
erosion (soft drinks)
enamel loss from loading force
abfraction
chewing of abrasive substance
demastication = attrition + abrasion
erosion due to gastric secretions
perimolysis
perimolysis
erosion due to gastric secretions
demastication
demastication = attrition + abrasion
chewing of abrasive substance
attrition
tooth/tooth contact -(eg bruxism)
abrasion
mechanical external agent on tooth (eg toothbrush)
internal resorption reasons
inflammatory or replacement
inflammatory internal resorption of coronal pulp
pink tooth of Mummery
pink tooth of mummery
inflammatory internal resorption of coronal pulp
rapid external resorption starting at cervical region
invasive cervical resorption
resorption of multiple teeth with no obvious cause
multiple idiopathic apical root resorption
congenital eryhtropoietic porphyria aka, inheritance, what’s wrong, teeth look
gunther disease
AR
porphyrin metabolism
red color of teeth under UV light (Woods lamp test)
alkaptonuria aka, inheritance, what’s wrong, why relevant
black urine disease
AR disorder of phenylalanine and tyrosine metabolism
ochronosis: blue/black discoloration in connective tissue, tendons, cartilage
ochronosis
blue/black discoloration in connective tissue, tendons, cartilage – in alkaptonuria
blue/black discoloration in connective tissue, tendons, cartilage
ochronosis – in alkaptonuria
hyperbilirubinemia causes and why relevant
erythroblastosis fetalis and biliary atresia
can stain teeth
green teeth why
chlorodontia – 2/2 biliverdin deposition
chlorodontia
green teeth – biliverdin deposition
biliverdin deposition
chlorodontia green teeth
pink teeth why
trauma, internal resorption, leprosy
leprosy teeth
pink teeth
why are teeth impacted
barrier or lack of force –> tooth ceases to erupt
eruption sequestrum
bone spicule overlying crown of a partially erupted tooth
bone spicule overlying crown of a partially erupted tooth
eruption sequestrum
ankylosis of tooth
cessation of eription after emergence 2/2 fusion of tooth w bone
fusion of tooth w bone –>
ankylosis
stops eruption after emergence
hypodontia genes
PAX9 molars
MSX1 distal tooth of each type
AXIN2 molars – assoc w colon polyps and colorectal ca
+ He-Zhao deficiency
PAX9 hypodontia
molars
MSX1 hypodontia
distal tooth of each type
AXIN2 hypodontia
molars – assoc w colon polyps and colorectal ca
supernumerary tooth of anterior maxilla
mesiodens
mesiodens
supernumerary tooth of anterior maxilla
distodens
aka distomolar
fourth molar
fourth molar
distodens or distomolar
dental transposition
normal tooth in abnormal location
assoc w hypodontia
teeth present at birth
natal – assoc w riga fede
normal tooth in abnormal location
dental transposition
diffuse microdontia 2 syndromes
Down and pituitary dwarfism
diffuse macrodontia 4 conditions
gigantism, otodental syndrome, Klinefelter (XXY), pineal hyperplasia
unilateral macrodontia manifestation of
hemifacial hyperplasia
single enlarged tooth, normal tooth count
gemination
gemination tooth count
single enlarged tooth, normal tooth count
single enlarged tooth, missing one count
fusion
gemination vs fusion
both have single enlarged tooth
gemination normal count
fusion missing one
union of teeth by cementum only
concrescence
concrescence
union of teeth by cementum only
3 types of accessory cusps
cusp of carabelli, talon cusp, dens evaginatus
cusp of carabelli
palatal surface of mesiolingual cusp of mx 1 molar
accessory cusp on palatal surface of mesiolingual cusp of mx 1 molar
cusp of carabelli
talon cusp where and when
anterior teeth
rubinstein-taybi, sturge weber. ellis van creveld
rubinstein-taybi components (3)
talon cusps, mental retardation, broad thumbs and toes
accessory cusp on mesiobuccal of MD molar
protostylid
protostylid
accessory cusp on mesiobuccal of MD molar
dens evaginatus
cusplike elevation in PM and molars
assoc w shovel-shaped incisors
100% of inuits and indians
cusplike elevation in PM and molars
assoc w
demographic
dens evaginatus
assoc w shovel-shaped incisors
100% of inuits and indians
dens invaginatus aka
and types
aka dens in dente (large invagination) or dilated odontome (–> anomalous tooth development)
coronal (types I, II, III) or radicular (similar to enamel pearls but inside)
enamel pearls inside the root
dens invaginatus radicular type
types of ectopic enamel
enamel pearl (on root) and cervical enamel extension (on bifurcation of molars)
ectopic enamel on molar bifurcation
cervical enamel extension
ectopic enamel on root and in root
on root: enamel pearl
in root: dens invaginatus radicular type
enlargement of body and pulp chamber
taurodontism (mild, moderate, severe)
taurodontism
enlargement of body and pulp chamber
hypercementosis vs cementoblastoma
latter has pain, expansion, and continuous growth
genes in amelogenesis imperfecta (6)
amelx enam klk4 mmp20 wdr72 dlx3 c4orf,,, fam83h
hypoplastic amelogenesis imperfecta what’s up and types (6 presentations)
type I
inadequate deposition of enamel matrix
generalized pitted, localized pitted, AD diffuse smooth, x-linked diffuse smooth, diffuse rough, enamel agenesis)
generalized thin hypoplastic amelogenesis imperfecta
joins all diffuse forms
smooth, rough, and enamel agenesis
diffuse smooth and rough enamel hypoplasia + enamel agenesis
generalized thin hypoplastic amelogenesis imperfecta
hypomaturation amelogenesis imperfecta: what’s up and types
teeth look like
type II
defect of maturation of of crystal structure
