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Pediatric Dentistry > Development & Eruption of the Primary & Permanent Dentitions > Flashcards

Development & Eruption of the Primary & Permanent Dentitions Flashcards

1
Q

At what morphological stage does initiation (of tooth germ) occur?

A

Dental lamina

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2
Q

At what morphological stage does proliferation (cell division) occur?

A

Bud stage

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3
Q

At what morphological stage does the beginning of histo-differentiation occur?

A

Cap stage

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4
Q

At what morphological stage does morpho-differentiation & prominent histo-differentiation occur?

A

Bell stage

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5
Q

At what morphological stage does apposition (formation of dentin & enamel) occur?

A

Early crown stage

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6
Q

At what morphological stage does continued apposition of dentin & enamel including enamel maturation occur?

A

Late crown stage

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7
Q

At what morphological stage does formation of root dentin & cementum occur?

A

Early root stage

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8
Q

Formation of dentin & enamel:

A

apposition

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9
Q

Deficient development during INITIATION (dental lamina) results in:

A

Number anomalies-

  1. adontia
  2. hypodontia
  3. oligodontia
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10
Q

Excessive development during INITIATION (dental lamina) results in:

A

Number anomalies-

  1. hyperdontia
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11
Q

Deficient development during PROLIFERATION (bud, cap, early & advanced bell stage) results in:

A

Number & structure anomalies-

  1. hypodontia
  2. oligodontia
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12
Q

Excessive development during PROLIFERATION (bud, cap, early & advanced bell stage) results in:

A

Number & structure anomalies-

  1. hyperdontia
  2. odontoma
  3. epithelial rests
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13
Q

Deficient development during HISTODIFFERENTIATION (cap, early & advanced bell stage) results in:

A

Enamel & dentin structure anomalies-

  1. Amelogenesis imperfecta type I (hypoplastic) & type IV (hypoplastic & hypomaturation)
  2. dentinogenesis imperfecta
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14
Q

Deficient development during MORPHODIFFERENTIATION (bud, cap, early & advanced bell stage) results in:

A

Size & shape anomalies-

  1. microdontia
  2. peg lateral
  3. mulberry molars
  4. hutchisons incisors
  5. absence of cusp or root
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14
Q

Excessive development during MORPHODIFFERENTIATION (bud, cap, early & advanced bell stage) results in:

A

Size & shape anomalies-

  1. macrodontia
  2. tuberculated cusps
  3. carabelli’s cusp
  4. taurodontism
  5. dens in dente
  6. dens evaginates
  7. dilaceration
  8. germination
  9. fusion
  10. concrescence
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14
Q

Deficient development during APPOSITION (deposition of enamel & dentin matrices) results in:

A

Enamel & Dentin & cementum apposition anomalies-

  1. amelogenesis imperfecta type II & IV
  2. enamel hypoplasia
  3. dentin dysplasia
  4. regional odontodysplasia
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15
Q

Excessive development during APPOSITION (deposition of enamel & dentin matrices) results in:

A

Enamel & dentin & cementum apposition anomalies-

  1. enamel pearls
  2. hypercementosis
  3. odontoma
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16
Q

Deficient development during MINERALIZATION (mineralization of enamel & dentin matrices) results in:

A

Enamel & dentin mineralization anomalies-

  1. amelogenesis imperfecta type II
  2. enamel hypo-mineralization
  3. fluorosis
  4. interglobular dentin
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17
Q

Excessive development during MINERALIZATION (mineralization of enamel & dentin matrices) results in:

A

Enamel & dentin mineralization anomalies-

  1. sclerotic dentin
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18
Q

Deficient development during MATURATION (maturation of enamel & dentin matrices) results in:

A

Enamel & dentin maturation anomalies-

  1. amelogenesis imperfecta type II & IV
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19
Q

Deficient development during ERUPTION (eruption of teeth) results in:

A

Eruption anomalies-

  1. primary failure of eruption
  2. ectopic eruption
  3. ankylosis
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20
Q

Excessive development during ERUPTION (eruption of teeth) results in:

A

Eruption anomalies-

  1. natal/neonatal teeth
  2. accelerated eruption
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21
Q

What anomalies occur during the initiation phase? Give two examples:

A

Anomalies of NUMBER

-Supernumerary teeth
-Congenital tooth absence

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22
Q

Hyperdontia =

A

supernumerary teeth

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23
Q

Incidence of supernumerary teeth =

A

0.3-3%
Males 2:1 over females

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24
Q

Are supernumerary teeth more frequent in primary or permanent dentition?

