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4 - paeds > dental anomalies > Flashcards

dental anomalies Flashcards

1
Q

What 4 things are commonly affected by dental anomalies?

A

Number of teeth
Size and shape of teeth
Hard tissue defects
Eruption and exfoliation

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2
Q

Name 4 conditions associated with hypodontia

A

Any from:
- ectodermal dysplasia
- Down syndrome
- Cleft palate
- Hurler’s syndrome
- Incontinencia pigmentii

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3
Q

Name 4 problems commonly caused by hypodontia

A

Any from:
- abnormal shape - often cone shaped
- abnormal form
- infraocclusion
- deep overbite
- reduced lower face height

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4
Q

Describe the prevalence of supernumeraries

A

1.5-3.5% prevalence
Males:females 2:1
More common in maxilla
Higher frequency in Japan
Higher frequency in cleidocranial dysplasia

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5
Q

What are the 4 types of supernumeraries?

A

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

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6
Q

What is the most common cause of delayed eruption of permanent incisors?

A

Supernumeraries

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7
Q

What is the prevalence of hypodontia?

A

6.3% in females
4.6% in males
0.9% in primary dentition

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8
Q

Which teeth are least likely to be missing?

A

First permanent molars
Upper central incisors

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9
Q

Describe microdontia, explain the prevalence and give an example

A

Smaller teeth than normal
2.5% prevalence, affects females more than males
Eg - peg shaped lateral incisor

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10
Q

Give 4 examples of anomalies of tooth size and shape

A

Any from:
- microdontia
- macrodontia
- odontomes
- taurodontism
- dilaceration
- accessory cusps

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11
Q

What is macrodontia and explain the prevalence?

A

Larger teeth than normal
Less than 1% for single teeth and 0.1% generalised

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12
Q

What is taurodontism and explain the prevalence?

A

Flame shaped pulp
6.3% prevalence in the UK

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13
Q

Give a common example of accessory cusps

A

Talon cusps

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14
Q

What is dens in dente and why must it be sealed?

A

A tooth within a tooth
The tooth inside has its own pulp system and RCT cannot be provided

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15
Q

What are the causes of short root anomaly?

A

Radiotherapy
Dentine dysplasias
Accessory roots

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16
Q

Describe the prevalence of short root anomaly

A

Mostly occurs on permanent maxillary incisors
2.5% incidence
15% of these also have short roots on canines and premolars

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17
Q

What is the danger of short root anomaly?

A

Very dangerous for orthodontic treatment

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18
Q

Give 3 examples of anomalies of enamel structure

A

Amelogenesis imperfecta
Environmental enamel hypoplasia
Localised enamel hypoplasia

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19
Q

Name 4 types of amelogenesis imperfecta

A

Hypoplastic
Hypocalcified
Hypomaturational
Mixed forms

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20
Q

Give 4 causes of environmental enamel hypoplasia

A

Any 4 from:
- systemic disease
- nutritional deficiency
- metabolic eg - rhesus incompatibility
- infection eg - measles
- trauma
- infection of primary tooth

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21
Q

What is the cause of localised enamel hypoplasia?

A

Trauma to primary teeth or infection of primary teeth

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22
Q

What are the different categories of hard tissue defects aetiologies?

A

Localised or generalised

23
Q

What are the 2 causes of generalised hard tissue defects?

A

Environmental
Genetic factors

24
Q

Describe the aetiology of fluorosis

A

Generalised and caused by environmental factors

25
Q

Describe the aetiology of MIH

A

Generalised and caused by environmental factors
Associated with childhood illness and chronological hypomineralisation eg - liver or kidney failure

26
Q

Give an example of a prenatal, neonatal and postnatal infection that can lead to a generalised environmental enamel defect

A

Prenatal - rubella
Neonatal - meningitis
Postnatal - measles

27
Q

Describe the prevalence of amelogenesis imperfecta

A

Affects 1 in 14,000
Familial inheritance
Autosomal dominant, recessive and x-linked

28
Q

What is used to diagnose amelogenesis imperfecta

A

Family history
Generally affects both dentitions but worse in permanent
Affects all teeth
Tooth size, structure and colour
Radiographs - fail to see changes in radiolucency between enamel and dentine

29
Q

Describe the biology of the aetiology of amelogenesis imperfecta

A

Enamel formation needs multiple genes to transcribe the process of crystal growth and mineralisation
Gene mutations found involve the enamel ECM molecules amelogenin, enamelin and kallikrein 4

30
Q

Describe hypoplastic AI

A

Enamel crystals do not grow to the correct length

31
Q

Describe hypomineralised AI

A

Enamel crystals fail to grow in thickness and width

32
Q

Describe hypomaturational AI

A

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

33
Q

Give 4 dental problems patients with AI may experience

A

Any from:
- sensitivity
- caries and acid susceptibility
- poor aesthetics
- poor oral hygiene
- delayed eruption
- anterior open bite

34
Q

What are the treatment options for AI?

