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CK 3 > Dental Anomalies 1 > Flashcards

Dental Anomalies 1 Flashcards

1
Q

An abnormality in dental lamina formation leads to …

A

an abnormality in the number of teeth

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2
Q

An abnormality in morphodifferentiation leads to …

A

an abnormality in the shape and size of the teeth

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3
Q

An abnormality in matrix deposition and mineralisation leads to …

A

an abnormality in structure

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4
Q

What is anodontia ?

A

no teeh

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5
Q

Fewer than normal teeth refers to …

A

hypodontia

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6
Q

Hypodontia can also be historically referred to as…

A

partial anodontia
Oligodontia

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7
Q

What is hyperdontia?

A

more teeth than normal present

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8
Q

Deciduous teeth are rarely missing (anodontia). True or false

A

True

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9
Q

What teeth are most frequently implicated in hypodontia ? (arrange in the order of most frequently implicated to least)

A

3rd molars> maxillary lateral incisors > lower second premolars

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10
Q

There is no familial tendency in hypodontia. True or false

A

false

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11
Q

What hypodontia tendency is most commonly found nationally in Sweden and Japan?

A

L1’s

(notes wrote lower first molars, but is it lower first incisors?)

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12
Q

Explain the reason for the absence of permanent teeth if their deciduous predecessor is missing?

A

this is because the tooth germ of the permanent successors from as a result of proliferative activity in the dental lamina, lingual to the deciduous tooth germ.

is dental lamina correct here?
is it proliferative activity in the tooth bud?

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13
Q

Why might molars not affected by the absence of deciduous teeth?

A

this is because they have no deciduous predecessor and they tooth germ originates directly from the dental lamina

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14
Q

What are the most common clinical signs of hypodontia?

A
  • retained deciduous teeth, well after date of exfoliation
  • spaces
  • infraoccluding deciduous teeth (submerging teeth)
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15
Q

What radiographic images are required for the assessment of missing teeth?

A
  • OPG
  • upper occlusal
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16
Q

In the absence of an upper occlusal radiograph, what alternative can be used instead?

A

periapical radiographs

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17
Q

What factors can potentially cause infraoccluding teeth?

A
  • ankylosis
  • impaction
  • absence of permanent successor
  • trauma causing damage to hertwigs epithelial root sheath
  • infection, chemical or thermal irritation
  • failure of bone growth
  • abnormal tongue pressure
  • genetic aetiology has also been suggested as it has been observed in siblings
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18
Q

What IOTN has been ascribed to infraocclusing teeth?

A

5s

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19
Q

What are some clinical considerations you must make regarding infraoccluded teeth?

A
  • orthodontic assessment 5S
  • If extractions indicated; are they ankylosed or impacted
  • the need for advanced restoration; stainless steel crowns for prevention, fissure sealants?
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20
Q

Give examples of medical conditions that may be associated with missing teeth

A
  • Hereditary ectodermal hypoplasia
  • cleft lip and palate
  • down syndrome
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21
Q

What teeth are most commonly absent in downs syndrome?

A

3rd molars are absent in 90% of cases

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22
Q

What are the clinical signs of hereditary ectodermal hypoplasia?

A

(affects ectodermal tissues
* hair is absent/thin/sparse
* small conical and sometimes missing teeth (rarely 100% missing teeth)
* reduction in/absence of sweat glands; dry smooth skin
* decreased skin pigment or colour
* abnormal fingernails
* small maxilla (maxillary hypoplasia)
* poor hearing, vision and decreased tear production

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23
Q

What is the pattern of inheritance for hereditary ectodermal dysplasias?

A
  • X linked recessive
  • autosomal dominant
  • autosomal recessive
  • ectodermal dysplasia is a group of genetic disorders. Inheritance pattern will depend on the type of dysplasia present; may be passed on from parent, mutations may occur at egg or sperm formation or at fertilisation
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24
Q

When is it best to perform cleft lip and palate repairs?

A
  • it has been found that repairs have better outcomes the earlier they are performed
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25
Q

What are some general characteristics of cleft palates ?

A
  • 75% of clefts are unilateral
  • left side is more common than the right
  • affects more boys than girls 3:2
  • less frequent in African populations
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26
Q

What are some suggested factors that contribute to the development of cleft lip and palate?

A
  • genetics
  • environment
  • drugs (corticosteroids, phenytoin - anticonvulsant)
  • infections in pregnancy (rubella)
  • alcohol consumption, smoking, some dietary deficiencies (folic acid/vitamin A)
  • maternal age
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27
Q

What teeth sit on the medial nasal prominence ?

A

the 4 incisal teeth

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28
Q

What dental issues can arise in cleft palate?

