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Module 6 - Paeds > Dental Anomalies > Flashcards

Dental Anomalies Flashcards

1
Q

Hypodontia?

A

The developmental absence of primary or permanent teeth.

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2
Q

Oligodontia?

A

Developmental absence of 6 or more teeth (excluding 8s).

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3
Q

Anodontia?

A

Complete absence of teeth (developmental, not acquired).

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4
Q

Aetiology of hypodontia - at what stage does this occur?

A
  • Occurs at INITIATION stage of dental development.
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5
Q

Another term for ankylosed tooth?

A

Infraocclusion

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6
Q

Role of dentist in hypodontia treatment?

A
  • Early detection.
  • Prevention
  • Early referral
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7
Q

When does tooth formation begin?

A

6 weeks IUL

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8
Q

5 stages to tooth formation?

A
  1. Dental lamina.
  2. Bud stage
  3. Cap stage.
  4. Bell stage.
  5. Eruption.
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9
Q

Name the processes that occur during tooth formation? (4)

A
  1. Initiation
  2. Morphogenesis.
  3. Cell differentiation.
  4. Matrix secretion.
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10
Q

What is the process of enamel deposition called? What is it controlled by? What are the 3 stages?

A
  • Amelogenesis
  • Ameloblasts
  • Secretory, calcification & maturation phase.
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11
Q

What is the process of dentine deposition called? What is it controlled by?

A
  • Dentinogenesis
  • Odontoblasts
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12
Q

What is hypodontia strongly associated with?

A

Strong GENETIC component:
- Single gene defects (ex. MSX1).
- Feature of many syndromes.

ENVIRONMENTAL component:
- Severe disease and cancer treatment in early childhood.

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13
Q

4 syndromes strongly associated with hypodontia?

A
  • Trisomy 21.
  • Ectodermal dysplasia.
  • Cleft lip and palate.
  • Solitary median maxillary central incisor syndrome.
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14
Q

Is hypodontia more prevalent in permanent vs primary dentition? M or F?

A
  • More prevalent in PERMANENT.
  • More prevalent in FEMALES.
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15
Q

Which teeth are most often affected by hypodontia?

A
  1. 3rd Molars (not considered hypodontia).
  2. Mandibular second premolars.
  3. Maxillary lateral incisors.
  4. Maxillary second premolars.
  5. Mandibular central incisors.
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16
Q

What is the significance of an absent primary tooth?

A

HIGH PROBABILITY THAT THE SUCCESSOR WILL BE ABSENT.

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17
Q

9 clinical features that would raise suspicion of hypodontia?

A
  • Failure of a primary tooth to exfoliate at the expected time.
  • Permanent tooth hasn’t erupted several months after the primary exfoliates.
  • Teeth erupting out of sequence.
  • The contralateral tooth has been erupted for some time (>6months should raise suspicion).
  • Other teeth appear unusually spaced.
  • Primary tooth may become infraoccluded.
  • Microdontia - high suspicion if there is microdontia of any erupted teeth.
  • Ectopic position of other permanent teeth (ex. palatally ectopic maxillary canines where lateral incisors are missing).
  • No tooth palpable in the buccal or lingual/palatal sulcus.
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18
Q

How is diagnosis of hypodontia confirmed?

A

RADIOGRAPH
1. Periapical (does not rule out ectopic teeth so if not present in expected position:)
2. DPT (confirm hypodontia and assess for other missing teeth).

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19
Q

What is very important for patients with hypodontia?

A

PREVENTION (fewer teeth so must remain caries free)

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20
Q

Can primary teeth be kept in cases of hypodontia?

A

YES, if they have:
- good root length.
- no significant infraocclusion.

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21
Q

What is ectodermal dysplasia?

A

Group of diseases affecting the structures arising from the ectoderm:
- Teeth, hair, nails, sweat glands, salivary glands.

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22
Q

What is the most known type of ectodermal dysplasia?

A

X linked hypohydrotic ectodermal dysplasia.

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23
Q

What is the clinical appearance of x linked hypohydrotic ectodermal dysplasia?

A
  • Sparce hair.
  • Dry skin.
  • Inability to sweat.
  • XEROSTOMIA, CONICAL TEETH, MICRODONTIA AND HYPODONTIA.
  • Dry eyes.
  • Nasal Congestion
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24
Q

Supernumerary?

A

Presence of a tooth/teeth in addition to the normal sequence.

25
Q

When do supernumeraries occur during tooth development

A

At the INITIATION stage of tooth formation.

26
Q

What causes supernumerary teeth?

A
  • GENETIC, often runs in families.
  • A feature of some syndromes.
27
Q

3 syndromes associated with supernumerary teeth?

A
  • Cleidocranial dysplasia.
  • Cleft lip and palate.
  • Gardner syndrome.
28
Q

Are supernumeraries more common in primary or permanent? M or F?

