Chapter 9 Part II Flashcards
These persons are phenotypic females who are usually missing one of the X chromosomes. They are chromosomally designated as 45,X
Turner Syndrome
T/F: Treacher collins syndrome: BILATERAL symmetric abnormal development of the structures arising from the first and second branchial arches
TRUE
The first branchial arch is involved with the growth of the mandible and zygomaticomaxillary complex and the second arch is involved with the hyoid bone and middle ear
Macrodontia = CHOG
What does CHOG stand for?
1) Crouzon
2) Hemifacial hyperplasia
3) Otodental
4) Glododontia
Gel foam 1.23% APF = ___ ppm
12,300 ppm
acidulated F can etch porcelain restorations
Maxillary canine impaction occurs in approximately ___ percent of the population and is twice as common in females as it is in males
2%
What is the triad of submucous cleft palate?
1) Bifid uvula
2) Palatal muscle diastasis
3) Notch in posterior surface of hard palate
Describe DI - Shields Type III
rare, brandywine population
bell shaped crowns
shell teeth with short roots and enlarged pulp chambers
enamel pitting, regular tubules, multiple pulp exposures
What is the sequence of calcification of primary teeth?
A, D, B, C, E
Fluoride varnish 5% NaF = __ PPM
22500 ppm
Where are pulp horns in primary teeth espcially more occlusally located on molars?
mesio-facially on molars
Approximately __% of the US population has a malocclusion, only ___% of the population have malocclusion severe enough to NEED orthodontic treatment
65%
29%
What occurs when there is interference with calcification?
hypocalcification
T/F: Dentin dysplasia type 2 is inherited as an autosomal dominant trait in which the primary dentition appears opalescent and on radiographs has obliterated pulp chambers, similar to the appearance in DI. Unlike in DI, however, in dentin dysplasia type 2 the permanent dentition has normal color and radiographically exhibits a thistle tube pulp configuration with pulp stones
True
What is the classic triad for submucous cleft palate?
1) Bifid uvula
2) Palatal muscle diastasis
3) Notch in the posterior surface of hard palate
Which chromosomal aberration is associated with deletion of Philadelphia chromosome no 22?
Chronic Myeloid Leukemia (CML)
Which papillae on the tongue are arranged in folds along the lateral margins of the tongue and are associated with taste sensation?
a) Fungiform
b) Filiform
c) Foliate
d) Circumvallate
c) Foliate
T/F: A gene that expresses a particular phenotype in single dose is a dominant gene, the phenotype is dominant or recessive and not the gene itself
True
Taurodontism and TDO (tricho-dento-osseous) are associated with what enamel defect?
enamel hypo-MINERALIZATION
What is a disorder that involves the process of maturation of the enamel crystal. This occurs after an essentially normal enamel matrix has been established. The enamel is of normal thickness (not hypoplastic) and relatively normal hardness (slightly hypocalcified) with reduced radiographic density and discoloration?
a) Hypocalcification
b) Hypoplasia
c) Hypomaturation
c) Hypomaturation
BQ: What is the first oral presentation of leukemia (often with AML)?
Gingival enlargement and bleeding secondary to neutropenia/thrombocytopenia may be a presenting symptom of AML
The most frequently reported oral abnormalities attributed to the leukemic process include regional lymphadenopathy, mucous membrane petechiae and ecchymoses, gingival bleeding, gingival hypertrophy, pallor, and nonspecific ulceration
In a periapical infection, which microorganism is present?
Strep viridans
What is the sequence of calcification of the molar cusp tips?
MB, ML, DB, DL
T/F: Patients with dentiongenesis imperfecta tend to have large pulp chambers
FALSE
Only DI Type III
others have SMALL pulp chambers
What is the chronic disseminated form of histiocytosis X?
Hans Schuller Christan disease
multifocal eosinophilic granulomas of bone; hepatosplenomegaly
What is the length of time for root completion of primary and permanent teeth?
Primary teeth: 18 months
Permanent teeth: 3 years
In cases of anodontia, what % of third molars are missing? What about mandibular second premolars?
3rds: 20%
mandibular second premolars: 0.85%
2% NaF = ___ ppm
9040 ppm
What is the optimal fluoride level in water?
