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Pediatric Dentistry > AAPD Handbook Chap 2 - Dental Development, Morphology, Eruption, and Related Pathologies > Flashcards

AAPD Handbook Chap 2 - Dental Development, Morphology, Eruption, and Related Pathologies Flashcards

1
Q

syndromes with supernumerary teeth

A

Apert, cleidocranial dysplasia, gardner syndrome, crouzon syndrome(craniofacial dysostosis), sturge-weber, orofaciodigital syndrome I, hallermann-strieff, CLP, down syndrome

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2
Q

apert snydrome? aka

A

aka acrocephalosyndactyly. narrow, high palate, 30% cleft of soft palate, delayed or ectopic eruption, shovel shaped incisors, hypoplastic midface, supernumerary teeth

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3
Q

cleidocranial dysplasia

A

delayed development/eruption of perm teeth, supernumerary, delayed primary exfoliation, pseudoprognathism(mid-face hypoplasia), enamel hypoplasia

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4
Q

gardner syndrome

A

delayed eruption, supernumerary teeth, osteomas of the jaw

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5
Q

crouzon syndrome, aka

A

aka craniofacial dysostosis. dysostosis is a disorder affecting development of bone. hypoplastic midface, maxillary hypoplasia, inverted V shaped palate, supernumerary teeth

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6
Q

sturge-weber syndrome

A

port-wine capillary malformation, overgrowth of bony maxilla, supernumerary teeth

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7
Q

orofaciodigital syndrome I

A

multiple or hyperplastic frenula, cleft tongue, cleft alveolus(hypodontia ensues), supernumerary teeth common if no cleft alveolus, median pseudocleft of upper lip, cleft palate

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8
Q

hallermann-strieff snydrome A

A

mandibular hypoplasia, high palatal vault, premature teeth, delayed primary exfoliation, malar hypoplasia(malar is zygomatic bone so afx maxilla, eyes), supernumerary teeth

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9
Q

hypodontia not associated with a syndrome is thought to be passed on in an

A

autosomal dominant fashion

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10
Q

there is a relationship between the agenesis(failure of organ to develop) of what teeth?

A

agenesis of third molars is associated with agenesis of one or both perm maxillary laterals

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11
Q

what conditions can be characterized by hypodontia

A

ectodermal dysplasia, crouzon(craniofacial dysostosis), non syndromic CLP, achondroplasia, chondroectodermal dysplasia(ellis-van creveld), incontinentia pigmenti, orofaciodigital syndrome I, hallermann-strieff, rieger syndrome, seckel syndrome, williams syndrome

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12
Q

ectodermal dysplasia features

A

conical crowns, hypodontia to anodontia, deficient alveolar ridge

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13
Q

achondroplasia features

A

midface hypoplasia, frontal bossing(prominent forehead)

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14
Q

chondroectodermal dysplasia(ellis-van creveld) features

A

premature teeth -25%, absent maxillary sulcus, conical crowns, partial anodontia, enamel hypoplasia

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15
Q

incontinentia pigmenti features?

A

conical crowns, delayed eruption, premature teeth, CLP

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16
Q

reiger syndrome features?

A

midface hypoplasia, delayed eruption, hypodontia, usually upper incisors

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17
Q

seckel syndrome

A

microcephaly(small head), facial hypoplasia

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18
Q

williams syndrome

A

partial anodontia, prominent lips, microdontia, enamel hypoplasia

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19
Q

anomalies of size(micro/macro dontia) associated with what stage of development?

A

proliferation

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20
Q

what must be ruled out when macrodontia is observed?

A

single tooth macrodontia is rare, rule out gemination and fusion

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21
Q

microdontia frequency?

A

lateral incisors, 2nd premolars, 3rd molars

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22
Q

Conditions exhibiting microdontia

A

oligodontia, ectodermal dysplasia, chondroectodermal dysplasia(ellis-von creveld), hemifacial microsomia, down syndrome, crouzons syndrome

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23
Q

conditions exhibiting macrodontia

A

hemifacial microsomia, accelerated eruption on affected side submucous cleft, crouzon syndrome, otodental dysplasia aka globodontia(teeth and hearing abnormalities)

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24
Q

gemination

A

more common in primary dentition, 1 tooth tries to divide into 2, bifid crown, single root and pulp chamber, familial inheritance, clinical dx is made by seeing an extra crown.

