Anomalies Flashcards
Name the variation in dental anomalies
Anomalies in: Number, size and shape, hard tissue defects, eruption and exfoliation
Hypodontia - most likely teeth
Mand premolars - 1.2-2.5%, Max lateral incisors - 1-2%
Conditions associated with hypodontia
CLP, Down Syndrome, ectodermal dysplasia, Hurler’s syndrome, Incontinentia pigmentii
Dental management of hypodontia
diagnosis, rem prosthesis, ortho, composite build up, porcelain veneer,Implant, crown & bridge and PREVENTION
Hyperdontia/Supernumerary occurence
maxilla more common and > in male
Likely in Cleidocranial dysplasia
Types of superumerary
Conical (cone shaped), tuberculate (barrel shaped - cause of eruption failure of central incisors), supplemental (like original tooth) & odontome (Complex - denticles and compound (mass of hard tissue)
Abnormalities of tooth shape/size
Microdont (peg shaped), Macrodontia, double teeth (germination/fusion), odontomes, Taurontism, dilaceration, accessory cusps (talon cusp)
Anomalies of tooth root
Short root, radiotherapy effect, dentine dysplasia, acessory roots
Structure abnormalities - Enamel
Amelogenesis Imperfecta - Hypoplastic, Hypocalcified, hypomaturational, mixed forms
Environmental enamel hypoplasia - Systemic (dialysis), Nutritional, metabolic (liver disease rhesus incompatible), infection (measles)
Localised enamel hypoplasia - trauma, primary tooth infection
Hard tissue defect aetiology
Localised, generalised, environmental and hereditary
Fluorosis - treatment
Microabrasion, vital bleaching, composite veneers
Warn patient that whitest part is the most unnatural
Generalised environmental enamel defects causes
prenatal
neonatal
postnatal
Prenatal - Rubella, thalidomide, congenital symphilis, cardiac & renal defect.
Neonatal - prematurity, meningitis
Postnatal - otitis media, measles, chickenpox, TB, Pneumonia, vitamin A/C/D, heart disease, organ failure
Amelogenesis imperfecta types & Features
Hypoplastic, hypomineralised, hypocalcified and mixed form.
Familial inheritance - Autosomal DOMINANT, RECESSIVE & X LINKED
Amelogenesis imperfecta diagnosis
family history, both dentitions affected, affects all teeth, tooth size/structure/colour (orange)
Radiograph - square crowns with multiple open contacts
Amelogenesis Imperfecta - problems
Sensitivity, aesthetic, poor OH, Caries/acid susceptibility, delayed eruption , AOB, Issues with dental bonding
Amelogenesis imperfecta - solutions/treatment
Preventative therapy, composite veneers (>16yr), fS, Metal onlays, SSC, ortho
Enamel defects and associated systemic disorders
Epiderolysis bullosa, incontinenta pigmenti, down syndrome, Prader willi, porphhyria, Pseudohypoparathyroidism, Hurler’s
Dentine abnormalities
Dentinogenesis imperfecta, Dentine dysplasia (pulpal obliteration/short constricted roots), Odontodysplasia (ghost teeth), Systemic disturbance
Dentinogenesis imperfecta - Types
Type I - Osteogenesis imperfecta
Type II - Autosomal DOMINANT
Type III - Brandywine
Dentinogenesis imperfecta - diagnosis
Aesthetic (Purple/grey teeth), family history, associated osteogenesis imperfecta, affect both dentitions,
Rg - Bulbous crowns, Obliterated pulp, enamel loss
Dentinogenesis Imperfecta - Problems
Aesthetics, caries/acid susceptibility, spontaneous abscesses
POOR PROGNOSIS!!
Dentinogenesis Imperfecta - Solutions
Prevention, composite veneers (>16yrs), overdentures, rem prosthesis, SSCs. - under GA
Abnormalities of cementum
Cleidocranial dysplasia - hypoplasia of cellular component of cementum
Hypophosphotasia - hypoplasia/aplasia of cemetum, early loss of primary teeth
Dentine defects - dentine limited and general disorder
Dentine only - Fibrous dysplasia of dentine, dentinogenesis imperfecta II
General disorders - osteogenesis imperfecta, rickets, hypophosphatasia
Eruption Abnormalities
prenatal
delayed
Premature - neonatal teeth (first 8wks) - Inh risk
Delayed - preterm/low weight malnurished children, syndrome (down/cleidocranial dysplasia/hypothyroidism), gingival hyperplasia
Premature exfoliation - CAUSES
Trauma, following pulpotomy, imunological deficiency, neutropenia
Delayed exfoliation
Infraoccluded - congenital absence of successor
Hypodontia, ectopic permanent successor, following trauma.
Amelogenesis imperfecta - name the 4 phenotypes
-Hypoplastic
-Hypocalcified
-Hypomature
-Hypomaturation and hypoplasia
Name the features of hypoplastic AI
-Enamel of reduced thickness due to a defect in the formation of normal matrix
-Pitting and grooves
-Hard and translucent enamel
-Radiographically, the enamel contrasts normally from dentine.
Name the features of Hypocalcified AI
Defect in enamel calcification
-Enamel of normal thickness
-Weak in structure
Appears opaque or chalky
-Teeth become stained and rapidly wear down
-Radiographically, enamel is less radio-opaque than dentine
Name the features of Hypomaturation AI
-Enamel of normal thickness but mottled in appearance
-Slightly softer than normal and vulnerable to tooth wear, but not as severe as the hypocalcified type
-Radiographically, similar radiodensity as dentine.
Name the features of Hypomaturation / hypoplasia AI
Mixed hypomaturation and hypoplasia appearance
Taurodontism: body and pulp chamber enlarged, and the floor of pulp chamber and furcation is moved apically down the root.