0.7 ppm, effectiveness 20-30% reduction of dental disease
What is the % effectiveness of fluoridated water?
20-30% reduction of dental disease. There is no benefit of prenatal administration of fluoride
What is the most common and least severe form of histiocytosis X?
eosinophilic granuloma
How much variation (months) in eruption times of primary teeth is considered normal?
up to 18 months
What happens to the tongue in syndromes such as downs, cretinism, and vitamin B complex?
fissured tongue
T/F: Low income children are affected disproportioniately with dental caries: 80% of decay is found in 20-25% of children. A dental home is the ongoing relationship between the dentist and the patient, inclusive of all aspects of oral health care delivery, in a comprehensive, continuously accessible, coordinated and family centered way
True
In neurofibromatosis, where are the most common oral locations for neurofibromas?
tongue and buccal mucosa
What % of children and adolescents (2-19 yo) are obese?
16.9%
What are monogenic traits?
Traits produced and regulated by a single gene locus; rare; albinism, achondroplasia (hypodontia), or neurofibromatosis
Where are 2/3 of impacted canines located?
Palatally
Where are 1/3 of impacted canines located?
Labially
What are the two developmentally different cell layers that are separated by an extra-cellular matrix and specific tooth development is then mutually dependent on reciprocal cell-to-cell signaling between these two developmentally different cell layers?
Inner enamel epithelium (enamel) and neural crest (dentin)
Cancer is the leading cause of death by disease in the US among children 1-15 years of age
True
What amount (ppm) of fluoride will result in moderate fluorosis?
2 ppm
What is the disorder in which the enamel matrix is so drastically altered that normal calcification cannot occur, with the result that the clinical phenotype is a soft, mushy enamel that easily wears away?
a) Hypocalcification
b) Hypoplasia
c) Hypomaturation
a) Hypocalcification
Which genetic syndrome is an extra X chromosome in males?
Klinefelters syndrome
A patient presents with enamel pitting. The roots appear to be short with enlarged pulp chambers. The crowns are bell shaped. What is your diagnosis?
DI Shields type III
T/F: More than 1/3 of the US population does NOT benefit from community water fluoridation
True
In enamel hypoplasia, why do teeth appear SMALL?
Defective in amount, even though enamel is hard and well calcified
Two types of deficient enamel phenotypes: generalized (all the enamel) and localized (pits and grooves in specific areas)
T/F: Pacifier use should be stopped or limited in the second six months of life to reduce risk of otitis media
True
Use of cup by what age?
3 or 4
Which form of histiocytosis X is characterized by multiple punched out radiolucent lesions of membranous bone, exophthalmos, multifocal eosinophilic granulomas of bone, hepatosplenomegaly?
Hans Schuller Chtistian disease
Triad: exophthalmos, lytic bone lesions, diabetes insipidus
What happens to the tongue in syndromes such as downs, cretinism, angio neurotic edema?
macroglossia
Which of the following is not true for cystic fibrosis patients?
a) Xerostomia
b) Short, early appointments
c) Osteoporosis
d) Hyper metabolic state
e) Higher caries risk
b) No morning appointments due to mucous
Klinefelter; ectodermal dysplasia; Williams syndrome; tricho-dento-osseous, AI are associated with:
Taurodontism
Which papilla on the tongue is associated with the taste sensation?
a) Fungiform
b) Filiform
c) Foliate
d) Circumvallate
c) Foliate
Does differentiation of odontoblasts come before or after that of ameloblasts?
Before
What is the inheritance pattern for DI and cherubism?
Autosomal dominant
How many chromosomes do we have? How many autosomes?
46 chromosomes 44 autosomes (chromosome that is not a sex chromosome)
What is the time interval between crown completion and eruption to full occlusion in permanent teeth?
5 years
What are the oral manifestations of Aplastic Anemia?
1) Petechial hemorrhages
2) Submucosal hemorrhages
3) Gingival swelling
4) Herpetic lesions
5) Spontaneous gingival bleeding
Only ___% of supernumerary primary teeth have a succedaneous supernumerary tooth
30%
What is the most common malignancy in children?
ALL
proliferation of abnormal leukocytes in bone marrow; 80% die of infection and the others often die from bleeding
What is the term for the entire DNA sequence necessary for the synthesis of a functional polypeptide molecule?
