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Pedo > Dental Anomalies I: Number, Shape, Size > Flashcards

Dental Anomalies I: Number, Shape, Size Flashcards

1
Q

What is the prevalence of hyperdontia?

A
  • M>F 2:1
  • More often seen in permanent dentition
  • 95% at anterior maxilla
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2
Q

What are the classifications of supernumeraries?

A
  1. Mesiodens: between upper central incisors
  2. Paramolar: buccal/lingual to max molar
  3. Distomolar: distal to 3rd molar
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3
Q

What are the different forms of supernumeraries?

A
  • Conical: sharp
  • Supplemental: looks exactly like permanent tooth
  • Tubercle: barrel shaped
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4
Q

What syndromes is hyperdontia associated with?

A
  • Cleidocranial dysplasia
  • Gardner syndrome
  • Cleft lip and palate (~40% have supernumeraries in area of cleft)
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5
Q

What are associated problems of hyperdontia?

A
  • Impede/deflect eruption of permanent teeth
  • Crowding/malalignment
  • Resorption of root of adjacent teeth
  • Cyst may develop around buried supernumerary teeth
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6
Q

What is the management of hyperdontia?

A
  1. Removal of supernumerary
    - When root of adj permanent tooth is 1/2 to 3/4 formed
  2. Leave alone and review
    - If tooth is buried + inverted => unlikely to erupt
    - Take x-ray in 3 years to look for signs of cystic growth
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7
Q

What are the types of hypodontia?

A
  • Hypodontia: missing ≥1
  • Oligodontia: missing ≥6
  • Anodontia: no teeth
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8
Q

What is the prevalence of hypodontia and which teeth are most affected by hypodontia?

A

F>M

Terminal teeth of a series:
8s > lower 5s > upper 2s > upper 5s > lower 1s

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9
Q

What are syndromes associated with hypodontia?

A
  • Ectodermal dysplasia
  • Cleft lip/palate
  • Trisomy 21

Often occurs with microdontia

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10
Q

What is the management for hypodontia?

A
  • Clinical & radiographic assessment +> referral
  • Regular preventive care – must maintain few teeth left
  • Restore aesthetics / function => multi-disciplinary approach (eg prostho, ortho)
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11
Q

Which teeth are most likely to have accessory/extra roots?

A

Lower 6s, canines and PMs
- May complicate exo, ortho, endo

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12
Q

What is the prevalence of reduction in number of roots and which teeth are most affected?

A

F>M

7s and 8s

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13
Q

Which is the only dental anomaly that is more common in primary dentition, and which teeth does it most commonly occur in?

A

Double tooth, incisors

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14
Q

What are the causes of double tooth and how do you differentiate between them?

A

Gemination or fusion, can be distinguished:
- Radiographically
- By counting the number of teeth in the arch

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15
Q

What is the presentation of gemination?

A
  • Budding of second tooth from single tooth germ
  • Usually 1 root canal present
  • Bifid crown with single root and pulp chamber
  • Familial inheritance
  • Normal number of teeth in arch
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16
Q

What is the presentation of fusion?

A
  • Joining of 2 teeth of the normal series or a normal tooth and a supernumerary by pulp and dentine
  • 2 canals present
  • Tooth has arisen from 2 tooth germs => number of teeth in dentition usually reduced by 1 unit
17
Q

What is the clinical significance of double tooth?

A

Possibility of same condition in permanent dentition

18
Q

What is the management for double tooth in primary teeth?

A
  • Site of fusion => deep groove => increased risk of plaque collection => may require FS
  • Monitor root resorption of primary double tooth => may retard eruption of permanent successor
19
Q

What is the management for double tooth in permanent dentition?

A
  • For permanent dentition, separation of fused teeth (fusion), reshaping or reduction (gemination) may be possible
  • If not, deliberate extraction and prosthodontic replacement
20
Q

What is concrescence? (etiology, prevalence, clinical significance)

A
  • Joining of 2 teeth by cementum
  • Fusion occurs after root formation is completed

Most common in maxillary posterior region

Significance: difficult extraction

21
Q

What are 3 dental anomalies of accessory cusps?

