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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 proliferation (cell division) occur?

A

bud stage

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1
Q

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

A

dental lamina

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2
Q

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

A

cap stage

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3
Q

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

A

bell stage

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4
Q

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

A

early crown stage

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5
Q

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

A

late crown stage

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6
Q

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

A

Early root stage

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7
Q

Formation of dentin & enamel:

A

apposition

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8
Q

Deficient development during INITIATION (dental lamina) results in:

A

Number anomalies

  1. adontia
  2. hypodontia
  3. oligodontia
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9
Q

Excessive development during INITIATION (dental lamina) results in:

A

Number anomalies

  1. hyperdontia
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10
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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11
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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12
Q

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

A

Enamel & Dentin structure anomalies

  1. Amelogenesis Imperfecta Type 1 (hypoplastic) & Type 4 (hypoplastic & hypomaturation)
  2. Dentinogenesis Imperfecta
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13
Q

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

A

Size & shape anomalies

  1. microdontia
  2. peg laterals
  3. mulberry mulars
  4. Hutchinson’s 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. Tauodontism
  5. Dens in dente
  6. Dens evaginates
  7. Dilaceration
  8. Germination
  9. Fusion
  10. Conrescence
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15
Q

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

A

Enamel & Dentin & Cementum Apposition Anomalies

  1. Amelogenesis Imperfecta type 2 & 4
  2. Enamel hypoplasia
  3. Dentin dysplasia
  4. Regional Odontodysplasia
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16
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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17
Q

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

A

Enamel & Dentin mineralization anomalies

  1. Amelogenesis IMperfecta type 2
  2. Enamel hypo-mineralization
  3. Flurosis
  4. Interglobular dentin
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18
Q

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

A

Enamel & Dentin mineralization anomalies

  1. Sclerotic dentin
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19
Q

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

A

Enamel and dentin maturation anomalies

  1. Amelogenesis Imperfecta Type 2 & 4
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20
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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21
Q

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

A

Eruption anomalies

  1. natal/neonatal teeth
  2. acceleration eruption
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22
Q

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

A
  • Anomalies of NUMBER
  • Supernumerary teeth
  • Congenital tooth absence
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23
Q

Hyperdontia =

A

supernumerary teeth

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24
Q

Incidence of supernumerary teeth =

A

0.3-3% and males 2:1 over females

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25
Q

Are supernumerary teeth more frequent in primary or permanent dentition?

A

permanent 5x more often

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26
Q

90-98% of supernumerary teeth are located in:

A

maxilla

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27
Q

The classification of supernumerary teeth may be:

A

normal or rudimentary (conical)

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28
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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29
Q

Hypodontia =

A

oligodontia

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30
Q

Incidence of hypodontia and anodontia in permanent teeth:

A

1/5-10% (excluding 3rds)

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31
Q

Incidence of hypodontia and anodontia in primary teeth:

A

less than 1%

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32
Q

Describe the frequency of hypodontia and anodontia starting with the most frequent tooth:

A

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

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33
Q

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

A

false- significant correlation

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34
Q

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

A

true

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35
Q

List some areas where problems may arise resulting hypodontia & andodontia:

A
  1. failure of induction
  2. abnormality of lamina
  3. insufficient space
  4. physical obstruction of lamina
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36
Q

Conditions associated with hypodontia:

A
  1. ectodermal dysplaisa
  2. crouzons
  3. achondroplasia
  4. chondroectodermal dysplasia (ellis-van creveld)
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37
Q

Describe the frequency of single tooth macrodontia:

A

rare

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38
Q

Microdontia is most frequently seen in:

A

lateral incisors, 2nd premolars, 3rd molars

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39
Q

Conditions associated with microdontia:

A
  1. ectodermal dysplasia
  2. chondroectodermal dysplasia
  3. hemifacial microsomia
  4. down syndrome
  5. crouzon’s
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40
Q

Conditions associated with macrodontia:

A
  1. hemifacial hypertrophy
  2. crouzons
  3. otodental syndrome
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41
Q

What stage of tooth development might conjoined teeth occur in?

A

proliferation and morphodifferentiation

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42
Q

Gemination occurs more frequently in ____ dentition than ____ dentition

A

primary; permanent

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43
Q

If gemination occurs, the tooth will present as:

A

bifid crown with single root and pulp chamber

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44
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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45
Q

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

A

twinnig

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46
Q

Describe the frequency of fusion/concresence :

A

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

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47
Q

How would you clinically diagnose gemination?

A

by counting crowns

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48
Q

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

A

fusion/ concrescence

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49
Q

How would you clinically diagnose fusion?

