Abnormalities of Teeth Flashcards by Kajal Khatri

systemic factors that influence enamel

birth trauma
chemicals
chromosomal anomalies
infections
inherited diseases
malnutrition
systemic disease
neurologic disease

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local factors that influence enamel

physical trauma
electrical burn
radiation
local infection

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which teeth are most affected - turner tooth

facial of premolars and central incisors

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why are premolars affected by turner tooth

usually because abscess under mandibular 1st molars (premolars are pelow)

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why are central incisors often impacted by turner tooth

trauma of central incisors

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molar incisor hypomineralization ethnic predilection

norther europeans (unknown cause)

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clinical features of molar incisor hypomineralization

-white, yellow, or brown enamel
-soft and porous
-enamel chips easily
-teeth very sensitivity and difficult to anesthetize

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hypoplasia cuased by antineoplastic therapy

-age at time of therapy
-form and dose of therapy
-can lead to hypodontia, microdontia, radicular hypoplasia, enamel hypoplasia, mandibular hypoplasia

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mottled enamel (dental fluorosis)

white, chalky demineralization
occasional pitting
caries resistance

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optimal levels of fluoride in water

0.7 ppm

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attrition

tooth to tooth contact
physiologic
occlusal and incisal edges + proximal surfaces
wear is prominent in bruxism

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abrasion

pathological wearing of tooth structure
external agent (ex. improper brushing)

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erosion

non-bacterial chemical loss
food / drink / chemical / GERD

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perimolysis

erosion from gastric contents

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abfraction

occlusal stress - flexural - fracture
usually cervical enamel

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internal resorption

uncommon
pink tooth of mummery

OUTLINE OF PULP CANAL IS WIDENED

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treatment for internal resorption

endo therapy prior to perforation

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external resorption

common
caused by trauma, cysts, tumors, inflammation

OUTLINE OF PULP CANAL IS NOT WIDENED

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causes of extrinsic staining

chromogenic bacteria
ferric sulfide
coffee / tea / tobacco
gingival hemorrhage
medications
stannous fluoride
chlorohexidine

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congenital erythropoietic porphyria

-porphyrin deposition in teeth
-red/brown discoloration
-red fluorescence

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hyperbilirubinemia

-from RBC breakdown
-erythroblastosis fetalis
-biliary atresia
-green discoloration

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calcific metamorphosis

only impacts dental pulp, no pulp seen in radiographs

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lepromatous leprosy

pink / red discoloration

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dental amalgam

gray / black

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medications causing intrinsic staining

tetracyclines (yellow / brown) minocycline (blue / grey)

extrinsic stain managemetn

mechanical removal

intrinsic stain management

chemical removal, cosmetic restorations

most common impacted teeth

17 / 32 1 / 16 6 / 11

treatment options for impacted teeth

observation orthodontically assisted eruption transplantation extration

ankylosis

cessation of eruption after emergence fusion with alveolar bone tooth below occlusal plane

hypodontia

reduction in number of teeth

anodontia

complete lack of tooth formation

oligodontia

lack of 6+ teeth

pseudo-oligodontia

failure of eruption

natal teeth problems

no lip seal problems with suckling trauma to breast trauma to infant tongue

microdontia (definition)

small teeth

microdontia is most often found in

lateral incisors (peg laterals) and maxillary third molars

macrodontia (definition)

large teeth

pituitary gigantism (+association)

increase in amount of growth hormone (generalized macrodontia)

macrodontia and jawbone size

teeth might be normal size, maxilla + mandible are small

unilateral macrodontia is associated with

hemifacial hyperplasia (half of face is large, teeth on one side larger)

germination

single enlarged tooth or joined double tooth. tooth count is normal

fusion

single enlarged tooth, fused teeth share cementum and dentin.

is the tooth count normal with fusion?

no, reduced by one

is the tooth count normal with germination?

yes!

concrescence (definition)

fusion of roots by cementum two fully formed teeth, joined along root surface by cementum

concrescence is related to

trauma and crowding

how does fusion affect extraction of teeth?

if trying to extract tooth + root is fused to adjacent tooth, that will pose problems

cusp of carabelli

palatal surface of mesiopalatal cusp of maillary permanent first molar

what is most important to remember about the cusp of carabelli?

must restore when doing restorative procedures

talon cusp

enlarged cingulum

talon cusps are most common in which teeth?

maxillary lateral and central incisors

dens evaginatus (leong's premolar)

additional cusp in the center of occlusal surface

which teeth do dens evaginatus affect the most?

primarily affects premolars

what 3 clinical implications are there for dens evaginatus?

