Dental Anomalies Flashcards
Outline the main types of dental anomaly.
Number
Size and shape
Structure - hard tissue defects
Eruption and exfoliation
Which are the teeth least likely to be missing?
The teeth least likely to be missing are the first permanent molars and upper central incisors
Which medical conditions can be associated with hypodontia?
Ectodermal Dysplasia
Down Syndrome
Cleft Palate
Hurler’s syndrome
Incontinentia pigmentii
What issue can missing upper lateral incisors cause in relation to the lower canines?
Over-eruption of the lower canines, leading to restorative and occlusion issues.
Outline the main management steps in a patient with hypodontia?
Diagnosis
Preventative treatment
Removal prosthesis
Orthodontics
Composite build ups
Porcelain veneers
Crown and bridgework
Implants
Outline the possible ways teeth can vary in shape and size in relation to developmental abnormalities.
Microdontia - peg shaped laterals
Macrodontia - large teeth
Double teeth - Germination (teeth split into two) or Fusion (teeth joined)
Odontomes (Simple or complex)
Taurodontism (Flame shaped pulps)
Dilaceration (Root or crown displacement)
Accessory cusps (Talon cusps)
What is dilaceration of a tooth?
Interruption in the development of teeth, usually from trauma. The long axis of the tooth is altered between root and crown, leading to the displacement between two portions of the tooth.
Outline the possible causes of anomalies of tooth structure within the root.
Short root anomaly
Radiotherapy
Dentine dysplasia
Accessory roots
Outline the possible structure anomalies that can occur within the enamel.
Amelogenesis imperfecta
Environmental enamel hypoplasia
Localized enamel hypoplasia
Which environmental factors/medical conditions can predispose a risk of enamel defect prenatally?
Rubella
Congenital syphilis
Thalidomide
Fluoride
Maternal A&D deficiency
Cardiac & kidney disease.
Which environmental factors/medical conditions can predispose a risk of enamel defect neonatally?
Prematurity
Meningitis
Which environmental factors/medical conditions can predispose a risk of enamel defect Postnatally?
Otitis media
Measles
Chickenpox
TB
Pneumonia
Diphtheria
Deficiency of Vits A,C&D
Heart disease
Long term health problem e.g. organ failure
What are the types of amelogenesis imperfecta?
Hypoplastic
Hypomineralised
Hypomaturation
Mixed with taurodontism
Describe hypoplastic amelogenesis imperfecta.
Genetic mutation inhibiting the process of enamel prism growth - leading to the crystals not growing to the correct length.
Describe hypomineralized amelogenesis imperfecta.
Genetic mutation inhibiting the process of enamel prism growth - leading to the crystals not growing to the correct thickness and width.
Describe hypomaturational amelogenesis imperfecta.
Genetic mutation inhibiting the process of enamel prism growth - leading to the crystals growing incompletely with incomplete mineralization.
What problems can amelogenesis imperfecta cause?
Sensitivity
Caries/ acid susceptibility
Poor aesthetics
Poor oral hygiene
Delayed eruption
Anterior open bite
What treatment options are there for patients with amelogenesis imperfecta?
Preventive therapy
Composite veneers/ composite wash
Fissure sealants
Metal onlays
Stainless steel crowns
Orthodontics
List the possible systemic disorders associated with enamel defects, unrelated to amelogenesis imperfecta.
Epidermolysis bullosa
Incontinenta pigmenti
Down’s
Prader-Willi
Porphyria
Tuberous sclerosis
Pseudohypoparathyroidism
Hurler’s
Outline the possible structure anomalies that can occur within the dentine.
Short root anomoaly
Dentinogenesis imperfecta
Dentine dysplasia
Odontodysplasia
Systemic disturbance
What are the three types of dentinogenesis imperfecta?
Type I - Osteogenesis imperfecta
Type 2 - Autosomal dominant
Brandywine
What are are the signs of dentinogenesis imperfecta?
Appearance
Family history
Both dentitions affected
Bulbous crowns
Obliterated pulps in type I and II
Enamel loss
Associated osteogenesis imperfecta (blue sclera of eye)
What problems are associated with dentinogenesis imperfecta?
Aesthetics
Caries / acid susceptibility
Spontaneous abscess
Poor tooth prognosis
What treatment options are there for dentinogenesis imperfecta?
Prevention
Composite veneers
Overdentures
Removable prostheses
Stainless steel crowns
Which hereditary dentine defects are limited to dentine only?
Dentinogenesis imperfecta type II
Dentine dysplasia Types I & II
Fibrous dysplasia of dentine
Which hereditary dentine defects are also associated with a general disorder?
Osteogenesis imperfecta
Ehlers-Danlos syndrome
Brachio-skeletal genital syndrome
Rickets
Hypophosphatasia
What anomalies can cause disruption in cementum structure?
Cleidocranial dysplasia
- Hypoplasia of cellular component of cementum
Hypophosphatasia
- Hypoplasia or aplasia of cementum
- Early loss of primary teeth
What conditions can cause delayed eruption of teeth?
Pre-term & low birth-weight children
Malnutrition
Associated general conditions:
Downs, hypothyroidism, hypopituitarism,
cleidocranial dysplasia
Gingival hyperplasia/ overgrowth
What can cause premature exfoliation?
Trauma
Following pulpotomy
Hypophosphatasia
Immunological deficiency e.g. cyclic neutropaenia
Chediak-Higashi syndrome
Histiocytosis X
What can cause delayed exfoliation?
Infra-occlusion
‘Double’ primary teeth
Hypodontia
Ectopic permanent successors
Following trauma
What are the genetic causes of amelogenesis imperfecta?
It is caused by an inherited gene mutation in the genes AMELX, ENAM or MMP20
These are responsible for making the proteins needed for normal formation of enamel through the enamel extracellular matrix molecules.
Different mutations occur depending on the type of AI.
Other than amelogenesis imperfecta, what are the other causes of enamel defects?
Fluorosis
MIH
Trauma
Nutritional defects
Illness during pregnancy
