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Pedo > Dental abnormalities > Flashcards

Dental abnormalities Flashcards

1
Q

Anomalies occurring during dental lamina formation stage? (induction & proliferation)

A 
Hypodontia/oligodontia/anodontia
Supernumerary teeth
Double teeth (fused/geminated)
Odontomes (complex/compound)
Odontogenic tumors (ameloblastic fibroma/fibrodentinoma/fibro odontoma)
Odontogenic keratocysts
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2
Q

Anomalies occurring during histodifferentiation? (dental tissue dev.)

A

Regional odontodysplasia

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3
Q

Anomalies occurring during morphodifferentiation? (size & shape)

A

~~~
Macrodondia
Microdontia
Dens invaginatus
Dens evaginatus
Carabelli trait
Talon cusp
Taurodontism
Hutchinson’s incisors and mulberry molars in congenital syphilis
```hy

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4
Q

Anomalies occurring during matrix deposition?

A 
Enamel:
Amelogenesis imperfecta
Chronological enamel hyperplasia
Molar-incisor hypoplasia
Enamel opacities
Fluorosis
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5
Q

Anomalies occurring during matrix deposition?

A 
Dentine:
Dentinogenesis imperfecta
Dentinal dysplasia
Vitamin-D resistant rickets
Pre-eruptive intracoronal resorptive lesions
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6
Q

Anomalies occurring during eruption & root development?

A

Premature eruption
Natal & neonatal teeth
Delayed eruption
Ectopic eruption
Eruption cyst
Transposition of teeth’
Impactions
Arrested root development from systemic illness or treatment thereof
Failure of eruption in: amlg. imperf., cleidocranial dysplasia, cherubism
Failure of eruption associated with inflammatory follicular cysts

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7
Q

Most common teeth to be affected in hypodontia?

A

Primary dentition:
- Maxillary central>lateral incisors

Permanent dentition:

  • Maxillary lateral incisors
  • Mandibular 2nd premolars
  • Mandibular central incisors
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8
Q

Hypodontia can be manifested in many syndromes:

A 
Ectodermal dysplasia
Dento-alveolar clefting
Incontinentia pigmenti
Trisomy 21/down syndome
Chondro-ectodermal dysplasia (Ellis van Creveld syndrome)
Reiger syndrome
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9
Q

Ectodermal dysplasia

A 
X-linked recessive defect
Defects in: sparse, brittle, light hair; 
-dry, pale, scaly, sensitive skin; 
-nails thick/thin, abnormally shaped, discolored, brittle;
-sweat glands missing or malfunctioning
Teeth: hypodontia or peg-shaped/pointed
Hypoplastic enamel, deficient ridge
Full lips, small nose

Cleft lip & palate also possible in severe conditions, with most teeth missing in primary & permanent dentition

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10
Q

Solitary median maxillary central incisor syndrome (SMMCI)

A

One incisor located in maxillary midline
Mutation in chr 7 - sonic hedgehog gene
Associations: hypoplasia of sella turcica, pituitary disfunction, GH def and shortness
Can present with other midline disturbances: Cleft palate, choanal stenosis/atresia, imperforate anus, umbilical hernia
Treatment: ortho- & prosthodontic

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11
Q

Hyperdontia

A

Supplemental - extra normal tooth
Supernumerary - dysmorphic and/or reduced (small, conical)
Associated syndromes:
Cleft lip & palate
Cleidocranial dysplasia
Apert syndrome, Gardner syndrome, Down syndrome, Crouzon disease, Sturge-Weber syndrome, Hallermann-Streiff syndrome

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12
Q

Hyperdontia (supernumerary) related complications

A

Ectopic eruption
Dentigerous cyst formation
Pericoronal space ossification
Crown resorption

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13
Q

Microdontia can be associated with?

A 
Associated with:
Hypodontia (often affects max lat. inc & 3rd molar)
Congenital hypopituitarism
Ectodermal dysplasia
Down syndrome
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14
Q

Microdontia has 2 forms:

A

True generalized microdontia:
Teeth have normal structure but smaller than normal teeth
Occur in pituitary dwarfism

Generalized relative microdontia:
Teeth have normal size, but jaw is larger than usual, therefore they appear relatively small

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15
Q

Macrodontia

A

General: involves all teeth
Pituitary gigantism

Local - unilateral congenital hemifacial hypertrophy:
Can look like fusion or gemination of adjacent teeth
Most common: maxillary incisor

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16
Q

Rhizomicry

A

Small root-to-crown size
Systemic conditions: Osteoporosis, dentinal dysplasia
Local factors: trauma, pulpal infection, radiation during root development, root resorption

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17
Q

Accessory cusps:

A

Talon & carabelli’s cusp

Talon:
Cusp-like cingulum on maxillary anterior teeth (most common central incisors)

Treatment: reduce height over time –> allow reactionary dentine to form inside pulp

Carabelli:
Permanent: maxillary 1st molar
Primary: maxillary 2nd molar

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18
Q

Double tooth

fusion, gemination, concrescence

A

Radiology necessary to determine pulpal fusion
More common anteriorly than posteriorly
Double tooth in primary often follows by aplasia of successor teeth

Associations:
Down syndrome
Thalidomide embryopathy
Cleft palate

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19
Q

Gemination vs Fusion vs Concrescence

A

Gemination:
One bud gives rise to two teeth (joined crowns) with one root, being counted as one tooth.

