dental anomolies 2 Flashcards by Caleb Houghton

Gemination
 which dentition?

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

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clinical features gemination
tooth count?
MC where?

Tooth count is normal when anomalous tooth is counted as one
 MC in the anterior maxilla

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gemination radio app

bifid crown with shared root canal

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gemination

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Fusion
 Affects which dentition

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

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fusion clinical features
tooth count? MC where?

 Tooth count reveals missing tooth when anomalous tooth is counted as one
 MC in anterior mandible

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fusion radio app

seperate canals usually present

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fusion

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Concrescence

 Two fully formed teeth joined by root surfaces by cementum

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 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

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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

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talon cusp

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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

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Dens evaginatus Frequent association with?

shovel shaped incisors (high marginal ridges)

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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

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types of dens invaginatus

type 1: only in crown
type 2: past CEJ
type 3: perforation possible

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dens en dente

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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

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enamel pearl

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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

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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

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taurodontism

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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

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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?

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

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

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

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

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)