Anomalies Flashcards
Turner’s Hypoplasia (Enamel)
- Periapical inflammatory disease of overlying deciduous tooth
- Varies from focal areas of white to yellow to brown discoloration to extensive hypoplasia
- Permanent PM frequent
- Anterior teeth less frequent bc crown formed before development of PA disease
- Cause: Trauma or caries in deciduous teeth
- MX CIs common
- Clinical appearance of permanent successor dependent on timing and severity of damage
Hypoplasia from Exanthematous Fever
- Age 2-3: Rows of pits or diminished enamel on permanent anterior incisors & M1s
- Age 4-5: Similar pattern seen in cuspids, bicuspids, M2s
- Temporal line: Line of deformed enamel
Fluorosis
- Fluoride enamel defects through retention of amelogenin proteins in enamel
- Creates hypomaturation of enamel, alters light reflection and gives white chalky areas
- Critical period is 2nd to 3rd yr of life when permanent teeth are forming
- Dose dependent from 1.2ppm to 0.7ppm w/ fluorosis in excess of 2.0ppm
- Local excess fluoride from toothpaste ingestion or from fluoride supplements given to infant
- Long term excess fluoride in H2O
Congenital Syphilis
- Transmitted across placenta from infected mother to fetus
- In untreated mother
- Oral Manifestations
- Hutchinson’s Incisors: Anterior teeth have crowns shaped like flat screwdrivers
- Mulberry Molars: Posterior teeth have constricted occlusal tables w/ disorganized surface anatomy
Tooth wear
- Normal physiologic loss of dental structures
- Considered pathologic when creates functional, esthetic, or dental sensitivity
Attrition
Loss of tooth structure caused by tooth to tooth contact
Abrasion
Pathologic wearing of tooth structure by mechanical action of external agent
Erosion
Loss of tooth structure caused by nonbacterial chemical process
Perimolysis
Erosion from dental exposure to gastric secretions
Abfraction
- Loss of tooth structure from occlusal stresses that create tooth flexure w/ failure of enamel and dentin
- Enamel rods are weaker under compression than tension
Ankylosis
- Anatomic fusion of cementum or dentin to bone
- Cause unknown
- Teeth frequently involved
- Primary MN M1
- Primary MN M2
- Primary MX M1
- Primary MX M2
- Rarely permanent teeth
- Tx
- Ortho cannot move teeth
- Extraction of tooth will allow permanent tooth to erupt
- No permanent tooth: Esthetic build up
Hypodontia
- Denotes lack of one or more teeth
-
Anodontia: Complete lack of tooth development
- Anodontia is rare and associated w/ ectodermal dysplasia
- Oligodontia: Lack of 6 or more teeth
- Absence of missing primary = strong chance of missing permanent successor
- M3s, MN PM2, MX LIs
Anodontia
- Complete lack of tooth development
- Rare and associated w/ ectodermal dysplasia
Oligodontia
Lack of 6 or more teeth
Hyperdontia
- Development of increased # of teeth
-
Supernumerary tooth: Single tooth hyperdontia
- 75% of cases
- 95% in MX
- Most common in incisor region
- Mesiodens: Supernumerary tooth in MX incisor area
- Distomolar: Supernumerary M4
- Paramolar: Supernumerary buccal or lingual to molar tooth
- Natal or Neonatal teeth: 85% are primary MN incisors
Supernumerary tooth
- Single tooth hyperdontia
- Most common in incisor region
Mesiodens
Supernumerary tooth in MX incisor area
Distomolar
Supernumerary M4
Paramolar
Supernumerary buccal or lingual to molar tooth
Natal or Neonatal Teeth
85% are primary MN incisors
Microdontia
- Unusually small teeth
- Peg lateral (MX lats) are most frequent, followed by M3
Macrodontia
Larger than avg teeth
Gemination
Single enlarged tooth or joined (double) tooth in which the tooth count is normal, when anomalous tooth is counted as one
Fusion
Single enlarged tooth or joined (double) tooth in which the tooth count is missing a tooth, when anomalous tooth is counted as one
Concresence
Union of 2 teeth by cementum alone w/o confluence of underlying dentin
Dilaceration
Bend in tooth root
Cusp of Carabelli
Accessory cusp located on palatal surface of ML cusp of MX molar
Talon Cusp
Well-delineated additional cusp located on the surface of anterior tooth and extends half the distance from CEJ to incisal edge
Dens Evaginatus
- Cusp-like elevation of enamel
- Located in central groove or lingual ridge of buccal cusp of PM or M teeth
- Usually located
- MN teeth
- PM teeth
- Bilateral
- Tx
- No occlusal interference: No tx
- Occlusal interference: Elimination of opposing occlusal interference
Dens Invaginatus
- Deep surface invagination of crown or root that is lined by enamel
- Two types
-
Coronal Dens Invaginatus
- More common
- Dens in dente: Invagination resembles tooth w/in a tooth
- Dilated odontome: Invagination dilates and disturbs root/tooth formation
- Radicular Dens Invaginatus
-
Coronal Dens Invaginatus
- Tx
- Small invaginations: Restoration after eruption
- Larger invaginations: Endo tx or extraction
What type of dens invaginatus is most common? Coronal or radicular?