A

Enhanced prevention
Composite veneers
Fissure sealants
Metal and ceramic onlays
SS crowns - later get replaced
Orthodontics - brackets often deboned but often required due to AOB

35
Q

Name 4 systemic disorders associated with enamel defects

A

Any 4 from:
- Down syndrome
- Prader-Willi syndrome
- Porphyria
- Hurler’s syndrome
- Epidermolysis bullosa
- Tuberous sclerosis
- Pseudohypoparathyroidism
- incontinente pigmentii

36
Q

Give 4 examples of anomalies of dentine structure

A

Dentinogenesis imperfecta
Dentine dysplasia
Odontodysplasia
Systemic disturbance - nutritional, metabolic, drugs

37
Q

What is dentine dysplasia?

A

Normal crown morphology, amber radiolucency, pulpal obliteration and short constricted roots

38
Q

What is Odontodysplasia?

A

Localised arrest in tooth development
Thin layers of enamel and dentine
Large pulp chambers
‘Ghost teeth’

39
Q

What is the prevalence of dentinogenesis imperfecta?

A

Very rare, far rarer than AI

40
Q

What are the 3 types of dentinogenesis imperfecta?

A

Type I
Type II
Brandywine

41
Q

How is dentinogenesis imperfecta diagnosed?

A

Appearance
Family history
Associated osteogenesis imperfecta (wheelchair, multiple bone fractures)
Both dentitions
Affected
Radiographs - bulbous crowns and obliterated pulps (I and II)
Enamel loss - normal but quickly lost due to no connection at ACJ
Occult abscess - abscess forming without any disease

42
Q

Describe the pulp chamber in DI

A

Huge pulps when tooth first erupts but quickly obliterated

43
Q

What is type I DI associated with?

A

Osteogenesis imperfecta - child will have blue sclera of eye in stead of white and teeth will appear amber/translucí ent grey

44
Q

What dental problems may patients with DI experience?

A

Poor aesthetics
Caries and acid susceptibility
Spontaneous abscess
Very poor prognosis

45
Q

What are the treatment options for DI?

A

Enhanced prevention
Composite veneers
Overdentures
Removable prosthesis
SS crowns on posterior teeth
Composite on anterior teeth

46
Q

Name 2 other hereditary dentine defects limited to dentine only

A

Dentinogenesis imperfecta type II
Fibrous dysplasia of dentine

47
Q

Name 2 other hereditary dentine defects associated with a general disorder

A

Any 2 from:
- Osteogenesis imperfecta
- Ehlers-Danlos syndrome
- Rickets
- Hypophosphatasia

48
Q

What are the main aims of treatment for tooth structure defects?

A

Enhanced prevention
Pain control
Restoration of lost tissue
Harness growth

49
Q

Give examples of 2 anomalies of cementum

A

Cleidocranial dysplasia - no clavicle, patient can touch shoulders together - hypoplasia of cellular component of cementum
Hypophosphatasia - hypoplasia or aplasia of cementum, early loss of primary teeth

50
Q

Name 3 signs of premature eruption of teeth

A

High birth weight
Precocious puberty (early)
Natal or neonatal teeth

51
Q

Give 4 signs of delayed eruption of teeth

A

Any 4 from:
- Preterm and low birth weight
- Malnutrition
- Down syndrome
- Cleidocranial dysplasia
- Gingival hyperplasia - pseudodelayed eruption, so much gingivae that teeth don’t seem to be erupting
- infraocclusion
- double primary teeth
- hypodontia
- ectopic permanent successors
- following trauma

52
Q

Name 4 causes of premature exfoliation

A

Any 4 from:
- trauma
- following pulpotomy
- Hypophosphatasia
- immunological deficiency eg - cyclic neutropenia
- Chediak-Higashi syndrome
- Hystiocytosis X

53
Q

Describe the prevalence of infra-occlusion

A

Affects 1-9% of people
Lower first primary molar most common, can happen to second too
Congenital absence of premolar successor
Majority exfoliate by 11-12 but some are properly ankylosed

4 - paeds (3 decks)

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