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BDS4 CDS Paeds > Dental anoamlies > Flashcards

Dental anoamlies Flashcards

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1
Q

4 classes of dental anonamlies

A

number
size and shape
structure - hard tissue defects
eruption and exfoliation

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2
Q

hypodontia

A

missing teeth from normal sequence

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3
Q

teeth commonly affected by hypodontia

A

3rd molars: 9-37% of population have more than 1 missing

1.0.1-0.9% in the primary dentition

4.3.5-6.5% in the permanent dentition

mandibular premolars: 1.2-2.5% (5s)
maxillary lateral incisors: 1.0-2.0% (2s)

The teeth least likely to be missing are the first permanent molars and upper central incisors
*tends to be end of series *

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4
Q

conditions associated with hypodontia

A

Ectodermal Dysplasia (sparse hair, small nose, sweating)
Down Syndrome
Cleft Palate
Hurler’s syndrome
Incontinentia pigmentii

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5
Q

hypodontia dental management

in chronological order

A

Diagnosis
Removable prosthesis (waiting to grow, full permanent dentition)
Orthodontics
Composite build ups – inc size and shape
Porcelain veneers
Crowns, bridges and implants – need to wait for gingival margin settle, early/mid 20s

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6
Q

class of preventative tx need for hypodontia pts

A

high risk as less teeth
enhanced prevention needed throughout life

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7
Q

possible dental issues associated with hypodontia pts

A

submergence/infraocclusion of permanent teeth
deep overbite
spacing
issues with occlusion - reduced LFH
abnormal shape/form
* cone shaped teeth or straight sided can happen

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8
Q

hypodontia tx aims

3

A

prevention
aesthetics
function

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9
Q

commmon solutions/tx for hypodontia pts

A

overdentures
partial dentures
composite additions
porcelain veneers
fixed prosthodontics

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10
Q

example tx plan for hypodontia pt

A

Local fixed orthodontics to oppose central incisors, and composite build up
Overdenture – restore face height
Implants
Bone augmantation, sinus lift, distraction osteogenesis

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11
Q

hyperdontia/supernumerary

A

extra teeth to normal sequence

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12
Q

most common hyperdontia/supernumerary

A

1.5-3.5% prevalence
males:females 2:1
higher frequency in Japanese
more common in maxilla
higher frequency in cleidocranial dysplasia

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13
Q

types of supernumerary

4

A

Conical (cone shaped)
Tuberculate (barrel shaped, has tubercles)
Supplemental (looks like tooth of normal series)
Odontome (irregular mass of dental hard tissue, compound or complex)

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14
Q

most common cause of delayed eruption of permanent incisor teeth

A

supernumerary teeth

*Conical supernumerary
Central incisors are at immature stage so wouldn’t go in at this stage
Wait till child is 7/8 then remove extra teeth as root formation of 1s complete *

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15
Q

microdontia

A

smaller teeth than normal

2.5%
F>M

e.g. peg shaped lateral incisors

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16
Q

macrodontia

A

bigger teeth than normal

rare
less than 1% for single teeth and 0.1% in generalised form in Caucasians

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17
Q

double teeth

2 types

A

Gemination (one tooth splits into 2)

Fusion (two teeth join to form 1)

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18
Q

odontomes

A

anomalies in size and shape

odd dentine/enamel masses

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19
Q

taurodontism

A

flame shaped pulp, teeth look normal but risk pulp exposure in restorations

6.3% in UK

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20
Q

dilaceration

A

can be to crown or root

due to trauma or anomaly

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21
Q

accessory cusp

A

e.g. talon cusp

Selective grinding over time, Fluoride on
Encourage pulp to regress

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22
Q

dens in dente

A

tooth in tooth

invagination on tooth, seal areas to prevent bacteria ingress as not able to RCT and plaque trap

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23
Q

anomalies in root structure

A

short root anomaly
* permanent maxillary incisors
* 2.5% incidence
* 15% of these children also have short roots on the canines and premolars
* Danger for orthodontic tx

Causes
* radiotherapy
* dentine dysplasias
* accessory roots

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24
Q

3 enamel anomalies

A

amelogenesis imperfecta
environmental enamel hypoplasia
localised enamel hypoplasia

