Dental Anomalies II Flashcards by sophie rosen

Gemination
(2)

 Attempt of a single tooth bud to divide, resulting in a bifid crown
 Affects deciduous and permanent dentition

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Gemination
Clinical and Radiographic features:
(3)

 Tooth count is normal when anomalous tooth is counted as one
 MC in the anterior maxilla
 RG: Bifid crown with shared root canal

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Fusion
(2)

 Union of two normally separate tooth buds → form a joined tooth
 Affects deciduous and permanent dentition

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Fusion
Clinical and Radiographic features:
(3)

 Tooth count reveals missing tooth when anomalous tooth is counted as one
 MC in anterior mandible
 RG: Separate canals usually present

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Concrescence

 Two fully formed teeth joined by root surfaces by cementum

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Concrescence
Clinical features:
 MC in
 Often involves
 May result from

posterior maxilla
2nd molar – root in close proximity to 3rd molar
postinflammatory/carious tooth

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Talon cusp
 Clinical features:

 Extends at least
 MC in — dentition
 MC in
 MC in

Well-delineated additional cusp located on the surface of an anterior tooth
half the distance between CEJ and incisal edge
permanent
maxillary lateral > central incisor
Asian, Inuit, Native Americans

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Dens evaginatus
 Clinical features:
(6)

 Cusp-like elevation of enamel
 central groove or lingual ridge of the buccal cusp
 Observed in posterior teeth (premolar MC)
 MC in mandible
 MC in Asian, Inuit, Native Americans
 May result in occlusal interferences

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Dens evaginatus
 Clinical features:
(1)

 Frequent association with shovel-shaped incisors

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Dens invaginatus
Dens in dente
 Clinical features:
(4)

 Deep surface invagination of the crown or root lined by enamel
 MC permanent maxillary lateral and central incisors
 “tooth within a tooth”
 Opening may become carious

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Enamel pearl
 Clinical features:
 Presence of
 MC
 MC at
 Precludes

enamel in an unusual location
max molars > mandibular molars
furcation area or near CEJ
normal periodontal attachment

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Taurodontism


 may be associated with

Enlargement of the body and pulp chamber of a multi-rooted tooth
Isolated or syndromic
cleft lip/palate

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Taurodontism
 Clinical features:
(4)

 Pulp chambers – increased apico-occlusal height
 Mild to severe cases
 MC in permanent teeth
 May appear bilateral

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Hypercementosis


 Generalized pattern: consider
 Associated with local factors like (2)

Non-neoplastic deposition of excessive cementum along the root
Isolated or involve multiple teeth
Paget disease
trauma, inflammation

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Hypercementosis
 Clinical and Radiographic features:

 MC in
 Frequency increases with

Thickening or blunting of the root surface
mandibular molars
age

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Dilaceration
(3)

 Abnormal angulation or bend in the root
 Majority arise following injury that displaces the calcified portion of the
tooth germ
 Idiopathic or syndromic

Dilaceration
Clinical features:
MC where
bend
complications

 MC mand 3rd molars > max 2nd premolar > mand 2nd molar
 Bend occurs anywhere along the root
 Complications in extractions or endo

Developmental alterations:
structure
(4)

 Amelogenesis imperfecta
 Dentinogenesis imperfecta
 Dentin dysplasia
 Regional odontodysplasia

Amelogenesis imperfecta
(2)

 A large group of hereditary conditions that show alterations in the enamel
in the absence of systemic disease
 More than 14 different subtypes

Amelogenesis imperfecta
 Alterations in the enamel may arise at any of the following stages:
(3)

 Matrix formation: Hypoplastic
 Mineralization of matrix: hypocalcified
 Maturation of the enamel: hypomaturation

Amelogenesis imperfecta
inheritance
affects

 AD, AR, X-linked inheritance
 Affects deciduous and permanent dentition

Amelogenesis imperfecta
 Clinical features:
 Hypoplastic type:
 Hypocalcified type:
 Hypomaturation type:

may see pits, rows of missing enamel
enamel is soft, “cheesy”, easily lost
enamel is soft

 Hypocalcified type: enamel is soft, “cheesy”, easily lost

 Yellow, brown, orange

 Hypomaturation type: enamel is soft

 Opaque white, brow

Dentinogenesis imperfecta   --- gene mutation  --- inheritance  Affects

Hereditary disturbance in the formation of dentin in the absence of any systemic disorder DSPP AD deciduous and permanent dentition

Dentinogenesis imperfecta  Clinical features:  --- teeth affected more severely  Permanent teeth: MC in  MC in --- patients  --- discoloration, distinct translucence  Enamel

Deciduous incisors and 1st molars White Blue to brown strips from poorly formed dentin

Dentinogenesis imperfecta  Radiographic features: (4)

 Bulbous crowns, cervical constriction, thin roots  Early obliteration of root canal and pulp chamber  OR  Normal to enlarged pulp chambers

 Significantly enlarged pulp –

“shell teeth”

Dentin Dysplasia I   --- inheritance  Type II  affected

Loss of organization of root dentin leads to shortened root length AD thought to be a variant of dentinogenesis imperfecta Deciduous and permanent teeth

Dentin Dysplasia I  Clinical features:  --- well-formed  --- dentin loses organization → ---  (2)

Enamel and coronal dentin Radicular, short roots Tooth mobility and premature exfoliation

Dentin Dysplasia I  Radiographic features:  Deciduous teeth:  Permanent teeth:

little or no detectable pulp, very short roots crescent shaped pulpal remnant, short root

Regional odontodysplasia   Most cases are  May be due to

Nonhereditary developmental abnormality of teeth that affects enamel, dentin, and pulp idiopathic, some syndromic alteration of vascular supply

Regional odontodysplasia  --- affected  MC in  Dx at  Affects   Erupted teeth are  --- of overlying soft tissue

Enamel, dentin, and pulp maxillary anterior teeth time of eruption of primary and permanent several teeth, quadrant distribution Impacted teeth, delayed eruption malformed, caries rampant Hyperplasia

Regional odontodysplasia  Radiographic findings: (3)

 Extremely thin enamel and dentin  Enlarged pulp chambers – ghost teeth  Short roots may be observed

Segmental odontomaxillary dysplasia

 Developmental disorder, affects jaw and overlying soft tissue

Segmental odontomaxillary dysplasia  Clinical features:   Usually dx during ---  --- of overlying gingiva  Primary teeth may be ---  --- teeth may be missing

Painless, unilateral enlargement of maxillary bone childhood Hyperplasia hypoplastic Maxillary premolar

Segmental odontomaxillary dysplasia  Radiographic features: (3)

 Thickened trabeculae, often vertically oriented  Radiopaque, granular appearance  Maxillary sinus may be smaller

Segmental odontomaxillary dysplasia  Treatment: (2)

 Remains relatively stable, may not require tx  Surgical recontouring