Gene
the smallest physical and functional units of inheritance that reside in specific sites
T/F: Leukemia some of the more common SYSTEMIC findings are pallor, fever, tachycardia, adenopathy, hepatosplenomegaly, petechiae, cutaneous bruises, gingival bleeding, and evidence of infection
True
Rapidly progressing severe periodontitis is a characteristic of all the following expect:
a) cyclic neutropenia
b) agranulocytosis
c) leukocyte adhesion deficiency
d) aplastic anemia
d) aplastic anemia
What amoutn (ppm) of fluoride will result in mottled fluorisis?
6 ppm
Taurodontism is associated with:
a) AI
b) DI
a) AI
The first branchial archis involved with the growth of the mandible and zygomaticomaxillary complex and the second arch is involved with the hyoid bone and ______
middle ear
What are the initiation times of calcification for the permanent teeth?
a) Central
b) Lateral
c) Canine
d) 1st premolar
e) 2nd premolar
f) 1st molar
g) 2nd molar
h) 3rd molar
a) 5 months IU
b) 5 months IU
c) 5 months IU
d) 5 months IU
e) 10 months AB
f) 20 weeks IU
g) 12 months AB
h) 5 years AB
What is the term for a benign neural neoplasm of schwann cell origin?
Neurofibroma
autosomal dominant; cafe au lait spots; lisch nodules; pigmented iris hamartomas
T/F: Xylitol is most effective on teeth that are erupting
True
The papilla on the tongue that show inflammatory and atrophic changes**
a) Fungiform
b) Filiform
c) Foliate
d) Circumvallate
a) Fungiform; scarlet fever - strawberry tongue affects the fungiform papillae
Kawasaki disease
T/F: In leukemia, the WBC will be LOW
False
Rubinstein Taybi; Mohr; Sturge Weber are syndromes associated with:
talon cusp; dens evaginatus
What occurs when there is interference with matrix formation?
hypoplasia
What is the optimum intake of fluoride per day?
1 ppm F per day
What is the minimum platelet level for dental procedures?
50,000-100,000 mm3
Opalescent dentin is associated with with dentinogenesis imperfecta?
DI Type II
occurs alone (not with OI). Amber. AD. Both dentitions. Periapical radiolucencies
A patient presents with amber colored permanent teeth and five periapical radiolucencies radiographically. Severe attrition is present. Her primary teeth were similar in appearance. She does not have any systemic manifestations of disease. What is your diagnosis?
DI Type II
Which syndrome is characterized by hemifacial microsomia that is unilateral with Nerve 7 palsy and OMEN (orbit, mandible, ear, facial nerve weakness, soft tissye hypoplasia)?
Goldenhar syndrome
What is characteristic of the pulp chambers in patients with dentin dysplasia and DI type III?**
LARGE pulp chambers
DI type III - shell teeth thin dentin and large pulp chambers
Mobius syndrome is a rare congenital palsy of what nerves?
The sixth and seventh cranial nerves (Abducens+facial)
What % of ectopic eruption molars will self correct?
66% 2/3 self correct
2-3% of population have ectopic eruption of first molars. They generally self correct by age 7
What structural protein is defective in osteogenesis imperfecta?
collagen
T/F: Systemic causes of impacted canines include endocrine deficiencies, febrile diseases, irradiation
True
Maxillary canine impaction occurs in approximately 2 percent of the population and is twice as common in females as it is in males
T/F: Pulp therapy is indicated for patients with leukemia
False
What are the three types of AI?
Hypocalcified
Hypoplastic (matrix formation stage)
Hypomatured
may be x liinked or autosomal dominant
taurodontism is associated with AI
What is the initiation of calcification time for the following primary teeth?
a) Central
b) 1st molar
c) Lateral
d) Canine
e) 2nd molars
a) 6 weeks
b) 6 weeks
c) 6 weeks
d) 7 weeks
e) 8 weeks
Which syndrome is characterized by cleft palate, eye, ear, joint deformities plus Pierre Robin Sequence?
Stickler Syndrome
What age in utero is dental lamina activity identifiable?
37-42 weeks
Xylitol is a five carbon sugar that inhibits what two key things?
