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
pink teeth reasons (4)
trauma
inflammatory internal resoprtion
leprosy (mx incisors)
postmortem
tetracycline and teeth
incorporates into developing tooth bright yellos to dark brown UV diagnostic (yellow fluorescence)
UV tetracycline teeth
yellow fluorescence
minocycline teeth
blue gray discoloration of alveolus evident though thin mucosa
impacted tooth what happens
eruption stops before emergence
green teeth reasons
chlorodontia
hyperbilirubinemia
2/2 biliverdin deposition
red teeth why
congenital erythropoietic porphyria )aka gunther dz
deposition of porphyrin
blue black teeth why
ochronosis, alkaptonuria (AR, phenylalanine and tyrosine metabolism)
blue gray alveolus discoloration
minocycline – seen through thin mucosa
yellow/brown teeth why
tetracycline – yellow fluorescence under UV
incorporates into developing tooth
eruption stops before emergence
impacted tooth
bone spicule over crown of partially erupted tooth
eruption sequestrum
eruption stops after emrgence – why? which teeth most common?
ankylosis
tooth fuses w bone
most common in md primary first molars
total lack of teeth
anodontia – usually hypohydrotic ectodermal dysplasia
lack of 1+ teeth
hypodontia
lack of 6+teeth
oligodontia
hypodontia vs oligodontia
hypo == lack 1+
oligo – lack 6+
PAX9 and teeth
hypodontia, esp molars
MSX1 and teeth
hypodontia, distal tooth of every type
he zhao
hypodontia
which hypodontia gene is assoc w colonic polyps and colorectal ca
AXIN2
AXIN2
hypodontia, colonic polyps, colorectal Ca
supernumerary tooth of anteiror maxilla
mesiodens
fourth molar
distodens or distomolar
paramolar location
supernumerary tooth lingual or buccal to molar
types of supernumerary teeth
supplemental – normal size/shape
rudimentary – abnormal size/shape
three looks of rudimentary supernumerary teeth
conical, tuberculate, molariform
normal tooth in abnormal location – which teeth affetced
dental transposition
usually canines and first premolars
dental transposition
normal tooth in abnormal location
usually canines and first premolars
teeth present at birth – risks?
natal teeth – birth or shortly thereafter
assoc w riga fede dz
relative microdontia
normal teeth bu macrognathia
diffuse microdontia syndromes (2)
Down syndrome and pituitary dwarfism
relative macrodontia
normal teeth but micrognathia
diffuse macrodontia syndromes (4)
gigantism, otodental syndrome, XYY males, pineal hyperplasia
unilateral macrodontia assoc w
hemifacial hyperplasia
hemifacial hyperplasia and teeth
unilateral macrodontia
otodental syndrome two main components
globe shaped molars and sensorineural deafness
globe shaped molars and sensorineural deafness
otodental syndrome
pituitary dwarfism teeth
diffuse microdontia
Klinefelter males teeth
diffuse macrodontia
pineal hyperplasia teeth
diffuse macrodontia
single enlarged tooth; normal tooth count if anomalous counted as one
gemination
single enlarged tooth; tooth count missin one if anomalous counted as one
fusion
gemination vs fusion
gemination normal tooth count, fusion missing one (if enlarged counted as one)
union of teeth only by cementum – why?
concrescence
developmental or post-inflammatory
3 types of accessory cusps
cusp of carabelli, talon cusp, dens evaginatus
cusp of carabelli
accessory cusp on palatal surface of mesiolingual cusp of mx 1 molar
accessory cusp on palatal surface of mesiolingual cusp of mx 1 molar
cusp of carabelli
protostylid
accessory cusp on mesiobuccal of md molar
accessory cusp on mesiobuccal of md molar
protostylid
talon cusp where and assoc
lingual ant teeth (esp mx lat incisor)
assoc w rubinstein-taybi syndrome
rubinstein-taybi syndrome and teeth
other things?
talon cusp on mx lat incisor
other things: mental retardation, broad thumbs and toes
cusplike elevation on occlusal of PM and molars – risks?
dens evaginatus
25% –> pulpal pathosis
dens evaginatus – risks?