A

Permanent 5x more often

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25
Q

90-98% of supernumerary teeth are located in the:

A

maxilla

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26
Q

The classification of supernumerary teeth may be:

A

normal or rudimentary (conical)

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27
Q

List the syndromes associated with supernumerary teeth:

A
  1. apert
  2. cleidocranial dysplasia
  3. gardner syndrome
  4. crouzon’s disease
  5. down syndrome
  6. hallerman-strief
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28
Q

Hypodontia =

A

oligodontia

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29
Q

Incidence of hypodontia & anodontia in permanent teeth:

A

1.5-10% (excluding thirds)

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30
Q

Incidence of hypodontia & anodontia in primary teeth:

A

Less than 1%

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31
Q

Describe the frequency of hypodontia & anodontia starting with the most frequently missing teeth:

A

3rd molars: 10-25%
mandibular 2nd premolar: 3.4%
maxillary lateral incisors: 2.2%
maxillary second premolar: 0.85%

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32
Q

T/F: There is no correlation between missing primary & missing permanent teeth

A

False- significant correlation

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33
Q

T/F: Familial patterns may play a role in missing teeth

A

true

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34
Q

List some areas where problems may arise, resulting in hypodontia & anodontia:

A
  1. failure of induction
  2. abnormality of lamina
  3. insufficient space
  4. physical obstruction of lamina
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35
Q

Condition associated with hypodontia:

A
  1. Ectodermal dysplasia
  2. Crouzon’s
  3. Achondroplasia
  4. Chondroectodermal dysplasia (Ellis-Van Creveld)
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36
Q

Describe the frequency of single tooth macrodontia:

A

rare

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37
Q

Microdontia is most frequently seen in:

A

lateral incisors, 2nd premolars, 3rd molars

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38
Q

Conditions associated with microdontia:

A
  1. ectodermal dysplasia
  2. chondroectrodermal dysplasia
  3. hemifacial microsomia
  4. down syndrome
  5. crouzon’s
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39
Q

Conditions associated with macrodontia:

A
  1. hemifacial hypertrophy
  2. crouzon’s
  3. otodental syndrome
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40
Q

What stage of tooth development might conjoined teeth occur in?

A

proliferation & morphodifferentiation

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41
Q

Gemination occurs more frequently in ____ dentition than ____ dentition

A

primary; permanent

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42
Q

If gemination occurs, the tooth will present as:

A

bifid crown with single root and single pulp chamber

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43
Q

Anomaly caused by a single tooth germ that attempted to divide during its development resulting in a bifid crown:

A

Gemination

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44
Q

Complete cleavage of single tooth bud resulting in supernumerary mirror image tooth:

A

Twinning

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45
Q

Describe the frequency of fusion/concresence:

A

incidence 0.5% more common in primary teeth and higher frequency in asian population

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46
Q

How would you clinically diagnose gemination:

A

By counting crowns

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47
Q

Dentinal union of two embryologically developing teeth with two separate pulp chambers:

A

Fusion/concresence

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48
Q

How would you clinically diagnose fusion?

A

By counting normal number of teeth/crowns

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49
Q

Fusion after root formation is complete:

A

Concresence

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50
Q

Dens in dente (Invaginatus) is an anomaly of:

A

morphodifferentation (size & shape)

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51
Q

Where do we typically see dens in dente (invaginatus) occur?

A

Maxillary lateral incisors

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52
Q

What is the clinical significance of dens in dente?

A

caries related

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53
Q

What is the etiology of dens in dente?

A

Invagination of inner enamel epithelium

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54
Q

Dens evaginatus may also be called:

A

talon cusp

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55
Q

What is the significance of Dents evaginatus (talon cusp)?

A

Pulp tissue in cusp may complicate restorations

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56
Q

What is the incidence & etiology of dents evaginatus (talon cusp)?

A

1.4%; caused by evagination of enamel epithelium focal hyperplasia of pulp mesenchyme

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57
Q

Failure of proper invagination of Hertwig’s epithelial root sheath:

A

Taurodontism

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58
Q

Incidence of taurodontism:

A

0.54-5.6%; higher in patients with hypophosphatemic rickets

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59
Q

What syndromes are associated with taurodontism?

