Dental Anomalies 1 Flashcards
What are the different cateogories of dental anomalies?
- Congenital:– Genetically inherited
- Developmental:– Anomalies occur during tooth formation
- Acquired:– Anomalies occur after teeth formation
What are the different types of developmental dental abnormalities?
- Number of teeth:
-Supernumerary teeth
-Missing teeth - Size of teeth
-Macrodontia
-Microdontia - Eruption of teeth
-Transposition - Enamel pearl or Enameloma
- Altered morphology
-Fusion
-Gemination
-Concrescence
-Taurodontism
-Dilaceration
-Supernumerary roots
-Dens invaginatus & dens in dente
-Dense evaginatus and talon cusp
What are acquired abnormalities?
1) Attrition
2) Abrasion
3) Erosion
What is the definition of supernumerary teeth?
Presence of extra erupted or unerupted teeth
- also called hyperdontia
What is the 2nd most common dental anomaly?
supernumerary teeth
_____% of the population has supernumerary teeth
1-4%
What is a mesiodens?
Supernumerary tooth in maxillary incisor region
What is a distodens?
4th molar
Most common single supernumerary tooth is…
mesiodens or distodens
Multiple supernumerary teeth most commonly found in _______________ region
mandibular premolar
How do you view multiple unerupted supernumerary teeth on a radiograph?
CBCT
How do you view an isolated supernumerary tooth on a radiograph?
Periapical or panoramic images
mesiodens
- supernumerary tooth
distodens
- supernumerary tooth
supernumerary teeth
supernumerary teeth
Is the tooth lingual or buccal to #8/#9?
Tube was moved to the distal
Mesiodens followed the same direction
SLOB
- mesiodens is lingual
What are the top differential diagnoses for supernumerary teeth?
- Cleidocranial dysplasia
- Gardner syndrome
What are the symptoms of cleidocranial dysplasia?
- Absent or hypoplastic clavicles
- High palate, cleft palate
- Open cranial sutures
- Hypoplastic paranasal sinuses
- Mandibular prognathism
- Multiple unerupted supernumerary teeth
What do radiographs of people with cleidocranial dysplasia?
What is this showing?
hypoplastic clavicles
- cleidocranial dysplasia
What is this showing?
- Open cranial sutures
- Hypoplastic paranasal sinuses
- cleidocranial dysplasia
What is this showing?
- Mandibular prognathism
- Open cranial sutures
- Supernumerary teeth in mandible
What are the symptoms of gardner syndrome?
- Osteomas
- Epidermoid cysts of skin
- Multiple supernumerary teeth
- Colorectal polyps with malignant potential
osteoma
- benign tumor of bone
What is the treatment of supernumerary teeth?
Conservative or removal of supernumerary teeth to reduce likelihood of complications, such as:
- Resorption of adjacent teeth
- Periodontal problems
- Crowding, malocclusion
- Development of pathology (e.g., dentigerous cyst)
What is missing teeth/hypodontia?
Absence of erupted tooth or dental follicle without history of extraction
Most commonly missing teeth are…
third molars > mandibular second premolars > maxillary lateral and mandibular central incisors
Excluding third molars absence, hypodontia it affects ______% of the population
3-10%
What is anodontia definition?
Total lack of development of teeth
What is hypodontia definition?
Lack of development of 1 or more teeth
What is oligodontia definition?
Lack of development of 6 or more teeth (excluding third molars)
What is the etiology of hypodontia?
- Absenceof dental lamina
- Environmental factors that may damage dental lamina prior to tooth formation
– Trauma
– Infection
– Radiation, chemotherapy, combo - Genetics
What is the top differential diagnosis for hypodontia?
ectodermal dysplasia
What is ectodermal dysplasia?
- Decreased number of sweat glands
- Sparse hair, eyelashes, eyebrows
- Dystrophic or malformed nails
- Hypodontia with abnormal crown shape in teeth that are present
What is shown here? (no extractions)
ectodermal dysplasia
- hypodontia
What syndome is this?
ectodermal dysplasia
What is macrodontia?
- Larger than normal tooth, seeing clinically or radiographically
- Often affects a single tooth
- May be associated with crowding and malocclusion
- The shape of the tooth is usually normal
What tooth has macrodontia?
What is microdontia?
- Smaller than normal tooth, seeing clinically or radiographically.
- Might involve all teeth, single tooth or a group of teeth
What teeth are usually affected by microdontia?
third molars and maxillary lateral incisors
What is the treatment for microdontia?
restorative if needed
What does this show?
microdontia
- peg lateral
What does this show?
microdontia
What is transposition?
condition in which two typically adjacent teeth have exchanged positions in the dental arch
What are the most frequently transposed teeth?
permanent canine and the first premolar
True/False: transposition in the primary dentition is impossible
False, however Transposition in the primary dentition has not been reported
What teeth have been transpositioned?