cusplike elevation on occlusal of PM and molars
25% –> pulpal pathosis
shovel shaped incisors who
lingual surface looks like a scoop of a shovel
100% inuits/native americans
15% asians
dens invaginatus
deep surface invagination of crown/root lined by enamel
most in mx lat incisors
deep surface invagination of crown/root lined by enamel
dens invaginatus
most in mx lat incisors
dens in dente
large invagination - dens invaginatus
dilated odontome
dilated invigination disturbing tooth development
dilated invigination disturbing tooth development
dilated odontome
ectopic enamel names and locations
enamel pearl – root
cervical enamel extension – CEJ of molars bifurcation
enlargement of body and pulp chamber – shape?
taurodontism
rectangular teeth
taurodontism classifications
mild (hypotauro), moderate (meso), severe (hyper)
pts w increased taurodontism
- other local troubles
- 4 syndromes
pts w hypodontia, cleft lip and cleft palate
assoc w ectodermal dysplasia, hypophosphatasia, Down, tricho-dento-osseous syndrome
hypercementosis vs cementoblastoma
cementoblastoma painful, expansion, continuous growth
generalized hypercementosis suggests what
Paget’s
dilaceration what is and why
abnormal angulation/bend of root
idiopathic, trauma, of adjacent lesion
abnormal angulation/bend of root
dilaceration
idiopathic, trauma, of adjacent lesion
all teeth present and erupted bu enamel is v thin
hypoplastic amelogenesis imperfecta
teeth normal shape but discolored and enamel is soft
hypomaturation amelogenesis imperfecta
AMELX9
amelogenesis imperfecta
amelogenin
ENAM
amelogenesis imperfecta
enamelin
MMP20
amelogenesis imperfecta
enamelysin
KLK4
amelogenesis imperfecta
kallikrein
DLX3
amelogenesis imperfecta
group of genes
AMBN
amelogenesis imperfecta
ameloblastin
normal tooth shape but soft and very dark enamel
hypocalcified amelogenesis imperfecta
amelogenesis imperfecta + taurodontism
hypomaturation-hypoplastic (IVa, thicker enamel) and hypoplastic hypomaturation (IVB)
tricho-dento-osseous syndrome components (5)
amelogenesis imperfecta + taurodontism, kinky hair, osteosclerosis, brittle nails
amelogenesis imperfecta + taurodontism, kinky hair, osteosclerosis, brittle nails
tricho-dento-osseous syndrome
dentinogenesis imperfetca aka
hereditary opalescnet teeth
Capdepont’s teeth
Capdepont’s teeth
dentinogenesis imperfetca
dentinogenesis imperfetca vs osteogenesis imperfecta
dentinogenesis imperfetca DSPP, no systemic disorder
osteogenesis COL1A1/A2
dentinogenesis imperfetca lewk
blue/brown and translucent
bulbous crowns, cervical construction, thin roots, obliteration of canals and chambers
blue/brown and translucent teeth
dentinogenesis imperfetca
bulbous crowns, cervical construction, thin roots, obliteration of canals and chambers
dentinogenesis imperfetca
shell teeth
enamel normal thickness, thin dentin, very enlarged pulp
dentinogenesis imperfecta
enamel normal thickness, thin dentin, very enlarged pulp
shell teeth
dentinogenesis imperfecta
dentinogenesis imperfecta histo
shot tubules in granular dentin w calcifications
dentin dysplasia types/subtypes
type I - radicular (Ia-Id)
rootless teeth, no pulp, periapical RL, pulp stones
type II – coronal
normal root length, DSPP mutation
deciduous teeth look like dentinogenesis imperfecta’
permanent normal color but flame/thistle shaped pulp and pulp stones
flame/thistle shaped pulp and pulp stones
dentin dysplasia type II if only permanent
pulpal dysplasia if both dentitions
rootless teeth
dentin dysplasia type I
fibrous dysplasia of dentin ddx
radiodensity fills pulp chamber and canal
small foci of RL in pulp (vs dentinogenesis imperfecta)
roots normal length (vs dentin dysplasia)
teeth no pulp and no roots
dentin dysplasia type I
