Dental Anomalies Part I Flashcards
what are the classifications of dental anomalies
- congenital
- developmental
- acquired
what are congenital dental anomalies
genetically inherited anomalies
what are developmental anomalies
anomalies occur during tooth formation
what are acquired anomalies
anomalies occur after teeth formation
what are the types of developmental abnormalities
- number of teeth
- size of teeth
- eruption of teeth
- enamel pearly or enameloma
- altered morphology
what are the acquired abnormalities
- attrition
- abrasion
- erosion
what are supernumerary teeth and what is another name for it
- presence of extra erupted or unerupted teeth
- AKA hyperdontia
what is the prevalence of supernumerary teeth
2nd most common dental anomaly
- 1-4% of population
what are mesodens
supernumerary tooth in the maxillary incisor region
what are distodens or distomolar
supernumerary 4th molar
what is the most common single supernumerary tooth
mesiodens or distodens
where are mutliple supernumerary teeth most commonly found
in the mandibular premolar region
what radiographic images are taken for isolated supernumerary teeth
periapical or panoramic images
what radiographic images are needed for mulitple unerupted supernumeraries
CBCT
what are the top differential dx for supernumerary teeth
cleidocranial dysplasia
gardner syndrome
describe cleidocranial dysplasia
- absent or hypoplastic clavicles
- high palate, cleft palate
- open cranial sutures
- hypoplastic paranasal sinuses
- mandibular prognathism
- multiple unerupted supernumerary teeth
describe gardner syndrome
- osteomas
- epidermoid cyst of skin
- multiple supernumerary teeth
- colorectal polyps with malignant potential
what is the treatment for supernumerary teeth
conservative or removal of supernumerary teeth to reduce likelihood of complications such as:
-resorption of adjacent teeth
- crownding, malocclusion
- periodontal problems
- development of pathology
what is the definition of missing teeth or hypodontia
absence of erupted tooth or dental follicle without history of extraction
what are the most commonly missing teeth
third molars > mandibular second premolars > maxillary lateral and mandibular central incisors
excluding third molars absence what percentage of the population is affected by missing teeth or hypodontia
3%- 10% of the population
what is hypodontia
lack of development of 1 or more teeth
what is anodontia
total lack of development of teeth
what is oligodontia
lack of development of 6 or more teeth excluding third molars
what is the etiology of missing teeth
- absence of dental lamina
- environmental factors
- genetics
what are the environmental factors that may damage dental lamina prior to tooth formation
- trauma
- infection
- radiation, chemotherapy, or combined treatment
what is the main differential dx for missing teeth
ectodermal dysplasia
what is ectodermal dysplasia
- decreased number of sweat glands
- sparse hair, eyelashes, eyebrows
- dystrophic or malformed nails
- hypodontia with abnormal crown shape in teeth that are present
describe macrodontia
- larger than normal tooth seen clinically or radiographically
- often affects a single tooth
- may be associated with crowding and malocclusion
- the shape of the tooth is usually normal
describe microdontia and what is the tx
- smaller than normal tooth seen clinically or radiographically
- might involve all teeth, single tooth or a group of teeth
- usually affects third molars and maxillary lateral incisors
- treatment: restorative if neeeded
what is transposition
the condition in which two typically adjacent teeth have exchanged positions in the dental arch
what are the most common transposed teeth
the permanent canines and the first premolar
is there transposition in the primary dentition
no
what is enameloma or an enamel pearl
a small formation of enamel 1-3mm in diameter that occurs on the roots of molars
what is the occurence of enameloma or enamel pearl
3% of the population
where do most enamel pearls form
- apical to the gingival crest
- typically develop in the furcal areas of molar teeth, often lying at or just apical to the CEJ
are enamel pearls detected during a clinical exam
no
what can enameloma/enamel pearl predispose to
formation of a periodontal pocket and subsequent periodontal disease
what is the differential dx for enameloma or enamel pearl
calculus
what is the management of enameloma/ enamel pearl
removal if it is a risk factor to periodontal disease. the possibility must always be considered that it may contain a pulp horn
what is fusion
results from the union of adjacent tooth germs of developing teeth
fusion results in:
a reduced number of teeth in the arch
what dentition is fusion more common in
primary
what area of the mouth is fusion most common
anterior teeth
what is the differential interpretation of fusion and how is it differentiated
gemination: fusion may be differentiated from gemination when the number of teeth is reduced by one
what is the management of fusion
- conservative
- RCT + restorative
what is gemination
arises when a single tooth bud attempts to divide
- result may be an invagination of the crown with partial clefting
what dentition does gemination occur in and which is more common
- both
- more common in primary teeth
what part of the mouth does gemination occur
incisor region
what is the imaging feature of gemination
the pulp chamber is usually single and enlarged and may be partially divided
what is the differential dx for gemination
- macrodontia
- fusion
what is the management of gemination
- restorative: the clef is a carious susceptible site
- extraction only when needed
what is concrescence
- occurs when the roots of two or more primary or permanent teeth are fused through cementum
what are the possible causes of concrescence
- space restriction during development
- local trauma
- excessive occlusal force
- local infection after development
what teeth are most affected in concrescence
maxillary molars- especially third molars or a supernumerary tooth
what is the fate of teeth with concrescence
may fail to erupt or may erupt incompletely
how is concrescence in teeth imaged
- small FOV CBCT
what is taurodontism
elongation of pulp chamber in multirooted tooth with apical displacement of pulpal floor
what dentition is affected in taurodontism
both
how many teeth can show taurodontist
single or multiple teeth
how can taurodontism be detected
only radiographiclly, NOT clinically
how does taurodontism appear radiographically
elongated pulp chamber and the more apically positioned furcation
- short roots
what is the differential interpretation for taurodontism
none
what is the management of taurodontism
none
what is dilaceration
sharp bend or curve in the tooth anywhere in the crown or root
where is dilaceration most commonly seen
maxillary premolars
what are supernumerary roots
increased number of roots compared to usual anatomic number
what is radix entomolaris
extra lingual root on mandibular molars
what is radix paramolaris
extra buccal root on mandibular molars
what teeth can be affected with supernumerary roots
any tooth
what treatments can the presence of supernumerary roots affect
- ortho
- endo
- extractions
- but they are great prosth abutments
what are dens invaginatus and dens in dente
represent varying degrees of invagination or infolding of the enamel surface into the interior of the tooth
what tooth is most commonly affected by dens invaginatus and dens in dente
maxillary lateral incisor
where are dens invaginatus and dens in dente rate
in deciduous dentition and mandibular teeth
what are teeth with dens invaginatus and dens in dente at high risk for
caries so do prophylactic restoration
what is dens evaginatus and talon cusp caused by
evagination or outpouching of the enamel organ
where does the resultant enamel covered tubercle in dens evaginatus and talon cusp occur
in or near the middle of the occlusal or incisal surface of tooth
what is the tubercle composed of in dens evaginatus and talon cusp
a dentin core and a very slender pulp horn frequently extending into the evagination
when would dens evaginatus and talon cusp be removed
if the tubercle causes any occlusal interference or shows evidence of marked abrasion
