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5th ACS - Dental Anomalies > Dental Anomalies > Flashcards

Dental Anomalies Flashcards

1
Q

What are 5 types of anomalies with teeth?

A

MENS Coat

tooth MORPHOLOGY
tooth ERUPTION
tooth NUMBER
enamel and dentine STRUCTURE
tooth COLOUR
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2
Q

Examples of enamel/ dentine defects?

A

Amelogenesis imperfecta

Dentinogenesis imperfect

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3
Q

How is enamel affected in AI?

A

Hypoplastic - thin or absent enamel

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4
Q

What symptoms might see in AI?

A

Sensitivity due to reduced enamel –> makes hard brush teeth = plaque/ calculus deposit

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5
Q

How to manage AI?

A

OHI
Manage sensitivity: F- varnish, tooth mousse, mouth guards to hold desensitising agents
Restorative management - composite direct or indirect/ PMCs

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6
Q

What orthodontic feature can be seen in AI?

A

AOB

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7
Q

What careful of if provide ortho to those w/ AI?

A

Enamel defect- brackets debond easily/ can lead to enamel shearing off

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8
Q

What see in DI?

A

Loss of enamel w/ brown/yellow/ opalescent dentine which wears rapidly

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9
Q

What is DI?

A

Developmental anomaly of dentine

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10
Q

How is DI inherited?

A

Autosomal dominant inheritence

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11
Q

What dentition does DI affect?

A

Both - primary more severely affected

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12
Q

Clinical features DI?

A

Fracture enamel due to lack dentine support
Soft exposed dentine wears quickly
Dentine brown/yellow opalescent shade

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13
Q

Histological features DI?

A

Irregularly formed and poorly mineralised dentine

Enamel-dentinal junction abnormal

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14
Q

What is pathology of DI?

A

DSPP mutation affecting non-collagenous proteintd

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15
Q

Clinical considerations in DI?

A
  1. Discolouration - masking w/ restorative materials
  2. Relying dentine bonding - reduced bond strength resin composites
  3. Bone modelling abnomrka - issue providing ortho
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16
Q

What restorative concept must be considered when restoring teeth w/ DI?

A

OVD

Often lost due to wear

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17
Q

What should be added to composite when restoring teeth w/ DI

A

Need opaquers/ non-translucent composite to mask discolouration

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18
Q

Why want to avoid full coverage crowns in children with DI?

A

Want to avoid prep as gingival margin still maturing

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19
Q

What restorative options are available for those with DI?

A

Composite build up
Composite onlar - direct/ indirect
Gold onlay

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20
Q

Example of abnormalities in tooth morphology?

A 
Dens in dente/ Dens invaginatus
Dens evaginates
Talon cusp
Double teeth - fusion/ germination
Microdontia - peg/ conical
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21
Q

What is dens in dente/ dens invaginatus?

A

Tooth within a tooth

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22
Q

What is dens evaginates?

A

Protrusion of tubercle - often occlusal surface post/ lingual surface anterior

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23
Q

What tx is challenging to provide if there is dens invaginatus?

A

RCT

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24
Q

How to avoid RCT in dens invaginatus?

A

Early dx

Fissure seal/ occlusal communicating channels and caries-prone see

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25
Q

Prevalence of talon cusp?

A

Uncommon
More prevalent in some racial groups - North Indian population
More common in males 2:1

26
Q

What dentition is more common to see talon cusp?

A

3x more likely in permanent dentition

27
Q

Most frequently affected tooth w/ talon cusp?

A

Maxillary Lateral incisor

28
Q

Aetiology of talon cusp/ dens evaginates?

A

Multifactorial - polygenetic and environmental = disturbance tooth formation
Familial association

29
Q

When more likely to see dens evaginates?

A

Pt w/ consanguineous parents
Some syndromes
Those other dental anomalies

30
Q

What syndromes are more likely to see dens envaginatus?

A

Ellis-van creveld

Struge-weber

31
Q

What clinical problems are associated w/ talon cusp?

A 
Occlusal interference 
Caries
Poor aesthetic 
Tongue irritation 
If attrition/fracutee - pulpal exposure
32
Q

Do all talon cusps have plural extensions?

A

Some do and some don’t
Large talon cusps projecting away tooth surface are most likely to contain plural tissue
Radiographs don’t help

33
Q

Issue w/ cusp reduction in talon cusp? How to?

A

Pulpal exposure

Can gradually reduce cusp and allow reparative dentine formation/ plural recession

34
Q

What interval should talon cusp be reduced?

A

4 weeks, 6 weeks, 8 weeks and 4 months
Remove 1-1.5mm tooth each time
Place F- varnish each time

35
Q

What tooth does dens dente often affect?

A

Lateral incisors - more common if conical

36
Q

Mild form of dens dente?

A

Deep cingulum pit

37
Q

Issue w/ dens dente?

A

Often involve malformation of pulp - pulp exposure very easily

38
Q

Difference between fusion nd germination?

A

Fusion - two teeth joined

Germination - single tooth germ divided

39
Q

What do pt often complain w/ double teeth?

A

Poor aesthetic as wide

40
Q

What is essential before providing tx of double teeth?

A

Radiograph - need assess root morphology (can share root/pulp)

41
Q

How tx double teeth?

A

Multidisciplinary approach

42
Q

Why can teeth become discoloured?

A 
Tetracycline staining
Enamel defects = opacities
Congenital herpetic disorder
Non-vital teeth
DI
Caries
43
Q

What q’s should consider if tooth discoloured?

A

Is this intrinsic or extrinsic staining

Is this anomaly of tooth development?

44
Q

What colour would teeth be if pt had herpetic disorder?

A

Green

45
Q

General management of discolouration?

A

Bleaching
Microabrasion
Resin infiltration - ICON
Veneers

46
Q

When is microabrasion used?

A

Often first line of treatment for superficial intrinsic enamel staining

47
Q

Difference between mild, moderate and severe Hypodontia?

A

Mild - less 2
Moderate - 3-5
Severe >6

Excludes 8s!

48
Q

What is associated w/ hyperdontia?

A

Cleidocranial dysostosis

49
Q

What issues can be associated w/ Hypodontia?

A

Poor aesthetic
Compromised function
Loss vertical dimension

50
Q

Why is VD lost in hypodontia pt?

A

No teeth to maintain alveolus

51
Q

Management of hypodontia?

A

Multidisciplinary - ortho, paeds and restorative

Vital maintain dentition

52
Q

Tx options for hypodontia|?

A

Ortho management of spacing
Partial dentures- useful mixed dentition
Adhesive dentistry - RBB
Implants

53
Q

What condition can be associated w/ hypodontia?

A

Ectodermal dysplasia

54
Q

What features can see in ectodermal dysplasia?

A

Sparse, thin hair
Dry skin
Missing teeth
Nails deficient

55
Q

Issues associated w/ hyperdontia?

A

Poor aesthetics
Malocclusion - impede tooth eruption
Pathology associated unerupted teeth

56
Q

What pathology can be seen in hyperdontia?

A

Resorption adjacent teeth

Follicular changes

57
Q

Examples abnormalities in tooth eruption?

A

Infraocclusion
Primary failure
Ectopic or failure eruption

58
Q

What see infra occlusion?

A

Teeth appear be sinking below contact point

59
Q

Principles of management of infra-occluded teeth?

A

Early dx w/ regular review
Ortho opinion is successor absent
Space maintenance if necessary
Early XLA avoid surgery due ankylosis

60
Q

What tooth often has ectopic eruption?

A

First permanent molar

5th ACS - Dental Anomalies (4 decks)

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