A
  1. Klinefelter
  2. Trichodento-osseus
  3. Orofacialdigital
  4. Ectodermal dysplasia
  5. amelogenesis imperfecta type IV
  6. Down syndrome
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60
Q

Usually due to trauma I primary dentition:

A

dilaceration

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61
Q

Dilaceration may be associated with what syndrome?

A

Lamellar ichthyosis

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62
Q

Diagnose this image:

A

Supernumerary teeth

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63
Q

Diagnose this image:

A

Hypodontia

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64
Q

Diagnose this image:

A

Gemination

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65
Q

Diagnose this image:

A

Twinning

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66
Q

Diagnose this image:

A

Fusion

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67
Q

Diagnose this image:

A

Dens in dente

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68
Q

Diagnose this image:

A

Dents evaginatus (talon cusp)

69
Q

Diagnose this image:

A

Taurodontism

70
Q

Diagnose this image:

A

Dilaceration

71
Q

Amelogenesis imperfecta is an example of an anomaly of:

A

Histodifferentiation (structure)

72
Q

inherited defect with multiple patterns such as X-linked, autosomal dominant, or recessive; anomaly of hxisodifferentiation:

A

Amelogenesis imperfecta

73
Q

What is the incidence of amelogenesis imperfecta?

A

Variable from 1;14,000 to 1;4,000

74
Q

How many types of amelogenesis imperfect are present?

A

4 major types with 14 subgroups

75
Q

Why is amelogenesis imperfecta distinguished from other enamel defects?

A

because of inheritance & no syndrome or systemic disease

76
Q

Diagnose this image:

A

amelogenesis imperfecta

77
Q

Heritable defect of predentin matrix; normal mantle dentin:

A

Dentinogenesis imperfecta

78
Q

What is the incidence of dentinogenesis imperfecta?

A

1:8,000

79
Q

What type of dentinogenesis imperfecta occurs with osteogenesis?

A

Shields type I

80
Q

What type of dentinogenesis imperfecta results in “opalescent dentin” & occurs alone, both dentitions affected:

A

Shields type II

81
Q

What type of dentinogenesis imperfecta is the most severe with several variants?

A

Shields type III

82
Q

Anomalies of apposition can occur in:

A
  1. dentin
  2. enamel
  3. cementum
83
Q

Dentin dysplasia (shields type I & II) is an anomaly of:

A

dentin apposition

84
Q

Regional odontodyspluasia “ghost teeth” is a anomaly of:

A

dentin apposition

85
Q

The following conditions are associated with:

  1. vitamin D resistant rickets
  2. hypoparathyroidism
  3. Albright’s syndrome
  4. Ehlers-Danlos syndrome
  5. epidermolysis bullosa
  6. osteogenesis imperfecta
A

Anomaly of dentin apposition

86
Q

Ghost teeth =

A

regional odontodysplasia

87
Q

Diagnose this image:

A

Dentinal dysplasia

88
Q

Anomalies of enamel apposition can occur anytime:

A

tooth calcification is occurring

89
Q

List the different ways anomalies of enamel apposition may be environmentally induced:

A
  1. physiologic
  2. developmental
  3. ingestional
  4. infectious
  5. traumatic
  6. iatrogenic
90
Q

Hypercementosis & hypophosphatasia are anomalies of:

A

cementum apposition

91
Q

List the four types of hypophosphatasia:

A
  1. perinatal
  2. infantile
  3. childhood
  4. adult
92
Q

Lack of serum alkaline phosphatase during apposition of cementum would result in:

A

Hypophosphotasia

93
Q

Describe the inheritance pattern of hypophosphotasia:

A

autosomal recessive

94
Q

Disease that results in little cementum being produced & early exfoliation of primary incisors with no resorption:

A

hypophosphotasia

95
Q

Diagnose this image:

A

Enamel hypoplasia

96
Q

Diagnose this image:

A

Hypophosphotasia

97
Q

Anomalies of mineralization can occur with both:

A

enamel & dentin

98
Q

What is the prevalence of hypo mineralized first molars?