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25
Q

twinning

A

complete cleavage of single bud results in supernumerary mirror image tooth

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26
Q

fusion

A

more common in primary dentition and higher frequency in japanese. is the dentinal union of two developing teeth. two separate pulp chambers, separate or fused canals, may appear as large bifid crown with one chamber. Clinical dx, bifid crown with normal complement of crowns

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27
Q

concresence? its etiology?

A

fusion that occurs after root formation(not a true developmental defect). Etiology: trauma, crowding may occur pre or post eruption

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28
Q

anomalies of size and shape occur during _____ and include?

A

morphodifferentiation. dens in dente, dens evaginatus, taurodontism

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29
Q

dens in dente(dens invaginatus)

A

maxillary lateral most affected in both dentitions, invagination of IEE. significant b/c communication b/w oral environment and invagination

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30
Q

dens evaginatus

A

afx mostly males and perm teeth, mostly maxillary incisors. characterized by evagination of enamel epithelium and focal hyperplasia of pulp mesenchyme. Pulp tissue within extra cusp may fx easy

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31
Q

taurodontism

A

failure of HERS invagination. Elongated crowns at the expense of the roots, significant b/c results in large pulps

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32
Q

syndromes with taurodontism

A

klinefelter, tricho-dento-osseous syndrome(TDO),mohr syndrome, ectodermal dysplasia, down syndrome, amelogenesis imperfecta, type IV(hypomaturation-hypoplastic type, with taurodontism), dilaceration

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33
Q

Klinefelter syndrome

A

small cranial dimension, bimaxillary prognathism, taurodontism in 30%

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34
Q

tricho-dento-osseous(TDO) syndrome

A

dolicocephalic(long narrow skull) with frontal bossing, taurodonts have PAROs and high pulp horns, delayed eruption

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35
Q

mohr snydrome(orofaciodigital syndrome II)

A

lobed tongue, upper lip midline cleft, oligodontia

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36
Q

dilaceration.

A

etiology: trauma to primary dentition, such as intrusion.

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37
Q

amelogenesis imperfecta general characteristics

A

heritable enamel defect, multiple inheritance patterns, 4 major types, differentiated from other enamel dfx as it has distinct patterns of inheritance and occurs apart from syndromic, metabolic, or systemic conditions

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38
Q

AI Type I

A

Hypoplastic, insufficient quantity of enamel, both dentitions afxed, autosomal dominant inheritance, anterior open bite seen in 45%

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39
Q

AI Type II

A

Hypomaturation

40
Q

AI Type III

A

Hypocalcified

41
Q

AI Type IV

A

Hypomaturation-hypoplastic with taurodontism

42
Q

Dentinogenesis Imperfecta general chars?

A

heritable dfx of predentin matrix, normal mantle dentin, amorphic and atubular circumpulpal dentin, 3 subtypes

43
Q

DI- Shields type I

A

occurs with OI, primary teeth affected more but perm centrals and 1st molars are often afxed, amber translucence, PARLs, autosomal dominant, rapid attrition

44
Q

DI Shields Type II

A

occurs alone, no OI, both dentitions equally afxed, same chars as DI Type I, irregular or tubular pattern, rapid attrition, autosomal dominant

45
Q

DI Shields Type III

A

rare, brandywine population. bell shaped crowns, shell teeth(short roots, large pulp chambers), multiple pulp exposures, regular tubules, enamel pitting, different expression for the same DI-DII gene.

46
Q

Osteogenesis Imperfecta general chars

A

4 major types, Type I most common, Type II lethal in perinatal period(5 months before and 1 month after birth), DI more common in types III and IV.
bowing of legs, fragile bones(fxs),blue sclera, bitemporal bossing,defective collagen, hearing loss, macrocephaly, autosomal dominant

47
Q

enamel hypoplasia is a potential marker for what dx?

A

celiac disease, predominant locations are both upper and lower primary and permanent central/lateral incisors

48
Q

Dentin dysplasia type 1 aka and chars?

A

radicular dentin dysplasia, normal crown color, short roots or rootless in both dentitions, obliterated pulp chambers, PARLs, mobility and misalignment, autosomal dominant

49
Q

dentin dysplasia type 2 aka and chars?

