dental anomolies 2 Flashcards
Gemination
which dentition?
Attempt of a single tooth bud to divide, resulting in a bifid crown
Affects deciduous and permanent dentition
clinical features gemination
tooth count?
MC where?
Tooth count is normal when anomalous tooth is counted as one
MC in the anterior maxilla
gemination radio app
bifid crown with shared root canal
gemination
Fusion
Affects which dentition
Union of two normally separate tooth buds → form a joined tooth
Affects deciduous and permanent dentition
fusion clinical features
tooth count? MC where?
Tooth count reveals missing tooth when anomalous tooth is counted as one
MC in anterior mandible
fusion radio app
seperate canals usually present
fusion
Concrescence
Two fully formed teeth joined by root surfaces by cementum
concresence Clinical features:
MC where?
Often involves which teeth?
May result from?
MC in posterior maxilla
Often involves 2nd molar – root in close proximity to 3rd molar
May result from postinflammatory/carious tooth
Talon cusp Clinical features:
Extends how far on tooth?
MC in which dentition?
MC in which teeth?
MC what ethnics?
Well-delineated additional cusp located on the surface of an anterior tooth
Extends at least half the distance between CEJ and incisal edge
MC in permanent dentition
MC in maxillary lateral > central incisor
MC in Asian, Inuit, Native American
talon cusp
Dens evaginatus Clinical features:
defined?
where on tooth?
Observed where in arch? MC tooth?
MC in what arch?
MC in ethnics?
May result in?
Dens evaginatus
Clinical features:
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 interference
Dens evaginatus Frequent association with?
shovel shaped incisors (high marginal ridges)
Dens invaginatus/ Dens in dente
Clinical features:
Defined?
MC teeth?
may become?
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
types of dens invaginatus
type 1: only in crown
type 2: past CEJ
type 3: perforation possible
dens en dente
Enamel pearl Clinical features:
def?
MC which teeth?
MC at area on tooth?
periodontal attachment?
Presence of enamel in an unusual location
MC max molars > mandibular molars
MC at furcation area or near CEJ
Precludes normal periodontal attachment, PDL not adhered to enamel
enamel pearl
Taurodontism
def?
Isolated or syndromic?
may be associated with?
Enlargement of the body and pulp chamber of a multi-rooted tooth
Isolated or syndromic
may be associated with cleft lip/palate
Taurodontism Clinical features:
Pulp chambers?
Mild/severe?
MC in which teeth?
May appear?
Pulp chambers – increased apico-occlusal height
Mild to severe cases
MC in permanent teeth
May appear bilateral
taurodontism
Hypercementosis
def?
Isolated or many teeth?
Generalized pattern; consider?
Associated with?
Non-neoplastic deposition of excessive cementum along the root
Isolated or involve multiple teeth
Generalized pattern: consider Paget disease
Associated with local factors like trauma, inflammation
Hypercementosis Clinical and Radiographic features:
root?
MC in which teeth?
Frequency increases with?
Thickening or blunting of the root surface
MC in mandibular molars
Frequency increases with age
hypercementosis
Dilaceration
Abnormal?
Majority arise following?
Idiopathic or syndromic?
Abnormal angulation or bend in the root
Majority arise following injury that displaces the calcified portion of thetooth germ
Idiopathic or syndromic
dilaceration clinical features
MC teeth?
Bend occurs where on root?
Complications in?
MC mand 3rd molars > max 2nd premolar > mand 2nd molar
Bend occurs anywhere along the root
Complications in extractions or endo
dilaceration
Developmental alterations of structure
Amelogenesis imperfecta
Dentinogenesis imperfecta
Dentin dysplasia
Regional odontodysplasia
Amelogenesis imperfecta
def
different subtypes
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 when? results?
inheritance?