(diffuse pigmented, x-linked, snow capped)
normal shape but discolored
hypocalcified amelogenesis imperfecta what’s up and to what extent
type III
mineralization does not occur
diffuse
defect of maturation of enamel crystal structure
type II
hypomaturation amelogenesis imperfecta
enamel mineralization does not occur
type III
hypocalcified amelogenesis imperfecta
inadequate deposition of enamel matrix
type I
hypoplastic amelogenesis imperfecta
type I amelogenesis imperfecta
hypoplastic: inadequate deposition of enamel matrix
type II amelogenesis imperfecta
hypomaturation: defect of maturation of crystal structure (normal shape but discolored)
type III amelogenesis imperfecta
hypocalcified: mineralization does not occur
AI with taurodontism types
hypomaturation-hypoplastic (IVA, thicker enamel) and hypoplastic-hypomaturation (IVB)
type IVA amelogenesis imperfecta
hypomaturation-hypoplastic (IVA, thicker enamel)
AI with taurodontism
type IVB amelogenesis imperfecta
hypoplastic-hypomaturation (IVB)
AI with taurodontism
tricho-dento-osseous syndrome components
AI, taurodontia, kinky hair, osteosclerosis, brittle nails
AI, taurodontia, kinky hair, osteosclerosis, brittle nails
tricho-dento-osseous syndrome
dentinogenesis imperfecta mutation and types
DSPP
I = OI + opaslescent teeth
II = hereditary opalescent teeth
III = Brandywine isolate
DSPP
dentinogenesis imperfecta and DD II
Brandywine isolate
type III dentinogenesis imperfecta
hereditary opalescent teeth
type II dentinogenesis imperfecta
teeth of dentinogenesis imperfecta
opalescent obliteration of root canals and chambers bubous crowns cervical constriction x ray very important for dx
shell teeth
normal thickness enamel, thin dentin, enlarged pulp in dentinogenesis imperfecta
normal thickness enamel, thin dentin, enlarged pulp
shell teeth
dentinogenesis imperfecta
dentin dysplasia type I aka, teeth
aka radicular DD
types Ia-Id
rootless teeth, no pulp, periapical RL, pulp stones
rootless teeth, no pulp, periapical RL, pulp stones
dentin dysplasia type I
dentin dysplasia histo
whorls of tubular dentin
stream flowing around boulders
whorls of tubular dentin histo
stream flowing around boulders
dentin dysplasia type I
stream flowing around boulders
whorls of tubular dentin dentin dysplasia type I
fibrous dysplasia of dentin
radiodensity fills pulp chamber and canal
small foci of RL in pulp (vs dentinogenesis imperfetca) and roots have normal length (vs dentin dysplasia)
radicular dentin dysplasia is
type I
coronal dentin dysplasia is
type II
radiodensity fills pulp chamber and canal
small foci of RL in pulp – ddx
fibrous dysplasia of dentin – and not dentin dysplasia type I
radiodensity fills pulp chamber and roots are normal length – ddx
fibrous dysplasia of dentin – and not dentin dysplasia type I
dentin dysplasia type II aka and teeth
coronal dentin dysplasia
normal root length
also DSPP
deciduous teeth features of dentinogenesis imperfetca
permanent – normal color but flame/thistle shaped pulp and pulp stones
flame/thistle shaped pulp and pulp stones in permanent dentition ddx and difference
dentin dysplasia type II
its primary teeth are like dentinogenesis imperfecta
pulpal dysplasia both dentitions
pulpal dysplasia teeth
both dentitions flame/thistle shaped pulp and pulp stones
regional odontodysplasia tissues, xrays, and histo
affects enamel, dentin, and pulp
ghost teeth on xray
enameloid conglomerates on histo
ghost teeth on xray
regional odontodysplasia
enameloid conglomerates on histo
regional odontodysplasia and amelogenesis imperfetca
cheese molars
molar-incisor hypomineralization
white chalky enamel
fluorosis
amoxicillin and developing teeth
similar to fluorosis
affects 1st molars and mx central incisors
cupped lesions on teeth
erosion (acid)
v shaped cervical lesions on teeth
abfraction
tooth resorption types, why,, which more common
internal (by pulp cells) and external (by PDL cells, more common)
factors assoc w external resorption (4)
zoster, Pagets, cysts, tumors
inflammatory internal resorption what happens
dentin replaced by granulation tissue
pink tooth of mummery what is
inflammatory internal resorption in coronal pulp
metaplastic internal resorption aka and what happens
aka replacement internal resorption
dentin replaced by bone
area is radiodense
external resorption on xrays
moth eaten, usually apical
which cells cause tooth resorption
dentinoclasts
dentin replaced by granulation tissue
inflammatory internal resorption
inner dentin replaced by bone
replacement/metaplastic internal resorption
moth eaten apical root defects
external resorption
rapid external resorption starting at cervix of teeth
invasive cervical resorption
resorption of multiple teeth without obvious cause
multiple idiopathic apical root resorption
how can gingival hemorrhage stain teeth
green from breakdown of Hb into biliverdin
stannous fluoride staining
labial surfaces of anterior teeth and occlusal of posterior teeth
chlorhexidine staining
interproximal surfaces near gingival margins
listerina and sanguinaria also
gunther disease aka and effect on teeth
congenital erythropoietic pophyria
deposition of porphyrin
red teeth
ochronosis what is??
blue/black teeth, connective tissues, tendons, cartilage
alkaptonuria (black urine disease: AR; phenylalanine and tyrosine metabolism)
chlorodontia why
green teeth
hyperbilirubinemia
2/2 biliverdin deposition