A

coronal dentin dysplasia, only primary teeth afxed, coronal and root dentin afxed, amber colored crowns, permanent teeth look normal but radiographically have thistle tube shaped pulps, pulp stones, autosomal dominant

50
Q

regional odontodysplasia chars?

A

aka ghost teeth. tooth development arrests. See atubular tracts, irregular tubules, no odontoblastic layer, cementum can be normal or aberrant, thin enamel, both dentitions afxed, central incisor most involved, no established etiology or inheritance pattern

51
Q

other conditions that exhibit dentin abnormalities?

A

vitamin d resistant rickets, hypoparathyroidism, pseudohypoparathyroidism, albright hereditary osteodystrophy, ehlers-danlos syndrome

52
Q

Conditions that exhibit cementum anomalies?

A

hypophosphatasia, epidermolysis bullosa, cleidocranial dysplasia

53
Q

Vitamin D resistant rickets chars?

A

x linked dominant or autosomal recessive, failure of distal tubule reabsorption of phosphate in kidneys, hypomineralized dentin, increased predentin width, enlarged pulp and pulp horns, enamel may be spared

54
Q

hypoparathyroidism chars?

A

permanent teeth afxed, short roots with delayed apical closure, enamel hypoplasia,

55
Q

pseudohypoparathyoridism

A

large pulp chambers, irregular dentinal tubules, small crowns and short roots, pitted enamel surfaces

56
Q

albright hereditary osteodystrophy

A

inadequate H- ion clearance, hypocalcemia, hyperphosphatemia, ectopic calcifications, short stature, brachydactyly(short fingers and toes), blunted roots, small crowns, mental deficiency, x linked dominant, intrapulpal calcifications

57
Q

ehlers-danlos syndrome

A

hyperelastic,fragile skin and mucosa, skin hemmorhages and scars, joint hypermobility, x linked, intrapulpal calcifications,

58
Q

hypophosphatasia

A

lack of serum alkaline phosphatase, urinary phosphoethanolamine, autosomal recessive, little cementum produced, ealy exfoliation of primary dentition

59
Q

epidermolysis bullosa

A

fibrous acellular cementum, excess cellular cementum

60
Q

what type of cementum is deficient in cleidocranial dysplasia?

A

cellular cementum

61
Q

AI Type 3, aka and chars?

A

aka hypocalcified. deficit in mineralization of matrix, normal thickness, soft enamel, anterior open bite in 60%, high calculus formation, delayed eruption, 2 subgroups(AD or AR)

62
Q

enamel fluorosis

A

anomaly of mineralization of enamel. >2ppm = 10% chance of fluorosis, >6ppm = 90% chance.

63
Q

AI Type 2 aka and chars?

A

hypomaturation. normal thickness, low radiodensity, poorly mineralized although less severe than hypocalcified type(type III),mottled brown-yellow-white color, x linked recessive, AR, and AD*

64
Q

AI Type 2 subgroups

A

AR - pigmented
XL-R
AD - snow capped, fairly common

65
Q

AI Type 4 aka and chars?

A

hypomaturation-hypoplastic with taurodontism, mottled yellow-brown enamel with pits, molars are taurodont,

66
Q

blood borne pigments can cause intrinsic staining of teeth. name the pigments and what color they turn teeth

A 
porphyria-porphyrin - purplish brown
bile duct defects - green
neonatal hepatitis, bilirubin - black, gray
Rh incompatibility, blue-green, brown
hemosiderin anemias - gray
dental trauma - red,gray,black
67
Q

Most favorable eruption sequence of primary dentition?

A

ABDCE

68
Q

most favorable eruption sequence of permanent maxillary dentition

A

61245378, sequence more important than timing

69
Q

most favorable eruption sequence of permanent mandibular dentition

A

61234578

70
Q

what clinical guides are used to assess eruption stage/rate of permanent dentition

A

root development, overlying bone, infection, timing of primary tooth loss(before 5yo - delays premolar, after 8yo - accelerates premolar)

71
Q

Premature teeth general chars? what findings associated with premature teeth?

A

erupt prior to 3 months of age, natal teeth(present at birth), neonatal teeth(present within 30 days of birth), natal:neonatal is 3:1, finding assoc with premature teeth is riga-fede dx(sublingual traumatic ulceration from teeth)

72
Q

what structures in the newborn are often confused with premature teeth?