teeth no pulp but normal roots
fibrous dysplasia of dentin
dentin-dysplasia like teeth – 5 systemic dzz
calcinosis universalis tumoral calcinosis rhematoid arthritis vitaminosis D sclerotic bone + skeletal abnormalities
dentin dysplasia type I histo
whorls of tubular dentin with peripheral layer of normal dentin
(stream flowing around boulders)
(stream flowing around boulders)
dentin dysplasia type I
whorls of tubular dentin with peripheral layer of normal dentin
dentin dysplasia type II histo
primary teeth like dentinogenesis imperfecta (short tubules in granular dentin with calcifications)
permanent teeth atubular dentin and pulp stones
regional odontodysplasia aka and what is
ghost teeth
non-hereditary developmental anomaly of enamel, dentin, pulp
what’s wrong in regional odontodysplasia
vascular, neural, growth abnormalities
some cases assoc w vascular nevi
teeth in regional odontodysplasia
ghost teeth
v thin enamel and dentin around enlarged radiolucent pulp
ghost teeth
v thin enamel and dentin around enlarged radiolucent pulp
regional odontodysplasia
regional odontodysplasia histo
enameloid conglomerates (focal collections of basophilic calcifications) also seen in AI
enameloid conglomerates
focal collections of basophilic calcifications)
regional odontodysplasia and amelogenesis imperfetca
qualitative vs quantitative enamel defect
qualitative - variation in translucency – enamel opacity
quantitative – hypoplasia – pits and grooves
decisuous teeth crown development
14th week in utero - 12 mo
permanent teeth crown development
6mo-15yo
enamel defect in permanent tooth 2/2 periapical disease or trauma of primary tooth
turner hypoplasia
radioation dose to cause enamel hypoplasia
0.72Gy
mottled enamel
fluorosis
attrition locations
occlusal surfaces, lingual max, labial mand
abrasion location
prominent teeth, buccal surface
abfraction location
cervical area or sublingual gingiva
facial of bicuspids
perimolysis conditions
gastric acid erosion
GERD< bulimia
erosion locations
facial/palatal maxilla
facial/occusal mandibular
central depression surrounded by enamel
inflammatory internal resorption what happens
dentinal tubules replaced by granulation tissue
replacement/metaplastic internal resorption what happens
dentinal tubules replaced by cementum or bone
pink tooth of mummery what it, why pink
internal resorption affecting the coronal part, causes the blood
vessels to approach the surface and pink discoloration
multiple areas of invasive external cervical resorption
occurs , cause unknown
Multiple idiopathic root resorption:
rapid external resorption at neck of tooth
invasive cervical resorption
moth eaten apical/mid portion of root
external resorption
stannous fluoride cause of staining
tin (stannous) + bacteria hydrogen sulfide
congeniral eryhtropoietic porphyria inheritance, reasons, color, additional color features
AR
Deposition of porphyrin in teeth
Also appears in urine
Red-brown color that exhibits a red fluorescence when exposed to Wood’s UV light
red brown teeth and urine
congeniral eryhtropoietic porphyria
alkaptonuria tissue phenomenon, inheritance, color features
(Ochronosis):
AR
Blue-black pigmentation in CT, sclera, teeth, cartilage
blue-black cartilage and sclera
ochronosis in alkaptonuria
Congenital erythropoietic porphyria aka and tooth color
Gunter disease
red brown teeth
red fluorescnece on Wood’s lamp test
alkaptonuria tooth color
blue black in cervical areas
jaundice tooth color
blue black in cervical area
green (chlorodontia) 2/2 biliverdin from bilirubin
causes of hyperbilirubinemia in infants
erhtroblastosis fetalis
biliary atresia
green teeth
chlorodontia
hyperbilirubinemia
IV ciprofloxacin for klebsiella in kids
trauma tooth color when
