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Pathology II > Dental Anomalies I > Flashcards

Dental Anomalies I Flashcards

1
Q

ameloblasts are extremely sensitive to:

A

external stimuli

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2
Q

enamel defect may be caused by:

A

local or systemic factors

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3
Q

enamel remodeling does not occur until after:

A

initial formation

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4
Q

abnormalities are _____ on tooth surface

A

etched permanently

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5
Q

what are the stages of enamel development

A
  • matrix formation: enamel proteins laid down
  • mineralization: minerals deposited, original proteins removed
  • maturation: final maturation, remaining original proteins removed. hard, translucent enamel
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6
Q

the timing of the enamel injury affects:

A

location and appearance of defect

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7
Q

the final enamel is a record of

A

all significant insults received during tooth development

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8
Q

what are the clinical features of enamel hypoplasia

A
  • large areas of missing enamel
  • pits, fissures, grooves
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9
Q

what are the clinical features of enamel opacities

A
  • areas of enamel hypomaturation
  • diffuse or demarcated
  • white, yellow, brown
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10
Q

what is turner hypoplasia

A

periapical inflammatory disease or trauma of overlying deciduous tooth

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11
Q

what are the clinical and radiographic features of turner hypoplasia

A
  • observed in permanent teeth- MC premolar
  • traumatic cases- max central incisors
  • focal areas of white, yellow, brown discoloration
  • extensive hypoplasia- may involve entire crown
  • RG: lack of enamel, irregular surface dentin
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12
Q

what does antineoplastic therapy cause

A
  • developmental abnormalities from use of radiation or chemotherapy
  • severity dependent on age of treatment, form of therapy, dose and field of radiation
  • radiation therapy- more severe alterations
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13
Q

what are the clinical features of antineoplastic therapy from radiation and chemotherapy

A
  • radiaiton: hypodontia, microdontia, radicular hypoplasia, enamel hypoplasia
  • chemotherapy: enamel hypoplasia, microdontia, occassionally radicular hypoplasia
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14
Q

describe dental fluourosis

A
  • ingestion of excessive FL -> significant enamel defects
  • retention of amelogenin proteins in enamel -> hypomineralized enamel
  • dose dependent
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15
Q

what are the clinical features of dental fluorosis

A
  • white, opaque enamel with areas of brown/yellow discoloration
  • affected teeth are caries resistant
  • bilateral, symmetrical distribution
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16
Q

what is the treatment for enamel defects

A
  • most defects are cosmetic
  • focal loss of enamel- increased prevalance of caries
  • composite restorations, veneers, full crowns
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17
Q

when is tooth wear considered pathologic

A

when the degree of destruction creates functional, aesthetic or dental sensitivity problems

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18
Q

what is attrition

A

loss of tooth structure due to tooth to tooth contact
- poor quality/absent enamel can accelerate the process

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19
Q

what are the clinical features of attrition

A
  • incisal and occlusal surfaces
  • large, flat, smooth and shiny wear facets
  • slow loss of tooth structure, reparative secondary dentin forms
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20
Q

what is abrasion and what is the most common cause

A
  • pathologic wearing of tooth structure secondary to an external agent
  • toothbrushing is the most common cause
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21
Q

what are the clinical features of abrasion

A
  • dependent on cause
  • toothbrushing: horizontal cervical notches on buccal surface
  • tobacco pipe and bobby pins: V shaped notches on incisal edge
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22
Q

what is erosion and what is it caused by

A
  • loss of tooth structure caused by a non bacterial chemical process
  • exposure to acidic source, reduced salivary flow
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23
Q

what are the clinical features of erosion

A
  • cupped lesion, central depression of dentin surrounded by elevated enamel
  • may create concave sloping areas on palatal surfaces
24
Q

what is the treatment for tooth wear

A
  • multifactorial cause
  • detailed diagnosis, preventative measures
  • erosion: may consider limiting toothbrushing to 1x daily
  • restorative treatment: composite, veneers, full corwn
25
Q

what are extrinsic stains, what are they caused by and what is the treatment

A
  • arises from the surface accumulation of exogenous pigment
  • tobacco, bacterial stains, food and beverages, iron, restorative materials, medications
  • can be removed with surface tx usually
26
Q