A

bohn nodules(buccal,lingual aspects of maxillary alveolar ridge, mucous gland tissue)
dental lamina cysts, found on crest of alveolar ridge, derived from remnants of dental lamina
epstein pearls, midpalatal raphe, trapped epithelial remnants, visible cysts in 80% of newborns

73
Q

Teething and its associated problems? what are the problems

A

While teething(eruption of primary teeth), babies usually have otitis media, paroxysmal atrial tachycardia, GERD(diarrhea).

74
Q

what is the differential dx when a teething baby presents with associated symptoms? Rule out what?

A

R/O febrile convulsions, URI, bronchitis, eczema, H. flu meningitis, fever, dehydration,

75
Q

Cysts can occur during dental development and eruption, name 4 cysts that can occur?

A

eruption hematoma, primordial cyst, dentigerous cyst, ameloblastoma

76
Q

eruption hematoma chars?

A

dilation of follicular space, blood or tissue fluid, form of eruption cyst

77
Q

primordial cyst chars?

A

from stellate reticulum

78
Q

dentigerous cyst?

A

from reduced enamel epithelium

79
Q

ameloblastoma

A

dentigerous cyst and odontogenic cyst, epithelial rests of malassez, disturbed anemal organ

80
Q

what local causes can delay primary exfoliation and permanent eruption?

A

trauma, impaction, ankylosis, supernumeraries

81
Q

what local and systemic causes can accelerate eruption of primary and permanent teeth?

A

local causes are early loss of primary tooth(closer to time of perm tooth eruption only). systemic causes are hemifacial hypertrophy, precocious puberty, hyperthyroidism, sturge-weber syndrome, chondroectodermal dysplasia, OI, pachyonychia congenita, sotos syndrome(cerebral gigantism)

82
Q

which dx of bone causes premature primary exfoliation

A

fibrous dysplasia

83
Q

which dx of periodontium causes premature primary exfoliation

A

LAP,GAP, papillon-leferve

84
Q

which dx of metabolism causes premature primary exfoliation

A

hypophosphatasia

85
Q

which deviations in growth and development causes premature primary exfoliation

A

hemihypertrophy, premature teeth

86
Q

which dx of blood causes premature primary exfoliation

A

chediak-higashi, cyclic neutropenia

87
Q

which physical and chemical injuries causes premature primary exfoliation

A

acrodynia, facial burns

88
Q

which benign and malignant tumors causes premature primary exfoliation

A

histiocytosis/langerhans cell group, letterer-siwe(fatal), hand-schuller-christian(better px), eosinophilic granuloma(excellent px)

89
Q

which dental anomalies causes premature primary exfoliation

A

dentin dysplasia, odontodysplasia

90
Q

etiologies for ectopic eruption of maxillary first permanent molars? how many self correct?

A

larger mean size of all max prim and perm teeth, larger affected Es and 6s, smaller maxilla, posterior position of maxilla in relation to cranial base(smaller SNA), abnormal angulation of erupting 6, delayed mineralization of some affected 6s
most(66% self correct), much lower in CLP

91
Q

order primary teeth most often ankylosed to least often

A

primary mandibular 1st molar, mandibular 2nd, maxillary 1st, maxillary 2nd molar

92
Q

ankylosed primary teeth often associated with

A

agenesis of succedaneous tooth

93
Q

sequelae of ankylosis

A

deflected eruption path, impacted premolars, loss of arch length and alveolar bone, supraeruption of opposing teeth(esp maxilla)

94
Q

Tx of ankylosed teeth?

A

primarily empirical(derived from experience). Observe primary mand molars, ext, restore to occlusion, luxate(for permanent teeth)

95
Q

prevalence of max central diastema more common in ?

A

6yo(44-97%) than 9yo than 14yo.

96
Q

etiologies of max central diastema

A

normal development of mixed dentition, excessive skeletal growth(acromegaly), pernicious habit(lip biting, digit sucking, pacifier use, infantile swallow with tongue thrust), spaced dentition, missing/peg laterals, exts, excessive OJ, excessive OB, ectopic laterals/crowded to lingual

97
Q

tx of maxillary central diastema

A

after eruption of perm canines, based on dx of cause(bolton analysis helpful)
eliminate habit if present, mesial tipping of central incisors, bodily movement of central incisors, reduction of excessive OJ, enlargement of incisors

Pediatric Dentistry (4 decks)

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