Affects which dentition
Amelogenesis imperfecta
Alterations in the enamel may arise at any of the following stages:
Matrix formation: Hypoplastic
Mineralization of matrix: hypocalcified
Maturation of the enamel: hypomaturation
AD, AR, X-linked inheritance
Affects deciduous and permanent dentition
AI clinical features based on types
Hypoplastic type: may see pits, rows of missing enamel
Hypocalcified type: enamel is soft, “cheesy”, easily lost
Yellow, brown, orange
Hypomaturation type: enamel is soft, not as soft as hypocalcified type
Opaque white, brown
likely dx?
AI
AI
AI
Dentinogenesis imperfecta
def?
gene mutation?
inheritance?
Affects which dentition
Hereditary disturbance in the formation of dentin in the absence of any
systemic disorder
DSPP gene mutation
AD inheritance
Affects deciduous and permanent dentition
what can app simialr to DI
OI
Dentinogenesis imperfecta Clinical features:
which teeth affected more severely
MC in which perm teeth?
MC in what race?
coloration?
enamel and dentin?
Deciduous teeth affected more severely
Permanent teeth: MC in incisors and 1st molars
MC in White patients
Blue to brown discoloration, distinct translucence
Enamel strips from poorly formed dentin
Dentinogenesis imperfecta Radiographic features:
crowns? cervical? teeth?
RC and pulp?
pulp additonal poss app?
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”
Dentinogenesis imperfecta
DI
DI
Dentin Dysplasia I
Loss of? leads to?
inheritance?
Type II thought to be?
which set of teeth affected?
Loss of organization of root dentin leads to shortened root length
AD inheritance
Type II thought to be a variant of dentinogenesis imperfecta
Deciduous and permanent teeth affected
Dentin Dysplasia I Clinical features:
Enamel and coronal dentin?
Radicular dentin?
Tooth support?
Enamel and coronal dentin well-formed
Radicular dentin loses organization → short roots
Tooth mobility and premature exfoliation
Dentin Dysplasia I Radiographic features:
Deciduous teeth:
Permanent teeth:
Deciduous teeth: little or no detectable pulp, very short roots (affected more severely)
Permanent teeth: crescent shaped pulpal remnant, short root
dentin dysplasia type 1
dentin dysplasia type 1
Regional odontodysplasia
def?
Most cases are?
May be due to?
Nonhereditary developmental abnormality of teeth that affects enamel, dentin, and pulp
Most cases are idiopathic, some syndromic
May be due to alteration of vascular supply
Regional odontodysplasia Clinical findings:
tissues affected?
MC where?
Dx at time of?
Affects how many teeth?
Impaction/eruption?
Erupted teeth are?
Hyperplasia of?
Enamel, dentin, and pulp affected
MC maxillary anterior teeth
Dx at time of eruption of primary and permanent
Affects several teeth, quadrant distribution
Impacted teeth, delayed eruption
Erupted teeth are malformed, caries rampant
Hyperplasia of overlying soft tissue
Regional odontodysplasia Radiographic findings:
enamel and dentin?
pulp chambers?
roots?
Extremely thin enamel and dentin
Enlarged pulp chambers – ghost teeth
Short roots may be observed
regional odontodysplasia
regional odontodysplasia
Segmental odontomaxillary dysplasia
Developmental disorder, affects jaw and overlying soft tissue
Segmental odontomaxillary dysplasia clinical features
def/pain?
Usually dx when?
Hyperplasia of?
Primary teeth may be?
missing teeth?
Painless, unilateral enlargement of maxillary bone
Usually dx during childhood
Hyperplasia of overlying gingiva
Primary teeth may be hypoplastic
Maxillary premolar teeth may be missing
segmental odontomaxillary dysplasia may be confused with? how to differentiate?
fibrous dysplasia, however SOD has missing maxillary PM often
Segmental odontomaxillary dysplasia Radiographic features:
trabeculae?
density? app?
Maxillary sinus?
Thickened trabeculae, often vertically oriented
Radiopaque, granular appearance
Maxillary sinus may be smalle
SOD tx?
Remains relatively stable, may not require tx
Surgical recontouring
segmental odontomaxillary dysplasia (likely not fibrous dysplasia due to missing PM)