A

4-70%

99
Q

Anomalies of mineralization (enamel & dentin) may be a possible problem with ____ after _____

A

ameloblast function; matrix completion

100
Q

May be associated with febrile illness, antibiotics, nutritional deficiencies & preterm birth:

A

Anomalies of mineralization (enamel & dentin)

101
Q

Tooth eruption is thought to occur because the interaction of:

A
  1. root growth
  2. hydrostatic pressure
  3. bone remodeling
  4. periodontal ligament traction (dental follicle essential)
  5. connective tissue proliferation at the pulp apex
  6. likely multifactorial
102
Q

initiation & calcification of primary teeth occurs _____ very early

A

in utero

103
Q

Tooth: maxillary central incisor
Initial calcification:
Crown completion:
Root completion:

A

Tooth: maxillary central incisor
Initial calcification: 14 weeks IU
Crown completion: 1.5 mo
Root completion:1.5 yrs

104
Q

Tooth: maxillary lateral incisor
Initial calcification:
Crown completion:
Root completion:

A

Tooth: maxillary lateral incisor
Initial calcification: 16 weeks IU
Crown completion: 2.5 mo
Root completion:2 yrs

105
Q

Tooth: maxillary canine
Initial calcification:
Crown completion:
Root completion:

A

Tooth: maxillary canine
Initial calcification: 17 weeks IU
Crown completion: 9 mo
Root completion: 3.25 yrs

106
Q

Tooth: maxillary 1st molar
Initial calcification:
Crown completion:
Root completion:

A

Tooth: maxillary 1st molar
Initial calcification: 15.5 weeks IU
Crown completion: 6 mo
Root completion: 2.5 yrs

107
Q

Tooth: maxillary 2nd molar
Initial calcification:
Crown completion:
Root completion:

A

Tooth: maxillary 2nd molar
Initial calcification: 19 weeks IU
Crown completion: 11 mo
Root completion: 3 yr

108
Q

Tooth: mandibular central incisor
Initial calcification:
Crown completion:
Root completion:

A

Tooth: mandibular central incisor
Initial calcification: 14 weeks IU
Crown completion: 2.5 mo
Root completion: 1.5 yr

109
Q

Tooth: mandibular lateral incisor
Initial calcification:
Crown completion:
Root completion:

A

Tooth: mandibular lateral incisor
Initial calcification: 16 weeks IU
Crown completion: 3 mo
Root completion: 1.5 yrs

110
Q

Tooth: mandibular canines
Initial calcification:
Crown completion:
Root completion:

A

Tooth: mandibular canines
Initial calcification: 17 weeks IU
Crown completion: 9 mo
Root completion: 3.25 yrs

111
Q

Tooth: mandibular 1st molar
Initial calcification:
Crown completion:
Root completion:

A

Tooth: mandibular 1st molar
Initial calcification: 15.5 weeks IU
Crown completion: 5.5 mo
Root completion: 2.5 yrs

112
Q

Tooth: mandibular 2nd molar
Initial calcification:
Crown completion:
Root completion:

A

Tooth: mandibular 2nd molar
Initial calcification: 18 weeks IU
Crown completion: 10 mo
Root completion: 3 yrs

113
Q

Tooth formation begins at:

A

7 weeks in utero

114
Q

Mineralization begins at the:

A

4th month of fetal development

115
Q

Describe the eruption pattern of primary teeth:

A

symmetrical

116
Q

_____ primary teeth erupt first

A

mandibular

117
Q

T/F: Timing of eruption is more important than sequence

A

False- sequence is more important than timing

118
Q

Favorable eruption sequence for primary teeth:

A

ABDCE

119
Q

Favorable eruption sequence for maxillary permanent teeth:

A

61245378

120
Q

Favorable eruption sequence for mandibular permanent teeth:

A

61234578

121
Q

What is the likely age of the child seen with these teeth:

A

6 months

122
Q

What is the likely age of the child seen with these teeth:

A

12 months

123
Q

What is the likely age of the child seen with these teeth:

A

16 months

124
Q

What is the likely age of the child seen with these teeth:

A

18 months

125
Q

What is the likely age of the child seen with these teeth:

A

22 months

126
Q

What is the likely age of the child seen with these teeth:

A

26 months

127
Q

The following conditions are all considered:

  1. gingival cyst of newborn
  2. Bohn’s nodules
  3. Dental lamina cysts
  4. Epstein’s pearls
A

Anomalies of eruption with primary dentition

128
Q

Inclusion cysts may also be called:

A

Epstein’s pearls

129
Q

Where are inclusion cysts (Epstein’s pearls) located?

A

Palatal midline

130
Q

What is the treatment for inclusion cysts (Epstein’s pearls?

