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Paeds > BDS4 Dental anomalies > Flashcards

BDS4 Dental anomalies Flashcards

1
Q

What conditions tend to have associated hypodontia?

A

Ectodermal dysplasia
Down syndrome
Cleft palate
Hurler’s syndrome
Incontinentia pigmenti

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2
Q

What are the most common missing teeth in the permanent dentition? (1st and 2nd most common)

A

Most common - Mandibular premolars

2nd most common - maxillary lateral incisors

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3
Q

What teeth are LEAST likely to be missing?

A

FPM and upper central incisors

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4
Q

Types of supernumerary

A

Conical - cone shaped
Tuberculate - barrel-shaped
Supplemental - normal tooth just extra
Odontome - irregular mass of dental tissue

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5
Q

What is dens in dente and what treatment would you provide for them?

A

Invaginations of enamel in teeth - tooth inside a tooth.

Seal off invaginations to prevent bacterial ingress.
Prep patient for extraction as very difficult to keep clean

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6
Q

What are the main causes of short root anomaly?

A

Radiotherapy
Dentine dysplasia
Accessory roots

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7
Q

What are the main different forms of amelogenesis imperfecta?

A

Hypoplastic
Hypocalcified
Hypo-maturational
Mixed forms

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8
Q

What are environmental causes of enamel hypoplasia?

A

Systemic - e.g. renal
Nutritional
Metabolic - liver disease
Infection - measles

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9
Q

What is hypoplastic amelogenesis imperfecta?

A

When the enamel is of normal QAULITY/ mineralisation but there are chunks missing

Problem with SECRETORY phase of amelogenesis - enamel crystals do not grow to correct length

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10
Q

What is hypocalcified/ mineralised amelogenesis imperfecta?

A

Enamel is of normal thickness but not mineralised properly - softer

Problem with MINERALISATION phase of amelogenesis - crystallites fail to grow in thickness and width

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11
Q

What are causes of localised enamel hypoplasia?

A

Trauma to primary tooth - causing localised enamel lesions in permanent tooth

Infection of primary tooth

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12
Q

What are 2 examples of generalised enamel defects?

A

Fluorosis
amelogenesis imperfecta

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13
Q

What is the incidence of amelogenesis imperfecta?

A

1:14000

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14
Q

What is taurodontism?

A

Enlarged, flame-shaped pulps.

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15
Q

What is the problem with enamel crystals in hypomaturational amelogenesis imperfecta?

A

Enamel crystals grow incompletely in thickness or width but to normal length with incomplete mineralisation

Think skinnnyyyy

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16
Q

What are some problems that arise as a result of amelogenesis imperfecta?

A

Sensitivity
Caries/ acid susceptibility
Poor aesthetics
Poor OH - painful because so sensitive
Delayed eruption
AOB

17
Q

Amelogenesis imperfecta treatment

A

Preventative therapy - FV
Micro abrasion
Bleaching
Composite veneers
Fissure sealants
Metal onlays
SSC

18
Q

Name some systemic disorders associated with enamel defects (not specifically amelogenesis)

A

epidermolysis bullosa
incontinenta pigmenti
Down’s syndrome
Prader-Willi
porphyria
tuberous sclerosis
pseudohypoparathyroidism
Hurler’s

19
Q

What are the 4 different dentine structural anomaly conditions?

A

Dentinogenesis imperfecta
Dentine dysplasia
Odontodysplasia
Systemic disturbance

20
Q

What is seen in dentine dysplasia?

A

Normal crown morphology
Amber radiolucency
Pulpal obliteration
Short constricted roots

21
Q

What is seen in odontodysplasia?

A

Localised arrest in tooth development
Thin layers of enamel and dentine
Large pulp chambers

22
Q

Clinical signs of dentinogenesis imperfecta?

A

Appearance - amber appearance of affected teeth
Associated osteogenesis imperfecta
Both dentitions affected
Enamel loss

23
Q

What is type 1 dentinogenesis imperfecta often associated with?

A

Osteogenesis imperfecta

24
Q

What are occult abscesses?

A

Abscesses that occur without any large evidence of demonstratable disease - no caries etc. in teeth.
More common in dentinogenesis imperfecta patients

25
Q

What are some problems with dentinogenesis imperfecta?

A

Aesthetics - grey appearance
Caries/ acid susceptibility
Spontaneous abscess

Pulp obliteration radiographically

26
Q

Solutions for dentinogenesis imperfecta?

A

Prevention
Composite veneers
Overdentures
Removable prostheses
SSC

27
Q

Name 2 anomalies of cementum

A

Cleidocranial dysplasia
Hypohosphatasia

28
Q

What would be a risk factor/ indicator for delayed eruption of teeth?

A

Pre-term & low birth-weight children
Malnutrition

Associated general conditions - downs, hypothyroidism, hypopituitarism, cleidocranial dysplasia

Gingival hyperplasia/ overgrowth

29
Q

Common reasons for delayed eruption?

A

Infra-occlusion
“Double” primary teeth (fused)
Hypodontia
Ectopic permanent successors
Following trauma
Crowding
Supernumeraries

30
Q

What are some anomalies of size and shape?

A

Microdontia e.g. peg laterals
Macrodontia
Double teeth - germination, fusion
Taurodontism
Accessory cusp e.g. talon cusp

31
Q

What is fluorosis?

A

Fluorosis is a condition that results in white or brown speckles on your teeth. It’s caused by overexposure to fluoride before the age of 8, when the permanent teeth are developing.
Aesthetic concern - does not affect tooth prognosis

32
Q

What are the steps for micro-abrasion for fluorosis?

A

Pre-op photos - for shade match
Pre-op radiographs
Sensibility test
Vaseline on gingiva
Rubber dam
Mix of sodium bicarbonate (GUARD for acid) and water (slurry) - make firm so it doesn’t all rinse off. Put around gingival margins of teeth to NEUTRALISE ACID
Pumice - mix water and 18% hydrochloric acid - firm.
Do either: 10 cycles for 5 seconds or 5 cycles for 10 seconds.
Wash after each application
Do this for 2x appointments
Polish with soflex discs to remove prismless layer
Finish with fluoride varnish
Review 4-6 weeks + post-op radiographs

33
Q

What is the aftercare for micro-abrasion?

A

Avoid staining foods for 2 weeks
Plain coloured diet to maximise avoidance of staining
Tooth mousse to aid re-mineralisation

34
Q

What is tooth mousse and what patient group is contra-indicated?

A

CPP-ACP amorphous calcium phosphate
Milk derivative so contra-indicated for patient’s with milk allergy.
Contains casein protein which can cause allergic reaction

35
Q

What are the clinical signs of osteogenesis imperfecta?

A

Blue sclera of the eye
Lots of bone fractures

36
Q

What are the radiographic signs of dentinogenesis imperfecta?

A

Occult abscess
Bulbous crowns
Short and thin roots
Erupt with large pulp chamber but pulp obliteration soon after

37
Q

Signs of fluorosis?

A

Varies dependant on severity
Symmetrical white spots/ brown spots
Mottling
Pitting
Occlusal surfaces of 6’s are UNAFFECTED

38
Q

Name 3 types of dentinogenesis imperfecta?

A

type 1 - associated with osteogenesis imperfecta
type 2 - autosomal dominant
type 3 - brandywine

Paeds (8 decks)

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