Dental Anomalies Flashcards by Alistair Stoddart

What dental anomalies are there

Number

Size and shape

Structure- hard tissue defects

Eruption and exfoliation

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What are the names for anomalies in number

Hypodontia

Hyperdontia/supernumery teeth

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What is the most common tooth missing with hypodontia

3rd molars

9-37% of the population

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What is the incidence for missing primary teeth

0.1-0.9%

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Other than 3rd molars what is the incidence of missing permanent dentition

3.5-6.5%

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In the permanent dentition what are the most common teeth missing

Mandibular premolars 1.2-2.5%

Maxillary lateral incisors 1-2%

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What are the least likely teeth to be missing in the permanent dentition

1st molars and upper centrals

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What conditions are asssociated with hypodontia

Ectodermal Dysplasia

Down Syndrome

Cleft Palate

Hurler’s syndrome

Incontinentia pigmentii

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What is the prevalance of hyperdontia

1.5-3.5%

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What are the types of supernumerary teeth

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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What anomalies of size and shape are there

microdont e.g. peg-shaped lateral incisors

macrodontia

double teeth
-Gemination (one tooth splits into 2)
-Fusion (two teeth join to form 1)

odontomes

taurodontism 6.3% in UK (flame shaped pulp)

dilaceration (crown or root)

accessory cusps e.g. talon cusp

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How would you treat accessory cusps

Grind them down overtime to encourage the pulp to ‘shrink’ as there is still pulp in the cusps that you dont want to damage

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How you treat dens in dente

Immediatly seal as much of the tooth to prevent bacterial ingress as root treating these teeth impossible

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What structure anomalies of the root can happenn

Short roots

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What is the most common tooth to have short root anomaly and what is the incidence

Permanent maxillary incisors

2.5%

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What can cause the short root anomnaly

Radiotherapy

Dentine dysplasias

Accessory roots

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What enamel structure anomalies are there

amelogenesis imperfecta

environmental enamel hypoplasia

localised enamel hypoplasia

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What are the main types of amelogenesis imperfecta

Hypoplastic

Hypcalcified

Hypomaturational

Mixed forms

What can cause enviromental enamel hypoplasia

Systemic causes

Nutritional

Metabolic eg. liver disease

Infection eg measles

What can cause localised enamel hypoplasia

Truama

Infection of the tooth

When hard tissue defects have been identified what do you do

Find out if its localised or generalised

If its localised hard tissue defect what could the cause be

Trauma

Caries then abscess of primary incisors

If its generalised hard tissue defect what do you do

Find out if its:

Enviromental
-Fluorosis
-childhood illness Eg. Liver or kidney failure

Hereditary
-Amelogenesis imperfecta

Give examples of generalised enviromental enamel defects

Prenatal
-rubella, congenital syphilis, thalidomide, Fluoride, maternal A&D deficiency, cardiac & kidney disease.

Neonatal
-prematurity, meningitis.

Postnatal
-otitis media, measles, chickenpox, TB, pneumonia, diphtheria, deficiency of Vits A,C&D. heart disease. Long term health problem e.g. organ failure

How many does Amelogenesis imperfecta affect

1:14,000

What causes Amelogenesis imperfecta

familial inheritance autosomal dominant, recessive, and x-linked no associated systemic disorder

How would you diagnose Amelogenesis imperfecta

Check family history Check both dentitions if you can as it affects both Check all the teeth as it affects all teeth Compare tooth size, structure, colour Take radiographs

What is though to be the cause of Amelogenesis imperfecta

Enamel formation needs multiple genes to transcribe the process of crystal growth and mineralisation, in Amelogenesis imperfecta gene mutations found so far, involve enamel extracellular matrix molecules amelogenin and enamelin and kallikrein 4

If its a Hypoplastic type of Amelogenesis imperfecta what is wrong

Enamel crystals do not gorw to the correct length

If its a Hypocalcified type of Amelogenesis imperfecta what is wrong

Enamel defect due to malfunction of enamel calcification, therefore enamel is of normal thickness but is extremely brittle

If its a Hypomaturational type of Amelogenesis imperfecta what is wrong

Enamel crystals grow incompletely in thickness or width but to normal length with incomplete mineralisation

What problems arrise from amelogenesis imperfecta

sensitivity caries/ acid susceptibility poor aesthetics poor oral hygiene delayed eruption anterior open bite

What solutions to amelogenesis imperfecta is there

preventive therapy composite veneers/ composite wash fissure sealants metal onlays stainless steel crowns orthodontics

What systemic disorders are associated with enamel defects

epidermolysis bullosa incontinenta pigmenti Down’s Prader-Willi porphyria tuberous sclerosis pseudohypoparathyroidism Hurler’s

What anomalies of dentine structure is there

dentinogenesis imperfecta dentine dysplasia odontodysplasia systemic disturbance

What is the most common anomaly of dentine structure and how many types

dentinogenesis imperfecta 3 types

What are the 3 types of dentinogenesis imperfecta

Type I- osteogenesis imperfecta Type II-autosomal dominant Brandywine

What is dentine Dysplasia

normal crown morphology, amber radiolucency, pulpal obliteration, short constricted roots

What is odontodysplasia

localised arrest in tooth development, thin layers of enamel and dentine, large pulp chambers

How would you diagnose dentinogenesis imperfecta

heck the apperance of all the appearance Check family history Is there associated osteogenesis imperfecta Check both dentitions as both dentitions affected Take a radiograph and look for: -bulbous crowns -obliterated pulps (I & II)

What problems is asociated with dentinogenesis imperfecta

aesthetics caries / acid susceptibility spontaneous abscess

What solutions is there for dentinogenesis imperfecta

prevention composite veneers overdentures removable prostheses stainless steel crowns

What anomalies of cementum are there and what are they

cleidocranial dysplasia -hypoplasia of cellular component of cementum hypophosphatasia -hypoplasia or aplasia of cementum -early loss of primary teeth