1) Enamel demineralization
2) Plaque formation
Note: Xylitol is associated with lower levels of LACTOBACILLUS and S. MUTANS
Which papillae on the tongue are affected in kawasaki disease/strawberry tongue?
a) Fungiform
b) Filiform
c) Foliate
d) Circumvallate
a) Fungiform
For ameloblastoma in children, are they uni or bicystic?
UNIcystic, plexiform variety in children
T/F: 28% of 2-5 yo have experienced dental caries. By the time children start kindergarden, 40% have experienced dental caries. By age 17, 78% of children in the US have experienced caries
True
__________ is the most common malignancy in children younger than age 15
Leukemia (ALL-75%/AML-19%) Highest incidence rate is in 1-4 yos
Only __% of supernumerary primary teeth have a succedaneous supernumerary tooth
30%
T/F: Dentin dysplasia type 2 affects the primary dentition and permanent dentition in different ways
True
Which type of dentin dysplasia is radicular dentin dysplasia?
a) Type I
b) Type II
a) Type I
Hypophosphatasia and epidermolysis bullosa are defects in which tooth structure?
Cementum
Which chromosomal aberration is the deletion of the “short arm chromosome 5”?
Cri du chat syndrome
chromosomal aberration
deletion of Philadelphia chromosome no 22: chronic myeloid leukemia
T/F: In aplastic anemia, the WBC will be LOW
True
T/F: There is no benefits of prenatal administration of fluoride
True
For acute herpetic stomatitis, children under what age are primarily affected?
under 6 years of age
Ehlers danlos syndrome, axenfeld-rieger syndrome, smith-magenis syndrome all have what in common?
they are congenital ichthyosis and have dilaceration
What is a swelling in the floor of the mouth associated with the sublingual gland?
Ranula
Which type of histiocytosis X initially has a scaly erythematous skin rash?
Letterer Siwe disease
Discontinuation of the nursing bottle by __ months of age
12
breastfeeding >=7 times a day after 12 months is associated with increased risk for ECC
What are three systemic causes of impacted canines?
1) Endocrine deficiencies
2) Febrile diseases
3) Irradiation
When should pacifiers be stopped/limited?
Pacifiers should be stopped or limited in the second six months of life to reduce risk of otitis media
Xylitol is associated with lower levels of what two microbes?
1) LACTOBACILLUS
2) S. MUTANS
Currently, there is lack of consistent evidence showing significant reductions in MS and dental caries in children
Which type of dentin dysplasia is coronal dentin dysplasia?
a) Type I
b) Type II
b) Type II
Which syndrome is characterized by malformed upper limbs, cleft palate, and severe palatal hypoplasia?
Nager Syndrome
Extracting the primary canine before the patient is 11 yo will normalize the erupting canine in 91% of the cases when the crown is ___ to the midline of the lateral incisor root
distal to the midline. If the canine crown is mesial to the midline it will erupt 64% of the time
T/F: There is only 1 calcification center for anterior teeth
True
What is the most common malignancy in the 1st year of life?
Neuroblastoma (sympathetic nervous system tumor)
Xylitol works by entering the cell by utilizing the membrane transport receptor protein for what molecule?
sucrose
but S mutans can’t use xylitol to produce energy
also xylitol disturbs protein synthesis in S. mutans so it cannot produce sticky polysaccharides and thus can’t form plaque and adhere to tooth surfaces
T/F: Both dentitions are affected in the AI disorders. Both primary and secondary dentitions are affected in dentin dysplasia type I which is inherited as an autosomal dominant trait
True
The most numerous papillae of the tongue are which?
a) Fungiform
b) Filiform
c) Foliate
d) Circumvallate
b) Filiform
thin and hairlike and evenly distrubted over the dorsal surface. The filiform papillae are without a vascular core, and their continuous growth is slight
T/F: Pulp therapy is indicated for hemophiliac patients
True
Which papilla on the tongue are vascularized?
a) Fungiform
b) Filiform
c) Foliate
d) Circumvallate
a) Fungiform
d) Circumvallate
T/F: 90% of caries in school aged children occur in pits and fissues
True
Where in the mouth do adenomatoid odontogenic tumors generally occur?
Predilection for the MAXILLA in the canine and incisor region; adenoameolblastoma; intraosseous and extraosseous variants; second decade of life
