Anomalies pt 1 Flashcards
what is hypodontia?
developmental absence of primary or permanent teeth
what is oligo and anodontia?
oligodontia = >=6 teeth missing (doesn’t include 8s)
anodontia = complete absence of teeth
at what stage of tooth development does hypodontia arise from?
initiation
what single gene defect causes hypodontia?
MSX1
what 5 conditions is hypodontia a symptom of?
ectodermal dysplasia
downs (trisomy 21)
cleft lip/palate
solitary maxillary central incisor syndrome
what environmental conditions can cause hypodontia?
severe illness or cancer in early childhood
what gender is hypodontia more prevalent in?
females
after the 8s, what other teeth more likely affected by hypodontia?
mandibular 2nd premolars
maxillary lat incisors
maxillary 2nd premolars
mandibular central incisors
what other anomaly is hypodontia often associated w/?
microdontia
what radiograph is first choice for diagnosing hypodontia? if the tooth is ectopic?
PA - but DPT if tooth ectopic
ectodermal dysplasia - how is hair, skin, mouth, eyes and nose affected?
how do teeth appear? (3)
group of diseases affecting ectoderm
sparse hair, dry skin, cannot sweat
xerostomia, dry eyes, nasal congestion
conical teeth, micro and hypodontia
what stage of tooth development do supernumaries arise from?
initiation
where are mesiodens and paramolar supernumaries positioned?
mesiodens = between centrals
para molar = buccal or palatal to molars or between molars
explain appearance of conical, tuberculate and supplemental supernumaries - how likely will they impede eruption?
conical = most common, cone shape, unlikely to impede eruption, likely erupts
tuberculate = barrel shaped, do not ususally erupt so likely to impede eruption
supplemental = normal anatomy, unlikely to impede eruption, likely erupts
odontome supernumaries - likely to erupt/impede eruption? explain difference between compound and complex.
will not erupt, likely to impede eruption
compound = bag of teeth (denticles)
complex = disorganised collection of tooth tissue
what radiographs are used to diagnose supernumaries?
parallax & CBCT
what 3 conditions are supernumaries a symptom of?
what gender is most likely affected?
cleidocranial dysostoses
cleft lip/palate
gardener syndrome
male>female
cleidocranial dysostoses - what group of conditions? what are absent? what tooth anomaly? what clinical sign?
rare AD condition
hypoplastic or absent clavicles - pt has short stature
supernumary teeth
delayed/failed exfoliation of teeth
what stage of development does microdotnia & macrodontia develop?
morphogenesis stage
what anomaly is micordontia associated w/? what 2 conditions is this seen in?
hypodontia
ectodermal dysplasia
cleft lip/palate
what is most common tooth to be affected by microdontia? how do roots of these present?
maxillary lateral incisors - peg laterals
short narrow root & lack of resoprtion
what two features make macrodontia teeth larger than average? what other anomaly is it associated w/?
double tooth or have talons cusp
associated w/ supernumaries
double teeth - explain difference between fusion and gemination
fusion - tooth germs join tog, 2 roots on radiograph
gemination - one tooth completely divided, 1 root on radiograph
what is dens invaginatus? what stage of tooth development does it occur?
enamel has folded within itself creating an enamel lined cavity
“tooth within a tooth”
morphogenesis
what teeth most commonly affected by dens invaginatus? what is a noticeable feature on these teeth?
- maxillary lateral incisors
- maxillary centrals
pronounced cingulum pit
what may the first indication of dens invaginatus be?
random loss of vitality in absence of trauma/caries
how do you manage dens invaginatus?
fissure seal cingulum pits
RCT when loss of vitality
XLA or referral if RCT too complex
Dens exvaginatus - known as, what stage of root development, what teeth most common
“talons cusp”
morphogenesis
maxillary incisors
how does dens exvaginatus present on premolars? what may happen to tooth in long term?
central talons cusp
worn down area of cusp may expose dentine and lead to loss of vitality
how does dens exvaginatus present on incisors?
palatal cusp
how do you manage dens exvaginatus?
OHI & fissure seal
gradual reduction/grinding of cusp to encourage reactionary dentine formation - prevents pulpal exposure
OR remove cusp, pulp cap & pulpotomy/RCT
what is dilaceration? what usually & rarely causes it? what teeth are most commonly affected?
bend in root or crown
usually acquired defect - due to trauma to primary tooth affecting permanent
rarely caused by pathology
maxillary centrals most commonly affected
give 3 clinical signs of crown dilaceration - what radiographs to investigate? (2)
failed eruption
altered path of eruption
ectopic position
lat cephalogram, CBCT
taurodont appearence - pulp chamber, bifurcation, roots, crown
elongated pulp chamber in a multi rooted tooth
low bifurcation
short roots
normal looking crown
what classification classes taurodonts? give 4 classifications
shaw classification
normal>hypotaurodont>mesotaurodont>hypertaurodont
what stage of root development does taurodontism occur?
morphogenesis
what 3 conditions is taurodontism associated w/?
amelogenesis imperfecta
trisomy 21 (down’s)
Klinefelter
how do short roots present clinically?
mobile
no response to sensibility test if cause due to loss of vitality
may have microdontia and enamel defects where cause childhood illness
what genetic condition causes short roots?
dentine dysplasia
list environmental reasons short roots may occur
loss of vitality prior to apexogenesis
illness (cancer) ot treatment during root formation
traumatised tooth, ortho treated, ectopic teeth, pathology
how do you manage short roots in vital and non vital teeth?
non vital teeth - RCT w/ apexification
vital teeth - no intervention, plans made for eventual loss
