Ch 2 - Abnormalities of Teeth 3 Flashcards by Austin Shackelford

Defined as an attempt of a single tooth bud to divide

gemination

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The union of two normally separated tooth buds with the resultant formation of a joined tooth with confluence of dentin

fusion

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The union of two teeth by cementum without confluence of the dentin

concresence

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People argue that gemination, fusion, and concresence should be discontinued and replaced with this term:

twinning (lol)

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A single enlarged tooth or joined (i.e., double)

tooth in which the tooth count is normal when the anomalous tooth is counted as one

Gemination

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A single enlarged tooth or joined (i.e., double) tooth in which the tooth count reveals a missing tooth when the anomalous tooth is counted as one.

Fusion

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Which population has a higher prevalance of “double teeth” (fusion/gemination) compared to whites?

Asian

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Gemination is more common in the ______ arch , whereas

fusion tends to occur more frequently in the ______ arch.

gemination = maxilla….fusion = mandible

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Accessory cusp located on the palatal surface of the mesiolingual cusp of a maxillary molar…Prevelence in whites? asians?

cusp of Carabelli..90% whites, rare in Asians

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Accessory cusp on the mesiobuccal cusp of a mandibular permanent or deciduous molar

protostylid

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A well-delineated additional cusp that is located on the surface of an anterior tooth and extends at least half the distance from the CEJ to the incisal edge

talon cusp

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Most common tooth for a talon cusp

permanent maxillary lateral incisor

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4 ethnicities for talon cusp

Asian 2.Native Americans 3. Inuit 4. Arab descent

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6 disorders associated with a talon cusp (so freaking random)…which one has the strongest correlation?

Rubinstein-Taybi syn(strongest: 92%) 2. Mohr syn 3. Ellis-van Creveld syn 4. incontinentia pigmenti achromians 5. Berardinelli-Seip syn 6. Sturge-Weber angiomatosis

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A cusplike elevation of enamel located in the central groove or lingual ridge of the buccal cusp of premolar or molar teeth

Dens evaginatus

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What is a Leong premolar?

an alternate term for dens envaginatus

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Which arch has a marked predominance for dens evaginatus?

mandibular

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4 ethnicities for dens evaginatus

1-4 % prev 1. Asians 2. Inuit 3. Native Americans 4. rare in whites

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Dens evaginatus is seen in association with what other tooth variation?

shovel-shaped incisors

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Shovel-shaped incisors occur predominantly in Asians,

with a prevalence of approximately 15% in whites but close to 100% in what 2 groups?

Native Americans and the Inuit

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What is the alternate term for Dens Invaginatus?

dens in dente

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Which tooth is most commonly affected by dens invaginatus?

perm max lat incisors

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What is the term for a dens invaginatus that disturbed the formation of the tooth?

dilated odontome

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_______ dens invaginatus is rare and thought to arise
secondary to a proliferation of Hertwig root sheath, with the formation of a strip of enamel that extends along the surface of the root.

Radicular

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What is the most common tooth affected by enamel pearls?

maxillary permanent molars

What is the % range for prevelence of enamel pearls? Which ethnicity is most affected?

1.1-9.7%....Asians

Which tooth is affected most by cervical enamel extensions?

mandibular molars

Cervical enamel extensions: What 4 regions have found a high prevelence? (20% - 78%)

1. US (lower 48) 2. Japan 3. China 4. Alaska

Even though the association is controversial, cervical enamel extensions can cause an inflammatory cyst at the buccal furcation of a molar and are thus called _______

buccal bifurcation cysts

Term for an enlargement of the body and pulp | chamber of a multirooted tooth, with apical displacement of the pulpal floor and bifurcation of the roots

Taurodontism

An increased frequency of taurodontism has been reported in patients with what 3 maxillofacial disorders? (think general)

hypodontia, cleft lip, and cleft palate

Please give 5 (of 20) syndromes associated with taurodontism

1. Amelogenesis imperfecta (IE, IV) 2. Down syn 3. Ectodermal dysplasia 4.Kleinfelter syn 5. Oral-facial-digital type II

A nonneoplastic deposition of excessive cementum that is continuous with the normal radicular cementum.. (2 terms plz)

Hypercementosis (cemental hyperplasia)

What 4 things help distinguish a cementoblastoma from hypercementosis?

1. pain 2. cortical expansion 3. continued enlargment 4. age - Blastoma = kids, cementosis = adults

Which tooth is most affected by hypercementosis?

mand molars

8 systemic factors associated with hypercementosis (all are weak associations except for which one?)

1. Acromegaly/gigantism 2. Arthritis 3. Calcinosis 4. **Paget disease**(strongest association) 5. Rheumatic fever 6. Thyroid goiter 7. Gardner syndrome 8. Vitamin A deficiency

What is the leading cause of dilaceration? What age does this typically occur by? What is the most common tooth affected?

trauma by 4 years of age...mand 3rd molars

4 syndromes associated with dilaceration

1. Smith-Magenis syn 2. Ehlers-Danlos 3.Axenfeld-Reiger syn 4. congenital ichthyosis (dry, scaly, thickened skin)

What is the most common tooth affected by supernumerary roots?

permanent 3rd molars (max or mand)

What are the 2 primary diagnostic features of Otodental syndrome? What are 3 less often associated findings?