A
  • hypodontia
  • hyperdontia (rare cases)
  • presence of natal or neonatal teeth (teeth present at birth)
  • microdontia
  • fused teeh
  • enamel hypoplasia
  • poor periodontal support
  • germination and dilacerations
  • anterior and posterior crossbite
  • class III tendency
  • spacing and crowding
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29
Q

What is the most common cause of downs syndrome?

A

trisomy 21

this is where there is a third copy of chromosome 21

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30
Q

What are some common developmental issues in downs syndrome that can lead to oral complications?

A
  • hypoplasia of mid face
  • underdeveloped maxilla
  • poorly developed paranasal sinus due to small maxilla
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31
Q

What issues are associated with under-developed maxilla in downs syndrome?

A
  • poorly developed maxilla which can make breathing difficult- considerations for dental chair position
  • maxillary hypoplasia means that most are class III and have a protrusive tongue
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32
Q

Outline some dental issues associated with people with downs syndrome

A
  • anterior open bite with lateral incisors missing
  • teeth appear smaller and can also be missing (hypodontia)
  • delayed eruption
  • relatively low incidence of caries
  • rapidly progressive periodontal disease is associated with downs syndrome
  • heavily fissured and enlarged tongues
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33
Q

What clinical considerations can be made for hypodontia ?

A
  • do nothing
  • direct restoration disguises (canines to laterals)
  • orthodontics with/without restoration
  • restoration of space with: implants, removable prosthesis, fixed prosthesis
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34
Q

Hyperdontia is most commonly present in what arch?

A

Maxilla

Maxilla 90% , premaxilla 98%
mandible 10%

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35
Q

How are hyperdontic teeth classified?

A

by shape

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36
Q

What are the classifications of hyperdontic teeth?

A
  • supplemental
  • supernumerary
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37
Q

What are the classifications of supernumerary teeth?

A
  • conical (inverted/everted)
  • tuberculate
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38
Q

What are the characteristics of supplemental teeth?

A
  • same structure as normal
  • erupt normally
  • usually tagged onto a series
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39
Q

What is the cause of supplemental teeth?

A

excessive but organised growth of the dental lamina

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40
Q

Supernumerary teeth can prevent the eruption of other teeth. True or false

A

True

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41
Q

What are the most common instances of hyperdontia in maxilla?

A
  • mesiodens (located in the centre line); conically shaped
  • paramolars (4th molars)
  • maxillary lateral incisors
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42
Q

What are the most common instances of hyperdontia in the mandible ?

A
  • premolars
  • 4th molars
  • extra incisors
43
Q

What radiographic examinations need to be performed for a diagnosis of hyperdontia?

A
  • OPG
  • upper occlusal
44
Q

Give an example of a medical condition associated with supernumerary teeth

A

cleinocranial dysplasia

45
Q

Outline some characteristics of cleinocranial dysplasia

A
  • aplasia/hypoplasia of one or both clavicles
  • delayed ossification of fontanelles
  • short stature
  • increased number of supernumerary teeth
  • delayed eruption
  • dentigerous cysts
  • frontal bossing
46
Q

What is the inheritance pattern of cleionocranial dysplasia?

A

autosomal dominant - mapped to short arm of chromosome 6

spontaneous mutation

47
Q

What are the clinical considerations for supplemental teeth?

A
  • do nothing
  • plaque traps
  • aesthetics
48
Q

What are the considerations of supernumerary teeth?

A
  • diagnosis is crucial as they are often unerupted
  • possible effects on rest of dentition e.g. prevention of eruption
  • possible resorption of adjacent teeth
  • aesthetics
    *
49
Q

What is microdontia ?

A

one or more teeth that are smaller than normal

can either be generalised or localised

50
Q

What is macrodontia?

A

one or more teeth that are larger than normal

can either be generalised or localised

51
Q

Although uncommon, give an example of a cause of true generalised microdontia ?

A

pituitary dwarfism

52
Q

Give instances associated with relative generalised microdontia?

A
  • jaw size larger than normal but teeth are normal size, this casues spaces and give the illusion of small teeth
  • spaces due to strong tongue (as is the case in downs syndrome)
53
Q

What teeth are most commonly affected by microdontia ?

A
  • lateral incisors (peg)
  • maxillar third molars (peg molars)
  • they both often appear small and conical
54
Q

Microdontia is not present in …

A

second premolars

55
Q

Microdontia can have iatrogenic aetiology. Give an example of this

A

Chemotherapy; teeth that are forming at the time that chemotherapy is being received will experience insult

56
Q

What is a cause of true generalised macrodontia?

A

pituitary gigantism

57
Q

Explain the circumstances behinds relative generalised macrodontia?

A

jaw size appears smaller than normal, but teeth are normal size so teeth are crowded

58
Q

Outline causes of regional macrodontia

A
  • hemifacial hypertrophy
  • segmented odontomaxillary dysplasia
59
Q

Localised macrodontia should not be confused/misdiagnosed with …

A

fusion

60
Q

What is rhizomegaly/radiculomegaly?