1. early wear 2. pulp exposure 3. interferes with occlusion

shovel shaped incisors

most often found in maxillary incisors no clinical implications

dens in dente / dens invaginatus

tooth inside a tooth

dens invaginatus clinical complications

1. tooth more prone to caries 2. decay not visible

enamel pearl location

CEJ of buccal root furcation of molars

are enamel pearls more common in the maxilla or mandible?

maxilla

clinical importance of enamel pearls

loss of periodontal attachment inflammatory cysts

enamel pearls + extraction

must engage pearls during extraction

cervical enamel extensions

enamel should stop at cervical margin. if enamel goes more apical, introducing furcation to oral cavity

buccal bifurfaction cyst

typically occur in children (when molar is erupting), swelling and severe pain

taurodontism

enlargement of body and pulpal chamber of premolar or (usually) molar teeth, apical displacement of pulpal floor

which dimension of the pulp chamber increases in taurodontism?

occluso-apical dimension

is the furcation more apically or coronally positioned in taurodontism?

apically positioned

clinical ipmlications of taurodontism

incidental finding no furcation to grasp if extracting

hypercementosis

excessive deposition of cementum (normal PDL space, intact lamina dura)

hypercementosis is often seen with ______

paget's disease

dilaceration

abnormal angulation (bend) in a tooth root

how can dilceration happen?

truama masses (tumors) in way of developing root/crown

dilacerations are more likely to _______ during extraction

fracture

supernumerary roots / extra roots most commonly seen in

third molars

clinical implications of supernumerary roots

supernumerary roots tend to be super slender and thin (difficult in endodontic therapy and extractions)

amelogenesis imperfecta

hereditary disorder of enamel

3 steps of enamel formation

1. deposition of organic matrix 2. mineralization of matrix 3. maturation

hypoplastic amelogenesis imperfecta

inadequate deposition of enamel matrix

size of teeth in hypoplastic amelogenesis imperfecta

small

morphology of enamel in hypoplastic amelogenesis imperfecta

rough type with enamel pitting, smooth type with no pitting OPEN CONTACTS

hypomineralized amelogenesis imperfecta

inadequate mineralizaiton

size of teeth in hypomineralized amelogenesis imperfecta

normal size

teeth with hypomineralized amelogenesis are more prone to _____

caries

morphology of enamel with hypomineralized amelogenesis imperfecta

enamel is soft and cheesy, lost early

early wear staining with hypomineralized amelogenesis imperfecta

stains easily black / brown in color

hypomaturation type of amelogenesis imperfecta

mineralized enamel fails to mature (water of mineralization is retained, hydoxyapatite crystals fail to enlarge)

morphology of enamel with hypomaturation type of amelogenesis iperfecta

not hard enough, easily penetrated with explorer tip, chips away from underlying dentin

characteristic feature of hypomaturation type of amelogenesis imperfecta

mottled or snow capped enamel surface

dentinal disorders

hereditary disorders of the dentin related to osteogenesis imperfecta

type I dentinogenesis imperfecta

associated with osteogenesis imperfecta

type II dentinogenesis imperfecta

isolated to teeth

radiogrpahic features fo dentinogenesis imperfecta (3)

1. crowns are bulbous 2. cervical constriction 3. absence of pulp chamber and canals

clinical features of dentinogenesis imperfecta

teeth appear translucent, opalescent

expected complications of dentinogenesis imperfecta

implants cannot be used! be careful, even with routine procedures (easy to fracture bone)

type I dentin dysplasia

radicular type (rootless teeth) roots very short, pulps obliterated, periapical lesions

radiographic differences between type I dentin dysplasia and dentinogenesis imperfecta

no bulbous tooth or cervical constriction in dentin dysplasia

expected complicaitons of type I dentin dysplasia

periodontal concerns (periapical pathologies)

type II dentin dysplasia

coronal type enlarged pulps, thistle tube appearance

expected complications with type II dentin dysplasia

pulp stones

ghost teeth of regional odontodysplasia

affects enamel, dentin, and pulp manage with extraction