1. sensorineural hearling loss 2. globodontia....less associated 1. ocular coloboma 2. odontomas 3. numerous microdontic teeth

Inheritance pattern, chromosome, and gene mutation for otodental syndrome?

AD....11q13....haploinsufficiency of FGF3

Which teeth are affected by globodontia?

primary and permanent cuspids and molars

What is the most excellent description of the occlusal surface of a molar globodontic tooth?

"tied end of a sausage" lol

What are the 4 syndromes associated with colobomas?

1. Regional odontodysplasia 2.otodental syndrome 3. Gorlin syndrome 4. Mandibulofacial dysostosis (Treacher Collins)

A rare hereditary dental anomaly in which numerous teeth resemble those noted in carnivores...what is the inheritance pattern?

Lobodontia...AD

Which teeth are most commonly affected by lobodontia? What is the descriptive term used?

cuspids and premolars, "fang-like" cusps

What encompasses a complicated group of conditions that demonstrate developmental alterations in the structure of the enamel in the absence of a systemic disorder or syndrome?

Amelogenesis Imperfecta

What is the name of the classification system for Amelogenesis Imperfecta?

Witkop (Same Witkop as Witkop-Von Sallmann Syndrome aka HBID)

What are the 8 associated gene mutations (and their protein products) with Amelogenesis Imperfecta?

1. AMELX (amelogenin protein, X-linked, 14 mutations known) 2. ENAM (enamelin protein, AD and AR) 3. MMP-20 (enamelysin protease, AR) 4. KLK4 (kallikren-4 protease) 5. FAM83H (AD, highest prevelance and most severe enamel alterations) 6. WDR72 (scaffold for protein-protein interactions, AR) 7. C4orf26 (extracellular matrix protein in the enamel organ, AR, Omani family) 8. DLX3 (controversial involvment, assoc w taurodontism)

What is the prevelence of Amelogenesis imperfecta in the US?

1:14,000 (so approx 24,000 people in the US)....compared to 1:700 in Sweden! woah! (14,000 people)

The X-linked patterns of generalized thin amelogenesis imperfecta are a lesson in what genetic effect?

lyonization

hypocalcification pattern of Amelogenesis Imperfecta has been associated with “_______” enamel

“cheesy” enamel

In a person with _________ amelogenesis imperfecta, the affected teeth are normal in shape but exhibit white opaque enamel that may reveal areas of mottling. Can resemble dental fluorosis

hypomaturation

In the ________ _______ Amelogenesis Imperfecta pattern, the surface enamel is mottled and agar-brown. The enamel often fractures from the underlying dentin and is soft enough to be punctured by a dental explorer.

pigmented hypomaturation

Which shows lyonization more: X-linked hypomaturation of AI or X-linked hypoplastic AI?

lyonization is not as obvious in hypomaturation as that seen in the X-linked hypoplastic pattern.

______ _____ AI patterns exhibit a zone of white opaque enamel on the incisal or occlusal one quarter to one-third of the crown

snow-capped hypomaturation

Name that AI pattern: "denture dipped in white paint"

Snow-capped hypomaturation

_________ amelogenesis imperfecta, the teeth are appropriately shaped on eruption, but the enamel is very soft and easily lost.

hypocalcified

What are the 4 clinical categories for Amelogenesis Imperfecta?

1. Hypoplastic 2. Hypomaturation 3. Hypocalcification 4. AI with Taurodontism (Hypomaturation-Hypoplastic)

What syndrome has a pattern of teeth alteration similar to amelogenesis imperfecta with taurodontism? .

tricho-dento-osseous syndrome

What are the 4 features of tricho-dento-osseous syndrome?

1. Pattern of teeth alteration similar to AI with taurodontism 2. kinky hair 3. osteosclerosis 4. brittle nails

Which form of Amelogenesis Imperfecta is associated with nephrocalcinosis and sometimes renal failure?

generalized thin hypoplastic amelogenesis | imperfecta

Name that clincal AI type: pinpoint-to-pinhead–sized pits are scattered across the surface of the teeth and do not correlate with a pattern of environmental damage

generalized pattern of hypoplastic AI

Name that AI type: the affected teeth demonstrate horizontal rows of pits, a linear depression, or one large area of hypoplastic enamel. Typically, the altered area is located in the middle third of the buccal surfaces of the teeth.

localized pattern of hypoplastic AI

Name that AI type: the enamel is extremely | thin with teeth that are shaped like crown preparations and demonstrate open contact points.

generalized thin variant of hypoplastic AI

Name that AI type: the affected teeth are normal in shape but exhibit white opaque enamel that may reveal areas of mottling.

hypomaturation AI