A
  1. Talon’s cusp: cusp projecting from cingulum of incisors
  2. Cusp of Carabelli: on mesio-palatal of 6s, usually bilateral
  3. Paramolar tubercle/cusp: extra cusp on buccal of molars
22
Q

What is the prevalence of dens invaginatus?

A

M>F
Most commonly in upper lateral incisor

23
Q

What is the clinical significance and management of dens invaginatus?

A
  • Caries may develop in invaginatus
  • Enamel lining of invaginatus may have incomplete enamel lining & deficient dentine => lead to pulpal infection

Mx: Prophylactic FS soon after eruption

24
Q

Which tooth is dens evaginatus most commonly seen?

A

Premolars (Leong’s premolar), sometimes canines and molars

25
Q

What is the clinical significance and management for dens evaginatus?

A

Tubercle may fracture => pulpal infection

  • Not in occlusion: reinforce w CR => allows for slow wearing instead of fracture
  • In occlusion: PRR w pulpal protection (e.g Ca(OH)2 lining)
26
Q

What is taurodontism?

A

Molar tooth with pulp chamber that is vertically enlarged at the expense of roots => enlarged chamber & short roots (detected radiographically)

27
Q

What syndromes are associated with taurodontism?

A
  • Ectodermal dysplasia
  • Klinefelter’s syndrome (XXY)
  • Amelogenesis Imperfecta (20% of cases)
28
Q

What is dilaceration and what is its etiology?

A

Abrupt deviation of the long axis of the crown or root portion

Etiology:
- Trauma to primary dentition (around 2-5 yo)
- Idiopathic or developmental disturbances

29
Q

What is the clinical significance and management of dilacerations?

A
  • If mild, tooth may erupt => reshape for aesthetics
  • If fail to erupt => track down orthodontically/remove surgically (ortho consult to determine if tooth worth tracking down)

If dilacerated at crown => may not erupt
If dilacerated at root => hard for orthodontic movt

30
Q

Which dental anomalies are seen in congenital syphilis?

A

Hutchinson’s incisors:
- Barrel shaped (cervical width > incisal edge)
- Incisal angles rounded, edge may be notched

Moon’s molars
- Reduction of crown form towards occlusal surface of 6s

Mulberry molars
- Hypoplasia of early mineralising parts of 6s

31
Q

What is globodontia?

A

Globular deformity of crowns of canines & posterior teeth of both dentitions

32
Q

What syndromes are associated with globodontia?

A

Otodental syndrome:
- Hereditary disorder
- Characterised by hearing loss (high frequency deafness from childhood) & globodontia

33
Q

Which teeth does microdontia most commonly affect?

A

Permanent upper 2s; 5s, 8s

34
Q

What syndromes are associated with microdontia?

A
  • Ectodermal dysplasia
  • Down’s syndrome
  • Pituitary dwarfism (generalised microdontia – rare)

Microdontia often occurs with hypodontia

35
Q

Which teeth does macrodontia most often affect?

A

Permanent upper 1s, lower 5s

36
Q

How to differentiate macrodontia from double tooth?

A

Macrodontia: absence of incisal notching and pulpal bifurcation

37
Q

What syndromes are associated with macrodontia?

A
  • Klinefelter syndrome (taurodontism also)
  • Hereditary gingival hyperplasia
  • On affected side of hemifacial hyperplasia
  • Pituitary gigantism
38
Q

What is the prevalence of increased root size?

A

M>F 5:1
Most common in upper canines
May occur with macrodontia

39
Q

What is decrease in root size associated with?

A
  • Dentine & pulp dysplasia
  • Hypoparathyroidism
  • Excessive irradiation of jaw during
    root formation

Pedo (15 decks)

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