pink 1-3 wks after trauma
yellow teeth after trauma
pulp obliteration, calcific metamorphosis
lepromatous leprosy teeth
pink/red maxillary incisors
pink/red maxillary incisors
trauma or leprosy
tetracycline teeth
yellow-brown
minocycline teeth and other locations
gray on incisal hald
also deposits in thyroid / sclera / nails / bones / teeth
cirpfloxacin scenario and teeth
IV for Klebsiella in kids
green teeth
ankylosis most freq affected teeth
Mandibular primary 1st molar > Mandibular primary 2nd molar > Maxillary primary 1st
permanent molar
pax9 teeth
AD / Oligodontia in permanent molars
msx1 teeth
AD / Distal tooth of each type
Most common 2nd PM / 3RD M
axin2 teeth
AD / 2nd + 3rd molars
+adenomatous polyps and colorectal ca
chinese hypodontia gene
He Zhao deficiency
pakistain hypodontia
LTBP3
eda teeth
Non syndromic x –linked
Max + mand CI > LI > C > PM
WNT10A teeth
Non syndromic
Max + mand lat. Incisors + 2nd PM
hypodontia which teeth
3rd molars > 2nd PM > LI
types of rudimentary supernumeraries
Conical; small peg shaped
Tuberculate; barrel shaped
Molariform; small PM-like or molar –like
normal teeth erupt in abnormal site
Dental transposition:
Dental transposition:
normal teeth erupt in abnormal site
neonatal teeth: timing, what are they
teeth
first 30 days of life / most are premature eruption of primary teeth Mandibular incisors (85%) > maxillary incisors (11%) > posterior teeth (4%)
Riga-Fede Disease:
New born with traumatic ulceration of anterior ventral
tongue during breast feeding due to neonatal teeth
New born with traumatic ulceration of anterior ventral
tongue during breast feeding due to neonatal teeth
Riga-Fede Disease:
5 macrodontia conditions
Gigantism Otodental syndrome : Globodontia + Sensory loss XYY Hyperinsulinemia Pineal Hyperplasia
Globodontia + Sensory loss
Otodental syndrome
2 microdontia conditions
Down syndrome
Pituitary dwarfism
Enamel pearl locations
Ectopic enamel on roots of max 3rd molars > mand molars
Dense Invaginatus types:
Type 1 = confined to crown ( Most common )
Type 2 = extends below CEJ
Type 3 = extends through root ( least common
cervical enamel extension location
Mandibular molars most common but can occur at any molar
globodontia look, association, dentition condition, radio look
gigantic globe shaped teeth “ TIED END OF SAUSAGE”
Ass w otodental syndrome
PM usually missing
Radiograph: short roots, bulbous crowns, pulp stones
gigantic globe shaped teeth
globodontia
TIED END OF SAUSAGE
globodontia
lobodontia inheritance, affected teeth
AD
Cuspids and PM fang-like cusps / Tooth size reduced
Cuspids and PM fang-like cusps /
lobodontia
three type families of amelogenesis imperfecta
Hypoplastic
Hypomineralization (hypomaturation / hypocalcification)
AI w taurodontism (hypomaturation / hypoplastic)
cheesy enamel
hypocalcified AI
hypocalcified AI enamel
cheesy
amelogenesis imperfecta similar to fluorosis
Hypomaturation
tricho-dento-osseous syndrome inheritance and look
AD
Kinky hair at birth but may straighten with age
Osteosclerosis affects base of skull and mastoid process
Short ramus and obtuse angle
assoc w AI
8 amelogenesis imperfecta genes with products
AMELX - amelogenin - 90% ENAM - enamelin - 5% MMP20 - enamelysin KLK4 - kallikrein 4 FAM83H C4orf26 - extracellular matrix DLX3 WDR72 - protein scaffold
most commonly affected genes in amelogenesis imperfetca with products
AMELX - amelogenin - 90%
ENAM - enamelin - 5%
AMELX inheritance and type
x-linked amelogenesis imperfecta
hypomat/hypoplastic
ENAM inheritance and type
AD, AR amelogenesis imperfecta
hypoplastic
MMP20 inheritance and type
AR
Pigmented hypomaturation amelogenesis imperfecta
KLK4 type
hypomaturation amelogenesis imperfecta
FAM83H inheritance and type
AD