A
  • More often in PERMANENT.
  • More often in MEN
29
Q

What is the significance of a primary tooth supernumerary?

A
  • 35-50% chance there will be a supernumerary in the PERMANENT.
30
Q

2 ways in which supernumeraries can be defined?

A

POSITION (mesiodens, paramolar) or SHAPE.

31
Q

4 different SHAPES of supernumeraries?

A
  1. Conical.
  2. Tuberculate.
  3. Supplemental.
  4. Odontome.
32
Q

What is the most common supernumerary shape?

A

Conical

33
Q

6 facts about conical supernumeraries?

A
  • Most COMMON.
  • Likely to erupt if not inverted but not always.
  • Often impede eruption of other teeth.
  • Often occur in MIDLINE maxilla.
  • Often in pairs.
  • Often inverted.
34
Q

Which part of the maxilla/ mandible do conical supernumeraries often occur?

A

Often MIDLINE MAXILLA.

35
Q

What are the radiographic features suggestive of hypodontia?

A
  1. PERIAPICAL.
  2. DPT (as PA does not rule out ectopic teeth so if not present in expected position DPT confirms hypodontia + allows to assess for other missing teeth).
36
Q

How is a hypodontia diagnosis confirmed?

A

RADIOGRAPH.

37
Q

Who is invilcved in the treatment of hypodontia?

A

Multidisciplanary approach.
- GDP (makes diagnosis).
- Orthodontist.
- Pediatric dentist.
- Restorative dentist.

38
Q

3 requirements to maintain primary teeth for years if permanent are absent?

A
  • Healthy.
  • Good root length.
  • No significant infraocclusion.
39
Q

Which primary teeth are good for being maintained when their permanent successors are absent?

A

Second primary molars

40
Q

What sex are hypodontia and supernumeraries more common in?

A
  • Hypodontia: F
  • Supernumerary: M
41
Q

How can supernumeraries be defined in terms of position?

A
  • Mesiodens.
  • Paramolar.
42
Q

Name the 4 supernumeraries (shape) in terms of most to least common?

A

Conical, Tuberculate, Supplemental, Odontome

43
Q

Which supernumeraries are likely to erupt? Which not?

A
  • Conical: likely to erupt if not inverted (not always + often inverted).
  • Supplemental: Likely to erupt (especially supplemental incisors).
  • Tuberculate: Do not usually erupt.
  • Odontome: Will not erupt.
44
Q

What is the shape of tuberculate supernumeraries?

A

Barrel shaped.

45
Q

Which supernumeraries often occur in pairs?

A

Conical, tuberculate.

46
Q

Which supernumeraries are likely to impede the eruption of nearby teeth?

A
  • Conical: often but not always.
  • Tuberculate: VERY likely.
  • Supplemental: Less likely.
  • Odontome: VERY likely.
47
Q

What teeth are usually supplemental?

A
  • Supplemental lateral incisor.
  • 3rd premolar.
  • 4th molar.
48
Q

What is an odontome? The 2 types?

A
  • Collection of tooth tissue.
  • Compound: denticles.
  • Complex: disorganized collection of tooth tissue.
49
Q

What are the 2 first signs of a supernumerary tooth?

A
  1. Eruption of the supernumerary.
  2. Delayed eruption of the normal sequence.
50
Q

Where do supernumerary teeth often occur? What does this lead to?

A
  • ANTERIOR MAXILLA.
  • Delayed eruption of central incisor.
51
Q

4 things that supernumerary teeth can cause to surrounding primary teeth?

A
  • Crowding.
  • Rotation.
  • Malposition.
  • Ectopic position.
52
Q

How do you radiographically locate an unerupted supernumerary?

A
  • PARALLAX.
  • CBCT (when necessary).
53
Q

A supernumerary tooth has erupted and been diagnosed clinically, do we still need a radiograph?

A

POTENTIALLY to:
- Exclude the presence of unerupted supernumeraries
- Especially when permanent dentition not fully established/ orthodontic treatment is planned.

54
Q

When would you take a radiograph if suspecting a supernumerary?

A
  • Permanent tooth is still not erupted MORE THAN 6 MONTHS after the contralateral tooth.
  • And/or teeth are erupting out of sequence.
55
Q

4 management methods for supernumeraries?

A
  • Monitor.
  • Simple XLA.
  • Surgical XLA.
  • Surgically expose + orthodontically repositioned.
56
Q

What is cleidocranial dysplasia?

A

Rare autosomal dominant condition.

57
Q

Non dental features of cleidocranial dysplasia (3)?

A
  • Hypoplastic/ absent clavicles.
  • Short.
  • Characteristic facial features.
58
Q

Dental features of cleidocranial dysplasia?

A
  • Multiple supernumerary teeth.
  • Delayed/ failed exfoliation of primary teeth.
  • Delayed/ failed eruption of permanent teeth.

Module 6 - Paeds (1 decks)

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