Dental Anomalies II Flashcards
Gemination
(2)
Attempt of a single tooth bud to divide, resulting in a bifid crown
Affects deciduous and permanent dentition
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
Fusion
(2)
Union of two normally separate tooth buds → form a joined tooth
Affects deciduous and permanent dentition
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
Concrescence
Two fully formed teeth joined by root surfaces by cementum
Concrescence
Clinical features:
MC in
Often involves
May result from
posterior maxilla
2nd molar – root in close proximity to 3rd molar
postinflammatory/carious tooth
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
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
Dens evaginatus
Clinical features:
(1)
Frequent association with shovel-shaped incisors
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
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
Taurodontism
may be associated with
Enlargement of the body and pulp chamber of a multi-rooted tooth
Isolated or syndromic
cleft lip/palate
Taurodontism
Clinical features:
(4)
Pulp chambers – increased apico-occlusal height
Mild to severe cases
MC in permanent teeth
May appear bilateral
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
Hypercementosis
Clinical and Radiographic features:
MC in
Frequency increases with
Thickening or blunting of the root surface
mandibular molars
age
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
