Acquired Dental Anomalies Flashcards
Acquired Dental Anomalies
Dental wear
Resorption
Pulpal calcifications
Hypercementosis
Gradual loss of dental hard tissue as a result of chewing
Attrition
Is attrition physiological or pathological
physiological
Curved surfaces gradually altered to flat planes
Attrition
Some factors may accelerate loss with attrition
Bruxism/grinding
Diet
Etc.
What surfaces are effected by attrition
Incisal/occlusal surfaces
Crowns shortened coronal-apically. Many adjacent teeth in each arch may show wear pattern
Attrition
What can get worn away with attrition
Enamel may get worn away –> dentin becomes exposed –> deposition of secondary dentin
(Pt does not complain of pain due to this secondary dentin protecting the dentinal tubules)
Attrition can cause a reduction in the size of the
pulp chambers and canals
With attrition, incisal edges of mandibular incisors tend to become
pitted or “dished out”
During attrition there is simultaneous widening of the
PDL space
Gradual loss of dental hard tissue as a result of external mechanical action
Abrasion
3 causes of abrasion
Parafunctional habits (holding objects between teeth)
Poorly-fitting partial dentures or retainers
Brushing or dental floss injuries
With abrasion, __ gets worn away and __ becomes exposed
enamel
dentin
Radiolucent well-defined defects at the cervical level of teeth are from
Toothbrush injuries
(contralateral to dominant hand)
PIC
Radiolucent semilunar well-defined defects in the interproximal surfaces at the cervical level of teeth are from
Dental floss injuries (distal)
Radiolucent semilunar well-defined defect in the distal surfaces at the cervical level of teeth are from
dental clasps of partial denture
Gradual loss of dental hard tissue as a result of chemical injuries (not involving bacteria)
Erosion
3 reasons for erosion
Excessive intake of acid beverages
Gastric reflux
Bulimia
Smoothly outlined defects of enamel with underlying dentin
Erosion (surfaces effected depend on cause)
If the restoration is showing and not flat with the dental wear this is an example of
Erosion
(Dentin> surrounding enamel > restorations)
How is erosion shown on a radiograph
Well defined radiolucent defects on the crowns
Loss of tooth structure from occlusal stresses that create repeated tooth flexure
Abfraction
Failure of enamel and dentin at a location away from the point of loading
Abfraction
Sharp angles compared to a flatter smooth surface
Abfraction vs abrasion
Removal of tooth structure by odontoclasts
Resorption
Only section of the tooth with __ are susceptible to resorption
soft tissue coverage
Progressive resorption of deciduous tooth that results in shedding and subsequent eruption of permanent tooth
Physiological root resorption of primary teeth
Odontoclasts resorb the outer surface of the tooth
External resorption
The causes of external resorption is __
Excessive mechanical and occlusal forces
Localized inflammatory lesions
reimplanted teeth
impacted teeth, tumors and cysts
Unknown
Apical root resorption associated with orthodontic treatment is an example of
External resorption
(Mechanical and occlusal forces)
Localized,subepithelial, supra-ossesous resorptive process of the tooth
Invasive cervical resorption
Resorbed root from external resorption is replaced by
ingrowth of bone
0.02%-2.3% (common)
Asymptomatic
Etiology and pathogenesis poorly understood
Invasive Cervical Resorption
Invasive cervical resporption occurs most commonly with
Maxillary central incisors
(then max canines)
Odontoclasts resorb the dentin wall of pulp chamber or root canal
Internal resorption
Focal enlargement of the pulp space
Internal resorption
Internal resorption is probably related to
inflammation (acute trauma, pulp capping, pulpotomy)
Radiolucent localized round, oval, or elongated lesions, continuous with the image of the pulp chamber or root canal
Internal resorption
This is important for proper diagnosis of resorptive lesions
CBCT (Tells you if its internal or external cause)
Changes in pulpal tissue resulting in mineralization
Pulpal calcifications
Function of the pulp
Dentin formation and nutrition
Deposited in the pulp structures, physiologic process, slow and continuous. Related to aging
Secondary dentin
Additional deposition related to stimuli
Tertiary dentin
Common idiopathic calcifications, freely in tissue or attached to wall, usually round radiopacities, no treatment requires
Pulp stones
Idiopathic calcification, associated with older age (may be related to trauma). Diffuse ill-defined, no treatment required, difficulty for endodontic procedures
Pulpal sclerosis
Excessive deposition of cementum on the tooth roots
Hypercementosis
3 possible causes of hypercementosis
Supraerupted tooth (lost opposing tooth)
Periapical inflammation
Paget disease of bone hyperpituitarism
Roots appear thickened on radiographs. Difference in radiopacity cementum vs dentin
Hypercementosis
Continuity of the __ and the __ that encompasses the extra cementum with hypercementosis
lamina dura
PDL space