A

uncommon condition where the roots of teeth are longer than normal

61
Q

What teeth are commonly implicated in rhizomegaly?

A

mandibular canines

62
Q

What is a dilaceration?

A

a sharp bend or angulation involving the root of a tooth

63
Q

What are the potential casues of dilaceration ?

A
  • trauma to a developing tooth
  • discrupted root formation along a tortuous path
  • this can cause root to from at an angle to the normal axis of the tooth
    *
64
Q

What is taurodontism?

A

this is a molar with an elongated crown and apically placed furcation, this results in an enlarged rectangular coronal pulpal chamber

65
Q

What is the characteristic appearance of taurodontism?

A
  • large pulpal chamber
  • no constriction at a-c junction
  • short pulpal canals
66
Q

Taurodontism affects both permanent and deciduous molars. True or false

A

True

67
Q

What is the cause of taurodontism?

A

late invagination of hertwigs root sheath

68
Q

What conditions can be associated with taurodontism?

A
  • amelogenesis imperfecta
  • Klinefelter syndrome
  • downs syndrome
69
Q

Define Dens invaginatus

A

(invaginated odontome)
developmental anomaly with deep enamel lined pit extending to varying lengths into the underlying denting, often displacing the pulp and altering the root shape

70
Q

Dens invaginatus is also known as …

A

dens in dente

71
Q

An extreme form of dens invaginatus is referred to as …

A

dilated odontoma

72
Q

Dens invaginatus is more likely to affect which type of teeth ?

A

permanent maxillary lateral incisors
Peg shaped laterals are more common

73
Q

Why is prevention key in dens invaginatus ?

A

the base enamel pit is thin, there is also defective enamel /dentine
this makes the tooth vulnerable

74
Q

Give examples of supernumerary cusps

A
  • cusp of carabelli (MP surface of maxillary first molar)- common
  • dens evaginatus
  • talon cusps
75
Q

Define dens evaginatus

A

a developmenral anomal characterised by a cusp like supernumerary focal enamel protrusion (spur) on the occlusal or lingual surface of the crown

76
Q

Dens evaginatus mainly affects _______ teeth

A

premolar

77
Q

What is the characteristic appearance of dens evaginatus in a premolar tooth ?

A

abnormal globe shape prohection of enamel in central groove

78
Q

Dens evaginatus is more common in what populations?

A
  • chinese
  • japanese
  • filipino
  • american indian
  • singapore/malaysia (leong premolar)
79
Q

What is a possible consequence of a dens evaginatus projection fracturing off?

A

pulpal exposure

80
Q

What tooth are talon cusps usually found and where ?

A
  • lingual aspect of maxillary lateral incisor
  • can extend to incisal edge
81
Q
A
81
Q

Why must you avoid reducing pulp horns?

A

this is due to the presence of a prominent pulp horn

82
Q

Fused and germinated teeth are more common in what type of dentition?

A

deciduous dentition

83
Q

Define fusion

A

a develomental anomaly characterised by abnormally shaped tooth with either a wide crown and one root or a normal crown with an additional root (or a combination)

combination of two adjacent tooth germs united by dentine

84
Q

Briefly describe the pulp in a fused tooth

A

pulp can be seperate or fused

85
Q

Fused teeth are less vulnerable to caries and periodontal disease. True or false

A

false

86
Q

Define germination

A

developmental anomaly where a single rooted tooth (unusually wide), with a partly divided crown or two seperate crowns

87
Q

What is the cause of germination ?

A

partial division or twinning of a single tooth germ

88
Q

What is the difference between fusion and germination ?

A

microscopically they appear the same but they have different developmental pathways

89
Q

What is hypercementosis ?

A

apposition of excessive amounts of cementum

90
Q

What are some causes of hypercementosis ?

A

ageing
inflammation

91
Q

What type of teeth are affected by hypercementosis ?

A

functionless and unerupted teeth

92
Q

What is a possible consequence of hypercementosis ?

A

concrescence

93
Q
A
93
Q

Define concrescence ?

A

union of roots caused by conflucence of cementum only

94
Q

Concresence is a type of ______

A

fusion

95
Q

What are possible causes of concresence ?

A
  • trauma
  • crowding with interseptal bone loss
96
Q

When can concresence occur?

A

before or after tooth eruption

97
Q

What are enamel pearls ?

A

ectopic droplets of enamel that primarily occur in bifurcation or trifurcation areas on roots of molars

98
Q

How do enamel pearls appear on radiographs ?

A

1-3mm radiopacities

99
Q

Enamel pearls may have a central core of __________.

A

dentine

100
Q

Why is the treatment of enamel pearls avoided?

A

may create root caries, external root resorption or pulpitis

101
Q

What causes enamel pearls (enamelomas)?

A

ameloblasts displaced below the amelocementa junction

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