What is an enamel pearl?
Is a small formation of enamel 1 to 3 mm in diameter that occurs on the roots of molars
Enamel pearls are found in about __% of the population
3%
What is shown here?
enamel pearl
Most enamel pearls form ________ to the gingival crest, and are not detected during aclinical examination
apical
Where do enamel pearls typically form?
furcal areas of molar teeth, often lying at or just apical to the cementoenamel junction
What is the problem with enamel pearls?
May predispose to formation of a periodontal pocket and subsequent periodontal disease
What is the differential diagnosis for enamel pearls?
calculus
How do you manage enamel pearls?
Removal if it is a risk factor to periodontal disease. The possibility must always be considered that it may contain a pulp horn.
What is fusion?
the union of adjacent tooth germs of developing teeth
Fusion results in a _________ number of teeth in thearch
reduced
Is fusion more common in the deciduous dentition or permanent dentition?
more common in deciduous
Is fusion more common in the anterior or posterior?
anterior
What is the differential interpretation for fusion?
gemination
What is the difference between fusion and gemination?
fusion may be differentiated from
gemination when the number of teeth is reduced by one
What is the managment for fusion?
- Conservative
- RCT + restorative
fusion
gemination
What is gemination?
Arises when a single tooth bud attempts to divide. The result may be an invagination of the crown with partial clefting.
What type of teeth are more likely to have gemination?
May occur in both the deciduous and the permanent dentitions. Primary teeth are more often affected, usually in the incisor region.
What does the pulp look like of a tooth with gemination?
The pulp chamber is usually single and enlarged, and may be partially divided
What is the differential diagnosis for gemination?
– Macrodontia
– Fusion
How do you manage gemination?
– Restorative
—The cleft is a carious susceptible site
– Extraction only when needed
gemination
What is concrescence?
Occurs when the roots of two or more primary or permanent teeth are fused through cementum.
What are the teeth most likely to have concrescence?
Maxillary molars are the teeth mostly affected, especially a third molar and a supernumerary tooth.
What is the cause of concrescence?
Cause is unknown → space restriction during development, local trauma, excessive occlusal force, or local infection after development.
An imaging examination may not always reveal concrescence because…
teeth may be in close contact or are simply superimposed → small FOV CBCT
What is taurodontism?
Elongation of pulp chamber in multirooted tooth with apical displacement of pulpal floor
- Affects primary or permanent dentitions
- Single or multiple teeth may show
- Cannot be detected clinically, only radiographically.
What does taurodontism look like radiographically?
- elongated pulp chamber
- more apically positioned furcation
- Short roots
What does this show?
taurodontism
What is dilaceration?
sharp bend or curve in the tooth anywhere in the crown or the root
What tooth is most often affected by dilaceration?
maxillary premolars
What does this show?
dilaceration
What are supernumerary roots?
Increased number of roots compared to usual anatomic number
Presence of supernumerary roots may affect treatment of…
- Orthodontics, endodontics, extractions.
- GREAT prosthodontic abutments
Radix entomolaris is extra _______ root on mandibular molars
lingual
Radix paramolaris is extra _______ root on mandibularmolars
buccal
What does this show?
supernumerary roots
What is dens invaginatus and dens in dente?
Represent varying degrees of invagination or infolding of the enamel surface into the interior of tooth.
What tooth is most commonly affected by dens invaginatus and dens in dente?
Maxillary lateral incisor
What teeth is dens invaginatus and dens in dente rare in?
deciduous dentition and mandibular teeth
What does this show?
dens invaginatus and dens in dente
What is the issue with dens invaginatus and dens in dente?
High risk of caries → prophylactic restoration
What does this show?
dens invaginatus and dens in dente
What are the differen types dens invaginatus and dens in dente?
What is dens evaginatus and talon cusp?
the result of an evagination or outpouching of the enamel organ
Where does dens evaginatus and talon cusp usually occur?
resultant enamel-covered tubercle usually occurs in or near the middle of the occlusal or incisal surface of tooth
What is the core of a dens evaginatus and talon cusp made of?
The tubercle often has a dentin core, and a very slender pulp horn frequently extends into the evagination.
What does this show?
dens evaginatus and talon cusp
If the tubercle (talon cusp) causes any ________________ or shows evidence of marked abrasion, it probably should be removed under aseptic conditions
occlusal interference
