BDS4 Dental anomalies Flashcards by Brodie Carmichael

What conditions tend to have associated hypodontia?

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

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

Most common - Mandibular premolars

2nd most common - maxillary lateral incisors

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What teeth are LEAST likely to be missing?

FPM and upper central incisors

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Types of supernumerary

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

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

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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What are the main causes of short root anomaly?

Radiotherapy
Dentine dysplasia
Accessory roots

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What are the main different forms of amelogenesis imperfecta?

Hypoplastic
Hypocalcified
Hypo-maturational
Mixed forms

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What are environmental causes of enamel hypoplasia?

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

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What is hypoplastic amelogenesis imperfecta?

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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What is hypocalcified/ mineralised amelogenesis imperfecta?

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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What are causes of localised enamel hypoplasia?

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

Infection of primary tooth

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What are 2 examples of generalised enamel defects?

Fluorosis
amelogenesis imperfecta

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What is the incidence of amelogenesis imperfecta?

1:14000

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What is taurodontism?

Enlarged, flame-shaped pulps.

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

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

Think skinnnyyyy

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

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

Amelogenesis imperfecta treatment

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

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

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

What are the 4 different dentine structural anomaly conditions?

Dentinogenesis imperfecta
Dentine dysplasia
Odontodysplasia
Systemic disturbance

What is seen in dentine dysplasia?

Normal crown morphology
Amber radiolucency
Pulpal obliteration
Short constricted roots

What is seen in odontodysplasia?

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

Clinical signs of dentinogenesis imperfecta?

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

What is type 1 dentinogenesis imperfecta often associated with?

Osteogenesis imperfecta

What are occult abscesses?

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

What are some problems with dentinogenesis imperfecta?

Aesthetics - grey appearance Caries/ acid susceptibility Spontaneous abscess Pulp obliteration radiographically

Solutions for dentinogenesis imperfecta?

Prevention Composite veneers Overdentures Removable prostheses SSC

Name 2 anomalies of cementum

Cleidocranial dysplasia Hypohosphatasia

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

Pre-term & low birth-weight children Malnutrition Associated general conditions - downs, hypothyroidism, hypopituitarism, cleidocranial dysplasia Gingival hyperplasia/ overgrowth

Common reasons for delayed eruption?

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

What are some anomalies of size and shape?

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

What is fluorosis?

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

What are the steps for micro-abrasion for fluorosis?

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

What is the aftercare for micro-abrasion?

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

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

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

What are the clinical signs of osteogenesis imperfecta?

Blue sclera of the eye Lots of bone fractures

What are the radiographic signs of dentinogenesis imperfecta?

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

Signs of fluorosis?

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

Name 3 types of dentinogenesis imperfecta?

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