Dental Anomalies

Question 1

what are the groups of dental anomalies that can occur?

Answer 1

• Number
• size & shape
• structure - hard tissue defects
• eruption & exfoliation

Question 2

give an example of a dental anomaly that can affect number of teeth?

Answer 2

Hypodontia, supernumerary

Question 3

what are some examples of hypodontia?

Answer 3

• 3rd molars
• lateral incisors (maxillary)

more common in permanent teeth than primary

Question 4

what are conditions associated with hypodontia?

Answer 4

• ectodermal dysplasia (outer layer [ectoderm] of embryo does not develop normally)
• down syndrome
• cleft palate
• hurler’s syndrome
• incontinentia pigmentii

Question 5

whats the chronology of dental management for a pt with hypodontia?

Answer 5

Question 6

Regarding supernumerary teeth, give answers to the following:
- prevalence %
- what gender has more chance
- what arch more common

Answer 6

• 2-3% prevalence
• males:female, 2;1
• more common maxilla

Question 7

what are the types of supernumerary, and what is each one?

Answer 7

• conical (cone shaped)
• tuberculate (barrel shaped)
• supplemental (normal tooth anatomy)
• odontome [irregular mass of enamel, dentine, pulp tissue] (compound/complex type)

Question 8

what are examples for anomalies of SIZE & SHAPE?

Answer 8

• Microdontia (peg-shaped laterals)
• Macrodontia (rare)
• double teeth (splitting of 1 tooth into 2, or 2 teeth join to form 1)
• odontomes
• dilaceration (crown or root)
• accessory cusps (talon cusp, cusp of carabelli)

Question 9

what are anomalies of root structure that can occur?

Answer 9

• short root anomaly
• accessory roots
• dilacerated roots

Question 10

what are anomalies of enamel structure that can occur?

Answer 10

• [Genetic] amelogenesis imperfecta (hypoplastic enamel)
• [Environmental] Enamel hypoplasia - nutritional/systemic/metabolic/infection
• Localised enamel hypoplasia - trauma, infection of primary tooth

Question 11

what is flurosis and how can it be treated?

Answer 11

• white/brown speckles on enamel (defect) caused by excessive fluoride intake during development

Microabrasion therapy, vital bleaching, veneers

Question 12

What is molar incisor hypomineralisation & its associations?

Answer 12

• developmental defect of enamel (hypomineralised) affecting molars & incisors

associated with:
- childhood illness
- prenatal factors
- environmental influences

Question 13

what are some PRENATAL (before/during pregnancy) ENVIRONMENTAL factors causing enamel defects?

Answer 13

• rubella
• congenital syphilis
• maternal vit a & d deficiency
• cardiac & kidney disease

Question 14

what are some NEONATAL (first 28 days birth) ENVIRONMENTAL factors that can cause enamel defects?

Answer 14

• prematurity
• meningitis

Question 15

what are some POSTNATAL ENVIRONMENTAL factors that can cause enamel defects?

Answer 15

• measles
• chickenbox
• tuberculosis
• Vit A,C & D deficiency,
• heart disease
• long term health problems

Question 16

how can amelogenesis imperfecta be diagnosed?

Answer 16

• family history
• generally affects both dentitions (so if primary teeth have it, permanent most likely will too)
• affects all teeth
• tooth size, structure, colour
• radiographs

Question 17

3 subtypes of amelogenesis imperfecta and what does each mean?

Answer 17

Hypoplastic:
enamel crystals do not grow to correct length

Hypomineralised/Hypocalcified:
crystallites fail to grow in thickness and width

Hypomaturational:
enamel crystals grow incompletely in thickness/width but to normal length with incomplete mineralisation

Question 18

what dental problems arise from amelogenesis imperfecta?

Answer 18

• sensitivity
• caries/acid susceptibility
• poor aesthetics
• poor OH
• delayed eruption
• anterior open bite

Question 19

what are solutions/tx options for amelogenesis imperfecta?

Answer 19

• prevention!! (Fluoride varnish!!)
• composite veneers/composite wash
• fissure sealants
• metal onlays
• SSC
• orthodontics

Question 20

what things/diseases can cause anomalies to the structure of dentine?

Answer 20

• dentinogenesis imperfecta
• dentine dysplasia
• odontodysplasia
• systemic disturbance (metabolic, nutrition, medication)

Question 21

how many types & what are the names of dentinogenesis imperfecta?

Answer 21

very uncommon

• type 1 (osteogenesis imperfecta)
• type 2 (autosomal dominant)
• brandywine (type 3)

Question 22

how can you diagnose dentinogenesis imperfecta?

Answer 22

• appearance
• FH
• associated osteogenesis imperfecta
• both dentitions affected
• radiography: bulbous crowns, obliterated pulps (I & II)
• enamel loss

Question 23

what problems can dentinogenesis imperfecta carry?

Answer 23

• aesthetics
• caries/acid susceptibility
• spontaneous abscess
• poor prognosis

Question 24

what tx options are there for dentinogenesis imperfecta?

Answer 24

• prevention!! (Fluoride varnish)
• composite veneers
• overdentines
• removable prosthesis
• SSC

Question 25

what are some conditions that are DENTINE DEFECTS ONLY?

Answer 25

• dentinogenesis imperfecta
• dentine dysplasia
• fibrous dysplasia of dentine

Question 26

what are some GENERAL DISORDERS that can provide dentine defects?

Answer 26

• osteogenesis imperfecta
• rickets
• hypophosphatasia (deficiency of serum & bone phosphatase activity)

Question 27

what are the 5 overviews of dental management for tooth structure conditions?

Answer 27

• continuous dental care
• management of growth & development
• removable prosthesis
• crowns & bridges
• interceptive ortho

Question 28

what are conditions that affect the cementum called?

Answer 28

• cleidocranial dysplasia (hypoplasia of cellular component of cementum)
• hypophosphatasia (hypoplasia of cementum)

Question 29

what can cause premature eruption?

Answer 29

• high birth weight
• precocious puberty (happens early)
• natal/neonatal teeth

Question 30

what can cause delayed eruption?

Answer 30

• low birth weight children
• malnutrition
• down syndrome, hypothyroidism

Question 31

what can things cause PREMATURE EXFOLIATION?

Answer 31

• trauma
• hypophosphatasia
• immunological deficiency
• following pulpotomy

Question 32

what can things cause DELAYED EXFOLIATION?

Answer 32

• infraoccluded tooth
• hypodontia
• ECTOPIC permanent successors
• trauma
• ankylosis??