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25
types of amelogenesis imperfecta | 100s but 4 main
hypoplastic hypocalcified hypomaturational mixed forms
26
causes of environmental enamel hypoplasia | 4
systemic (kidney/liver failure) nutritional metabolic e.g. Rhesus incompatability, liver disease infection e.g. measles
27
causes of localised enamel hypoplasia | 2
trauma infection to primary tooth
28
hypomineralised enamel
all tooth tissue there normal shape but have marks on them correct thickness
29
hypoplasitc enamel
chunks of enamel missing mineralisation fine
30
how to categorise hard tissue defects
localised/generalised if generalised environental or hereditary if localised - trauma or abscess/infection primary tooth
31
tell tale sign generalised environmental enamel defect
can see lines on teeth from onset of the generalised environmental defect to stop, different on each tooth as form at different times
32
example generalised enviornmental enamel defects | 2
fluorosis MIH associated with childhood illness or chronological hypomineralisation e.g. liver/kidney failure
33
possible tx for fluorosis | generalised environmental enamel defect
Treat using microabrasion therapy/veneers/vital bleaching Microabrasion remove surface layer so teeth will look more dull as dark and light parts removed – ensure pt aware
34
generalised environmental enamel defects 3 times cause can happen
prenatal neonatal postnatal
35
prenatal factors for generalised environmental enamel defects
rubella, congenital syphilis, thalidomide, Fluoride, maternal A&D deficiency, cardiac & kidney disease
36
neonatal factors for generalised environmental enamel defects
prematurity meningitis
37
postnatal factors for generalised environmental enamel defects
otitis media, measles, chickenpox, TB, pneumonia, diphtheria, deficiency of Vits A,C&D. heart disease. Long term health problem e.g. organ failure
38
example generlised hereditary enamel defect
amelogenesis imperfecta
39
prevalance of amelogenesis imperfecta
1: 14,000 4 main types: * Hypoplastic * Hypomineralised * Hypomaturation * mixed with taurodontism familial inheritance * autosomal dominant, recessive, and x-linked no associated systemic disorder (studies ongoing)
40
5 parts of dx for amelogenesis imperfecta
family history generally affects both dentitions (primary and permanent, worse in permanent) affects all teeth tooth size, structure, colour radiographs * fail to see change in radiolunceny between enamel and dentine
41
enamel formation and genes
Enamel formation needs multiple genes to transcribe the process of crystal growth and mineralisation. Gene mutations found so far, involve enamel extracellular matrix molecules amelogenin and enamelin and kallikrein 4 Hypoplastic type * Enamel crystals do not grow to the correct length Hypomineralised * Crystallites fail to grow in thickness and width Hypomaturational * Enamel crystals grow incompletely in thickness or width but to normal length with incomplete mineralisation
42
dental problems in amelogenesis imperfecta
sensitivity caries/ acid susceptibility - erosion poor aesthetics (brown colour, white teeth with flecks, alike fluorosis) poor oral hygiene delayed eruption anterior open bite
43
solutions for dental problems in amelogensis imperfecta
preventive therapy composite veneers/ composite wash (aid sensitivity) fissure sealants metal onlays stainless steel crowns (replace at older age) orthodontics (troublesome to bond to)
44
systemic disorders associated with enamel defects (not amelogensis imperfecta) | 8
epidermolysis bullosa incontinenta pigmenti Down’s Prader-Willi porphyria tuberous sclerosis pseudohypoparathyroidism Hurler’s
45
4 anomalies of dentine structure
dentinogenesis imperfecta dentine dysplasia odontodysplasia systemic disturbance (nutritional, metabolic, drugs)
46
dentine dysplasia
normal crown morphology, amber radiolucency, pulpal obliteration, short constricted roots
47
odontodysplasia
localised arrest in tooth development, thin layers of enamel and dentine, large pulp chambers, “Ghost Teeth”
48
dentinogenesis imperfecta
uncommon 3 types * Type I *osteogenesis imperfecta (issue with bone)* * Type II *autosomal dominant (no underlying medical conditions)* * Brandywine
49
type I dentinogenesis imperfecta
have osteogenesis imperfecta (issue with bone) blue sclera of eye teeth amber/translucent/grey
50
dx dentiogenesis imperfecta
appearance family history associated osteogenesis imperfecta both dentitions affected enamel loss radiography: * bulbous crowns * obliterated pulps (I & II) *Crowns look like primary teeth but roots are like adult Pulps quickly become obliterated Get occult abscess, impossible to tx due obliteration*
51
type III dentinogenesis imperfecta -Bradywine
Brandywine, Maryland, USA. – genetic defect in that area
52
dental problems in dentinogenesis imperfecta | 3
aesthetics caries/acid susceptibilty spontaneous abscess
53
dental solutions to dentinogenesis imperfecta | 5
prevention (enhanced) composite veneers overdentures –* cover vulnerable dentine * removable prostheses stainless steel crowns – *varied success, but prevents wear* POOR PROGNOSIS
54
hereditary dentine defects limited to dentine only | 3
dentinogenesis imperfecta type II dentine dysplasia Types I & II fibrous dysplasia of dentine
55
hereditary dentine defects associated with general disorder | 5
osteogenesis imperfecta Ehlers-Danlos syndrome brachio-skeletal genital syndrome rickets hypophosphatasia
56
tooth structure defects tx overview
prevention and pain control harness growth restoration of lost tissue
57
overview of dental management | anomalies in paeds
continous dental care management of growth and development removable prosthesis crowns and bridges interceptive ortho
58
anomalies of cementum | 2
cleidocranial dysplasia * hypoplasia of cellular component of cementum * no clavicle hypophosphatasia * hypoplasia or aplasia of cementum * early loss of primary teeth (nothing holding them into bone)
59
premature eruption causes | 3
high birth weight precocious puberty natal / neonatal teeth * 1: 2000-3000 births * Just early – try to get to stay as usually part of series * But extract if issue with feeding or inhalation risk
60
delayed eruption causes | 4
pre-term & low birth-weight children malnutrition associated general conditions: * Downs, hypothyroidism, hypopituitarism, cleidocranial dysplasia gingival hyperplasia/ overgrowth
61
premautre exfoliation causes | 6
trauma following pulpotomy hypophosphatasia immunological deficiency e.g. cyclic neutropaenia Chediak-Higashi syndrome Histiocytosis X
62
delayed exfoliation causes | 5
‘double’ primary teeth Hypodontia – retain primary tooth ectopic permanent successors following trauma infra-occlusion * 1-9%, m=f, lower 1st primary molar most common * congenital absence of premolar * the majority exfoliate normally by age 11-12 yrs

BDS4 CDS Paeds (3 decks)

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