A

Self-limiting without intervention

131
Q

Diagnose the following image:

A

Inclusion cysts

132
Q

Most likely ectopic mucous glands, occurring on buccal & lingual aspect of alveolus:

A

Bohn’s nodules

133
Q

What treatment is indicated for Bohn’s nodules?

A

No Tx indicated

134
Q

Diagnose the following image:

A

Bohn’s nodules

135
Q

Remnants of the dental lamina occurring on the crest of the alveolus:

A

Dental lamina cysts

136
Q

Diagnose the following image:

A

Dental lamina cyst

137
Q

Teeth present at birth:

A

natal teeth

138
Q

Teeth present within the first 30 days of life:

A

neonatal teeth

139
Q

Most natal/neonatal teeth are:

A

actual primary teeth

140
Q

natal/neonatal teeth may be associate with:

A

syndrome

141
Q

What treatment is indicated for natal/neonatal teeth?

A

Possible extraction if aspiration risk or malformed

142
Q

Diagnose the following image:

A

Natal/neonatal teeth

143
Q

Traumatic ulceration from feeding:

A

Riga Fede disease

144
Q

Conditions associated with teething:

A
  1. normal process
  2. increased drooling
  3. desire to bite or chew
  4. mild discomfort
  5. no direct link to high fever, diarrhea, facial rash or sleep problems
145
Q

For permanent dentition, typically root formation is completed:

A

2-3 years after eruption of the tooth

146
Q

List some possible eruption disturbances associated with permanent teeth:

A
  1. eruption hematoma
  2. retained primary teeth
  3. ectopic eruption
  4. early or late loss of primary teeth
147
Q

-bluish swelling
-asymptomatic
-treatment is indicated when eating is impaired or pain is present
-can be associated with primary or permanent teeth
-radiograph should be taken to verify tooth position

A

Eruption hematoma

148
Q

Diagnose the following image:

A

eruption hematoma

149
Q

Delayed exfoliation of primary teeth can be related to:

A
  1. lack of permanent successor
  2. ankylosis
150
Q

Delayed exfoliation of primary teeth commonly occurs with:

A

primary first and second molars

151
Q

How should you evaluate for an ankylosed or submerged tooth?

A

Evaluate marginal ridges in mouth & on the radiograph

152
Q

For an ankylosed tooth it is important to make sure:

A

successor tooth is present

153
Q

Occurs when a tooth erupts outside the typical path of eruption:

A

ectopic eruption

154
Q

Diagnose the following image:

A

ectopic eruption

155
Q

Ectopic eruption commonly occurs in:

A

maxillary permanent first molars

156
Q

Systemic conditions causing delayed eruption of permanent teeth:

A
  1. cleidocranial dysplasia
  2. hypothyroidism
  3. hypopituitarism
157
Q

Systemic conditions causing premature exfoliation of primary teeth:

A
  1. hypophosphotasia
  2. langerhans histiocytosis
  3. hyperthyroidism
158
Q

With time, the frenum attachment will typically migrate:

A

apically

159
Q

Somewhat controversial among practitioners; may be performed by other professionals including ENT, plastic surgeons & pediatricians

Surgical intervention may be needed if impacting nutrition and feeding and/or speech:

A

Frenectomy

160
Q

Non-nutritive sucking habits spontaneously develop:

A

between 2-4 age or earlier

161
Q

Non-nutritive sucking habits may cause:

A

protrusion of maxillary incisors

162
Q

When considering non-nutritive sucking habits, evaluate:

A

frequency, intensity & duration of habit

163
Q

Most non-nutritive sucking habits are:

A

self-limiting

164
Q

Most common types of non-nutritive sucking habits:

A
  1. digit sucking
  2. pacifier sucking
165
Q

Non-nutritive sucking habit usually ceases at:

A

4-6 years of age

166
Q

The success of intervention of non-nutritive sucking habits is dependent on:

A

readiness of child

167
Q

Comparison of primary & permanent incisors & cuspids : (3)

A
  1. primary crowns are wider M-D
  2. primary crown width at cervical third is greater
  3. root:crown ratio is greater
168
Q

Describe the primary molar roots:

A

long, slender & flaring

169
Q

Describe the occlusal table of primary teeth:

A

narrow

170
Q

Describe the cervical ridges on primary teeth:

A

pronounced

171
Q
A

Pediatric Dentistry (3 decks)

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