hypocalcified amelogenesis imperfecta
C4orf26 inheritance and type
AR amelogenesis imperfecta
hypomineralized
DLX3 type
Hypmat/hypoplastic amelogenesis imperfecta w taurodontism
Maybe ass w trich-dento-oseeous syndrome
WDR72 inheritance and type
AR
amelogenesis imperfecta
hypomaturation
amelogenin gene
AMELX
enamelin gene
enamelin
enamelysin gene
MMP20
kallikrein 4 gene
KLK4
scaffold gene in amelogenesis imperfecta
WDR72
extracellular matrix gene in amelogenesis imperfetca
C4orf26
AD genes of amelogenesis imperfecta
ENAM and FAM83H
x linked genes of amelogensis imperfetca
AMELX only
tricho dento osseous syndrome gene
DLX3 poss
AR genes of amelogenesis imperfetca
MMP20, C4orf26, WDR72
hypoplastic amelogenesis imperfecta genes, inheritance, mechanism, presentations
AD: ENAM
AR: More severe
Inadequate deposition of enamel matrix
Generalized: pinpoints
Local: mid 1/3 of buccal
Inadequate deposition of enamel matrix amelogenesis imperfecta
hypoplastic
amelogenesis imperfecta what’s affected, teeth look, other mouth problems
Both dentition Pulpal calcification Taurodontism Delayed eruptions Gingival overgrowth Open bite occlusion
hypomaturation vs hypocalcification amelogenesis
both are hypomineralization
Hypomaturation: Enamel chips & fractures but no loss of enamel during eruption White opaque, mottled E Resemble fluorosis 1- Pigmented 2- X-linked 3- Snow capped
Hypocalification:
Normal shape
Enamel soft and lost easily (cheesy) except cervical
portion (spared)
amelogenesis:
Hypomat /hypoplastic vs Hypoplastic/hypomat
inheritance?
AI with taurodontism – AD
Hypomat /hypoplastic : pits only
Hypoplastic/hypomat : Enamel is thin and pits
dentinogenesis imperfecta-like changes in systemic diseases (4)
OI
Ehlers-Danlos Syndrome
Goldblatt syndrome
Schimke immune-osseous dysplasia
dentinogenesis imperfecta what is and aka
Development of dentin is disturbed WITHOUT systemic disease
Capdepont’s teeth/hereditary opalescent dentin: Also known as DGI
Shell teeth: expanded pulp in DGI
Systemic diseases in correlation with dentin dysplasia-like alterations:
Calcinosis Universalis
RA and hypervitaminosis D
Sclerotic bone and skeletal anomalies
Tumoral calcinosis
OI w opalescent teeth inheritance and genes
AD
COL1A1, COL1A2
DSPP disorders and inheritance
DI, dentin dysplasia 2
AD
dentin dysplasia 1 inheritance and gene
AD, gene unknown!
Dentinogenesis Imperfecta aka, injeritance, affected teeth, look
AKA:
Hereditary opalescent dentin
Capdepont’s teeth
AD
Both Dentition Dec > per Bulbous crowns cervical constriction early obliteration of pulp shell teeth hearing LOSS
dentin dysplasias types and inheritance
DD1 – radicular
DD2 – coronal
both AD
regional odontodysplasia aka, inheritance
age, affected teeth
ghost teeth
localized non hereditary
Both dentitions
Bimodal peak : 2-4 / 7-11 yrs
Max > mand
Ant > post
One qua > 2 quad
otodental syndrome genetics, teeth, major points
AD / chr # 11q13
FGFR3
Globodontia (large teeth)
Hearing loss
tricho-dento-osseous syndrome inheritance, possible mutation,
manifestations
AD – poss DLX3
hypoplastic/hypomaturation AI-like
Osteosclerosis base of skull & mastoid process mainly Kinky hair Brittle nails Short ramus and obtuse angle
Enameloid conglomerate: what is and where
basophilic enamel like calcifications
regional odontodysplasia and amelogenesis imperfecta
pathoses associated with regional odontodysplasia (9)
Ectodermal dysplasia Epidermal nevi Hypophosphatasia NF Rh factor incompatibility Ipsilateral facial hypoplasia Hydrocephalus Orbital Coloboma Vascular Nevi
proposed causes of regional odontodysplasia (9)
Abnormal migration of neural crest cells Latent virus Local circulatory deficiency Local trauma Hyperpyrexia Malnutrition Medication Radiation Somatic