Fusion:
Two buds develop separately and join later, having two canals, thus the tooth count is reduced
However if a normal tooth is fused to a supernumerary, the tooth number is still normal

Concrescence:
Two teeth joined by the cementum

20
Q

Evagination/dens evaginatus

A

Small tubercle on occlusal part, central on fissure
When fractured during normal wear and tear –> pulpal exposure & involvement
Premolars most common, then molars

Treatment: grinding over time to allow formation of reactionary dentine in pulp, removal of tubercle and partial pulpotomy

21
Q

Dens invaginatus

A

Invagination of dental papilla during development, infolding of enamel
Dentine can start from tip of cusps or foramen cecum and extend deep into root
Most commonly maxillary lateral incisors

22
Q

Taurodontism

A

Body of tooth and pulp chamber are elongated vertically, while the roots are short and underdeveloped, the furcation having moved far down apically
Failure of Hertwig’s epithelial root sheath to invaginate at horizontal level
Affects molars

23
Q

Qualitative defects of dental hard tissue?

A

Opacity - hypomineralization
Demarcated opacity - well demarcated, white, yellow, brown
Diffuse opacity - no clear boundaries

24
Q

Quantitative defects of dental hard tissue?

A

Hypoplasia - deficient enamel formation
Enamel is thin, pitted, grooved, even missing

Associated with:
Down syndrome
Epidermolysis bullosa
Tuberous sclerosis
Treacher Collins syndrome
Phenylketoneuria
Lesch-Nyhan syndrome
Fanconi syndrome
Strurge-Weber syndrome
Turner syndrome
25
Q

Genetically determined defects restricted to dental hard tissues?

A

Amelogenesis imperfecta
Dentinogenesis imperfecta
Dentin dysplasia

26
Q

Amelogenesis imperfecta

A

Genes involved: AMLEX, ENAM, MMP20, KLK4, FAM83H, WRD72
Anterior open bite in 60%
4 types:
Hypoplastic
Hypomaturation
Hypocalcified
Hypomaturation, hypoplastic with taurodontism

27
Q

Hypoplastic AI type 1

A

Most common type
Quantitative - enamel doesn’t reach normal thickness
Both dentitions
Enamel: rough, smooth, pitted, furrowed, locally hypoplastic
Teeth fail to meet in contact points
Delayed eruption or resorption of unerupted teeth
Anterior open bite

28
Q

Hypomaturation AI type 2

A

Qualitative - normal enamel thickness, but low in minerals
After eruption, small pieces chip away
Radiography: reduced difference btw enamel & dentin

29
Q

Hypocalcified AI type 3

A

Qualitative
In worst places can be penetrated/scraped away with explorer/scaler
Posteruptively chips away exposing dentine
Enamel more soft in incisal areas, and more resistant in cervical regions
Sometimes anterior open bite
Radiography: no contrast btw enamel & dentine

30
Q

Pathologies associated with AI

A 
Enlarged follicles
Impacted permanent teeth
Ectopic eruption
Congenitally missing teeth
Crown/root resorption
Pulp calcification
31
Q

Treatment of AI

A 
Fluoride
Fissure sealing (GI)
Ceramic veneers & crowns
Stainless steel crowns
Restorations
32
Q

Molar incisor hypomineralization (MIH)

A 
Cause: systemic factors up to 3 yrs
Infections, specific antibiotics
Permanent dentition
Symptoms:
Predisposes to caries & attrition
Discomfort during brushing, sensitivity to cold
Asymmetrical
33
Q

Severe MIH

A

Fracture of enamel
Multi-surfaced caries
Open pulpopathies
Hypersensitivity in teeth

34
Q

Tooth whitening should be done:

A

Before resin restoration
Reduces enamel hardness
Should be done after pt is 14 yrs old
Use of 10% carbamide peroxide

35
Q

Microabrasion

A

Done after whitening

Indications:
Superficial opacity (incl fluorosis & AI) 0.2mm into enamel
Clear contour & darkening spots (deeper lesions)

36
Q

Genetic defects restricted to dentin

A

Dentinogenesis imperfecta

Dentin dysplasia

37
Q

Dentinogenesis imperfecta

A

Type 1 - dental manifestation of osteogenesis imperfects
Type 2 - gene trait
Type 3 - isolated trait

Dentine tubules are sparse, coarse, branched & irregular
Both dentitions (primary worse affected)
Discoloration is bluish-brown opacity, enamel chips away
Primary teeth may wear down to G. margin
Permanent teeth pulp involvement is rare

Radiography: crown bulbous, roots thin & short

38
Q

Dentinogenesis imperfecta treatments

A

Stainless steel crowns
Restorations
Cast gold onlays
Ceramic crowns

39
Q

Dentin dysplasia

A

type 1 & 2

40
Q

Dentin dysplasia type 1

A
  • Radicular dentin dysplasia, rootless teeth

Crowns are normal, roots super-short
Pulp chambers obliterated, periapical lesions & inflammations
Canals undiscernible on x-rays
Teeth mobile due to root shortness

41
Q

Dentin dysplasia type 2

A
  • Coronal dentin dysplasia

Primary teeth discolored, permanent appear normal
Primary pulp chambers obliterated
Permanent pulp chambers - thistle-like tube with thread-like canals

42
Q

Regional odontodysplasia

A

Arrested tooth development
Hard tissues poorly calcified & thin, pulp chamber large, roots thin
Radiographs: ghost-like teeth, shell-like & dysmorphic crowns

43
Q

Turner tooth

A

Permanent tooth bud affected by overlying primary tooth infection
Usually affects lower premolars

44
Q

Natal/neonatal teeth

A

Extraction of tooth if it traumatizes nipple or infant tongue
Often mobile from limited root development
Ellis-van Creveld syndrome
Hallermann-Streiff syndrome

45
Q

Ridge-Fede ulceration

A 
Soft tissue (tongue, lower lip) trauma from natal tooth
Repeated trauma --> fibrous mass

Pedo (1 decks)

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