Dental Anomalies Flashcards
- what is it called for missing teeth?
- what teeth are least likely to be missing?
- what are conditions are associated with hypodontia?
- what are features of ectodermal dysplasia?
- hypodontia
- first permanent molars and upper central incisors - (if a tooth is going to be missing it tends to be the last one in a series)
- Ectodermal Dysplasia - (very sparse hair, blonde, saddle shaped noses, intolerant to sweatin)
Down Syndrome
Cleft Palate
Hurler’s syndrome
Incontinentia pigmentii
what is this and what is happening here?
- hypodontia - missing lateral
what is happening here?and what problem can arise?
retained baby tooth
Over-eruption of lower canines can be a restorative problem when upper lateral incisors are missing
- what do hypodontia patient also tend to have?
- what is chronology of dental management for hypodontia patients?
- small teeth and straight sided teeth
- diagnosis
removable prosthesis - bridge not until older
ortho
comp build ups - common. increase size and shape
porcelain veneers - not until pt early 20s when gingival margin is at the level
crowns bridges
preventative tx - high risk they can’t lose anymore
- what are problems with hypodontia?
- what are solutions to hypodontia?
- abnormal shape - (cone shaped)
spacing
submergence - ( or infraocclusion of primary teeth) - (could be why overdenture good idea)
deep overbite
reduced LFH - overdenture
partial denture
composite
porcelain veneers
fixed prostheses
implants
- what is more teeth called?
- what are tendencies of it?
- hyperdontia/supernumerary
- more common males, more common maxilla, higher frequence in cleidocranial dysplasia
what are types of supernumerary?
Conical (cone shaped)
Tuberculate (barrel shaped, has tubercles)
Supplemental (looks like tooth of normal series) - (tend to be a little smaller) - (keep tooth that is best orthodontically)
Odontome (irregular mass of dental hard tissue, compound or complex)
Supernumerary teeth are the most common cause of delayed eruption of permanent incisor teeth
what are anomalies of size and shape?
microdont (2.5%, F>M) e.g. peg-shaped lateral incisors:
macrodontia rare, less than 1% for single teeth and 0.1% in generalised form in Caucasians
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
what is this an example of?
peg shaped lateral incisors
what is this an example of?
talon cusp
what is this? what do you do?
dens in dente
- seal all areas to stop ingress of bacteria as these teeth are impossible to treat
- what is main types of amelogenesis imperfecta?
- causes of environmental enamel hypoplasia?
- causes of localised enamel hypoplasia?
- what do you ask if a patient has localised enamel hypoplasia?
- hypoplastic
hypocalcified
hypomaturational
mixed forms
there are 100s
- systemic
nutritional
metabolic e.g. Rhesus incompatability, liver disease
infection e.g. measles - trauma
infection of primary teeth - ask if they had any bad baby teeth or removed early
What is this? features? what would be cause of hypoplastic?
hypomineralised enamel
- appears as brown or white patches
- all tissue there and normal shape just have marks on them
- enamel chunks missing
how would you treat fluorosis?
treat using microabrasion therapy, veneers/ vital bleaching
what kind of illnesses can MIH be associated with?
MIH assoc. with childhood illness or chronological hypomin. Eg. Liver or kidney failure
what are generalised environment enamel defects
1. prenatal
2. neonatal
3. postnatal
- rubella, congenital syphilis, thalidomide, Fluoride, maternal A&D deficiency, cardiac & kidney disease.
- prematurity, meningitis.
- otitis media, measles, chickenpox, TB, pneumonia, diphtheria, deficiency of Vits A,C&D. heart disease. Long term health problem e.g. organ failure
what can you see here?
hypoplastic tooth - left premolar has chunks missing
what is hereditary hard tissue defects?
amelogenesis imperfecta
how do you diagnose amelogensis imperfecta?
family history
generally affects both dentitions - (lots of diagnossi not made until permanent dentition)
affects all teeth
tooth size, structure, colour
radiographs - (you will fail to see an obvious change in radiolucency between enamel and dentine)
what do the gene mutations found involve?
Gene mutations found so far, involve enamel extracellular matrix molecules amelogenin and enamelin and kallikrein 4
describe each type
1. hypoplastic
2. hypomineralised
3. hypomaturational
- Hypoplastic type
Enamel crystals do not grow to the correct length - Hypomineralised
Crystallites fail to grow in thickness and width - Hypomaturational
Enamel crystals grow incompletely in thickness or width but to normal length with incomplete mineralisation
- what are problems with amelogenesis imperfecta?
- what are solutions
- sensitivity - leads to poor OH - difficulty brushing
caries/ acid susceptibility
poor aesthetics
poor oral hygiene
delayed eruption
anterior open bite - preventive therapy
composite veneers/ composite wash
fissure sealants
metal onlays
stainless steel crowns
orthodontics
what are SYSTEMIC DISORDERS ASSOCIATED WITH ENAMEL DEFECTS (not Amelo)/
epidermolysis bullosa
incontinenta pigmenti
Down’s
Prader-Willi
porphyria
tuberous sclerosis
pseudohypoparathyroidism
Hurler’s
What are types of DENTINOGENESIS IMPERFECTA?
Type I - osteogenesis imperfecta
Type II - autosomal dominant
Brandywine
how to DIAGNOSE DENTINOGENESIS IMPERFECTA?
appearance
family history
associated osteogenesis imperfecta
both dentitions affected
radiography:
bulbous crowns
obliterated pulps (I & II)
enamel loss
what is this?
TYPE I DENTINO
what is this and why?
Child with osteogenesis imperfecta, (blue sclera of eye apparent)
what are 1. problems 2. solutions of dentinogensis imperfecta
- aesthetics
caries / acid susceptibility
spontaneous abscess - prevention
composite veneers
overdentures
removable prostheses
stainless steel crowns
what are other hereditary dentine defects you can get?
1) limited to dentine only?
2) associated with a general disorder?
1) dentinogenesis imperfecta type II
dentine dysplasia Types I & II
fibrous dysplasia of dentine
2) osteogenesis imperfecta
Ehlers-Danlos syndrome
brachio-skeletal genital syndrome
rickets
hypophosphatasia
what are conditions that have anomalies of cementum?
cleidocranial dysplasia
- hypoplasia of cellular component of cementum
hypophosphatasia
- hypoplasia or aplasia of cementum
early loss of primary teeth
what causes anomalies of eruption?
pre-term & low birth-weight children
malnutrition
associated general conditions:
Downs, hypothyroidism, hypopituitarism, cleidocranial dysplasia
gingival hyperplasia/ overgrowth
what causes premature exfoliation?
trauma
following pulpotomy
hypophosphatasia
immunological deficiency e.g. cyclic neutropaenia
Chediak-Higashi syndrome
Histiocytosis X
what causes delayed exfoliation?
infra-occlusion - also from trauma
‘double’ primary teeth
hypodontia
ectopic permanent successors
following trauma