Coronal dens invaginatus
Dens in dente
Coronal dens invaginatus
Tooth w/in a tooth
Dilated odontome
Coronal dens invaginatus
Invagination dilates and disturbs root/tooth formation
Taurodontism
- Enlargement of body and pulp chamber of a multi-rooted tooth w/ apical placement of pulpal floor and bifurcation of roots
- Tx: None required
Hypercementosis
- Cemental hyperplasia
- Non-neoplastic deposition of excessive cementum
- Continuous w/ normal radicular cementum
- Enlarged root
- Surrounded by RL PDL space
- Lamina dura intact
Amelogenesis Imperfecta
- 14 different hereditary subtypes of developmental alterations of enamel in the absence of systemic disease
- Different classification schemes
-
Wiktop’s classification: Phenotype & pedigree
- Hypoplastic
- Hypomaturation
- Hypocalcified
- Gene mutations
-
Wiktop’s classification: Phenotype & pedigree
- Hypoplastic AI
- Hypermaturation AI
- Hypocalcified AI
- AI w/ Taurodontism
Hypoplastic AI
- Inadequate deposition of enamel matrix
- Any matrix present is mineralized
- Generalized pattern: Pin-point pits scattered across surface of the teeth
- Localized pattern: Horizontal rows of pits
- AD smooth pattern
- X-linked smooth pattern
Hypomaturation AI
- Enamel matrix laid down properly and begins to mineralize
- Defect in maturation of enamel
- Normal shape, discolored, enamel chips off
- Pigment pattern: Mottle brown color; punctured by explorer
- X-linked pattern: Enamel chips, pierced by explorer
- Snow-capped pattern: White opaque enamel on incisal or occlusal third of crown
Hypocalcified AI
- Enamel matrix laid down properly
- No mineralization occurs
- Enamel very soft and easily lost
Dentinogenesis Imperfecta
- Hereditary development disturbance of the dentin in the absence of systemic disorder
- Mutation of DSPP gene
- 8 different mutations
- Clinical & Rad Features
- Translucent teeth
- Blue to brown discoloration
- Bulbous crowns, cervical constriction
- Thin roots
- Obliteration of root canals and pulp chamber
- Dentinogenesis Imperfecta vs. Osteogenesis Imperfecta w/ Opalescent Teeth
- OI: AD Type 1 Collagen disorder; COL1A1, COLA12 gene mutation
- DI: DSPP gene mutation
- 8th mutation DSPP is known to cause dentin dysplasia Type II (more closely related to dentinogenesis imperfecta)
Dentin Dysplasia
- Developmental defect of dentin
- Loss of dentin organization
- No evidence of systemic disease or DI
- Two types
- Type I: Radicular Dentin Dysplasia
- Type II: Coronal Dentin Dysplasia
Type I Dentin Dysplasia
Type I: Radicular Dentin Dysplasia
- Rootless teeth
- Tooth mobility & premature exfoliation
- Pulpal obliteration
- Rarefying osteitis w/o cause
Type II Dentin Dysplasia
Type II: Coronal Dentin Dysplasia
- Caused by DSPP mutation
- Root length normal
-
Pulp chambers enlarged
- Thistle-tube-shaped or flame shaped