what are instrinsic stains, what are they caused by and what is the tx

A
  • arises from endogenous materials that are incorporated into enamel and dentin
  • amelogenesis imperfecta, dentinogensis imperfecta, dental fluorosis, hyperbilirubinemia, trauma, medications
  • cannot be removed by prophylaxis
27
Q

what is internal resorption

A
  • loss of tooth structure on the dentinal walls of the pulp
  • commonly arises secondary to inflammatory reaction
  • continues if vital pulp tissue remains
28
Q

what are the clinical and radiographic features of internal resorption

A
  • inflammatory resorption
  • replacement resorption
  • coronal pulp affected -> pink tooth of mummery
29
Q

what happens in inflammatory resorption

A

resorbed dentin replaced by inflamed granulation tissue
- RG: well circumscribed radiolucent enlargement of pulp chamber

30
Q

what happens in replacement resorption

A
  • pulpal dentinal wall is resorbed with bone and cementum like bone
  • RG: partial obliteration of canal by bone - radiopacity
31
Q

what is external resorption, what are the common causes

A
  • loss of tooth structure along external surface of root
  • exposure of adjacent mineralized cementum to cementoclasts
  • common causes: localized pressure (ortho), excessive occlusal forces, tumors
32
Q

what are the clinical and radiographic findings of external resorption

A
  • “moth eaten” loss of tooth structure
  • over pulp chamber, radiolucency superimposed
33
Q

what is ankylosis and what is it caused by

A
  • anatomic fusion of tooth cementum with the alveolar bone
  • may be caused by trauma, chemical/thermal irritation, genetically decreased PDL
34
Q

what are the clinical features of ankylosis

A
  • most common in 1st-2nd decade
  • most common mandibular primary first molar
  • mandible 10:1
  • ankylosis of permanent teeth uncommon
  • sharp, solid sound upon percussion
35
Q

what are the radiographic features of ankylosis

A
  • absence of PDL space (difficult to detect)
  • adjacent teeth inclined towards affected tooth
  • supraeruption of opposing tooth
36
Q

what is the treatment for ankylosis

A

for primary teeth (lack of exfoliation) -> extraction

37
Q

what is anodontia

A

total lack of development of teeth

38
Q

what is hypodontia

A

lack of development of one or more teeth

39
Q

what is oligodontia

A

lack of development of 6 or more teeth

40
Q

what is hyperdontia

A

development of an increased # of teeth

41
Q

more than ____ genes associated with odontogenesis

A

200

42
Q

tooth number anomalies are ____ and _____

A

syndromic and non syndromic

43
Q

what are the genes most commonly implicated in tooth number anomalies

A
  • PAX9
  • MSX1
  • AXIN2 genes
44
Q

what is the prevalance of hypodontia and what is the associated syndrome

A
  • prevalence of 3-10% in permanent teeth
  • syndrome associated : ectodermal dysplasia
45
Q

absence of primary teeth correlates strongly with:

A

missing successor

46
Q

what are the clinical features of hypodontia

A
  • after 3rd molars, most common in 2nd premolar and lateral incisor
  • most common in females
47
Q

most cases of hyperdontia represent as a:

A

single tooth supernumerary

48
Q

what are the syndromes associated with hyperodntia

A

cleidocranial dysplasia and gardner syndrome

49
Q

hyperdontia is positively correlated with:

A

macrodontia

50
Q

what are the clinical features of hyperdontia

A
  • single tooth hyperdontia: most common in anterior maxilla- mesiodens
  • acessory 4th molar: distomolar/distodens
  • 2:1 male
51
Q

describe microdontia and the conditions associated with it

A
  • presence of unusually small teeth
  • genetic and environmental factors play a role
  • isolated cases more common than diffuse cases
  • conditions: down syndrome, pituitary dwarfism
52
Q

what are the clinical features of microdontia

A
  • isolated microdontia: MC in maxillary lateral- peg lateral
  • most common in females
53
Q

describe macrodontia and the conditions associated with it

A
  • teeth larger than average
  • genetic and enivronmental factors play a role
  • conditions: pituitary gigantisim, XYY males, pineal hyperplasia, hyperinsulinism
  • isolated cases more common than diffuse caseswh
54
Q

what are the clinical features of macrodontia

A
  • isolated macrodontia: MC in incisors or canines
  • MC in males
55
Q
A

Pathology II (19 decks)

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