A

by counting normal number of teeth/crowns

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50
Q

Fusion after root formation is completed:

A

concrescence

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51
Q

Dens in dente (invaginatus) is an anomaly of:

A

morphodifferentation (size & shape)

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52
Q

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

A

maxillary lateral incisors

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53
Q

What is the clinical significance of dens in dente?

A

caries relate

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54
Q

What is the etiology of dens in dente?

A

invagination of inner enamel epithelium

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55
Q

Dents evaginatus may also be called:

A

talon cusp

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56
Q

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

A

pulp tissue in cusp may complicate restorations

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57
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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58
Q

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

A

Taurodontism

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59
Q

Incidence of taurodontism:

A

0.54-5.6%; higher in patients with hypophosphatemic rickets

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60
Q

What syndromes are associated with taurodontism?

A
  1. Klinefelter
  2. Trichodento-osseous
  3. Orofacialdigital
  4. Ectodermal dysplasia
  5. Amelogenesis imperfecta Type IV
  6. Down syndrome
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61
Q

Usually due to trauma in primary dentition:

A

dilaceration

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62
Q

Dilaceration may be associated with what syndrome?

A

Lamella ichthyosis

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63
Q

Diagnose this image:

A

supernumerary teeth

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64
Q

Diagnose this image:

A

hypodontia

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65
Q

Diagnose this image:

A

gemination

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66
Q

Diagnose this image:

A

twinning tooth

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67
Q

Diagnose this image:

A

fusion

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68
Q

Diagnose this image:

A

Dens in dente

69
Q

Diagnose this image:

A

Dents evaginatus (Talon cusp)

70
Q

Diagnose this image:

A

taurodontism

71
Q

Diagnose this image:

A

dilaceration

72
Q

Amelogenesis imperfecta is an example of an anomaly of:

A

histodifferentation (structure)

73
Q

Inherited defect with multiple patterns such as x-lined, autosomal dominant or recessive; Anomaly of histodifferentiation

A

amelogenesis imperfecta

74
Q

What is the incidence of amelogenesis imperfecta?

A

variable from 1:14,000 to 1:4,000

75
Q

How many types of amelogenesis imperfecta are present?

A

4 major types with 14 subgroups

76
Q

Why is amelogenesis imperfecta distinguished from other enamel defects?

A

because of inheritance and no syndrome or systemic disease

77
Q

Diagnose this image:

A

amelogenesis imperfecta

78
Q

heritable defect of predentin matrix; normal mantle dentin:

A

dentinogenesis imperfecta

79
Q

What is the incidence of dentinogenesis imperfecta?

A

1:8000

80
Q

What type of dentinogenesis imperfecta occurs with osteogenesis imperfecta?

A

Shields Type I

81
Q

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

A

Shields Type II

82
Q

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

A

Shields Type III

83
Q

Anomalies of apposition can occur in:

A
  1. dentin
  2. enamel
  3. cementum
84
Q

Dentin dysplasia (shields type I & II) Is an anomalies of:

A

Dentin Apposition

85
Q

Regional odontodysplasia (Ghost teeth) is an anomaly of:

A

dentin apposition

86
Q

The following conditions are associated with:

  1. Vitamin-D resistant rickets
  2. Hypoparathyroidism
  3. Albrights syndrome
  4. Ehlers-Danlos syndrome
  5. Epidermolysis Bullosa
  6. Osteogenesis imperfecta
A

Anomaly of dentin apposition

87
Q

Ghost teeth=

A

regional odontodysplasia

88
Q

Diagnose this image:

A

Dentinal dysplasia

89
Q

Anomalies of enamel apposition can occur:

A

anytime tooth calcification is occuring

90
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
91
Q

Hypercementosis & Hypophosphotasia are anomalies of:

A

cementum apposition

92
Q

List the 4 types of hypophosphotasia:

A
  1. Perinatal
  2. Infantile
  3. Childhood
  4. Adult
93
Q

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

A

Hypophosphotasia

94
Q

Describe the inheritance pattern of hypophosphotasia:

A

autosomal recessive

95
Q

Disease that results in little cementum being produced and early exfoliation of primary incisors with no resoprtion

A

Hypophosphotasia

96
Q

Diagnose this image:

A

enamel hypoplasia

97
Q

Diagnose this image:

A

Hypophosphotasia

98
Q

Anomalies of mineralization can occur with both:

A

enamel & dentin

99
Q

What is the prevalence of hypo mineralized first molars?

A

4-70%

100
Q

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

A

ameloblast function; matrix completion

101
Q

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

A

Anomalies of mineralization (enamel & dentin)

102
Q

Tooth eruption is thought to occur because of 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 multifactoria
103
Q

The initiation and calcification of primary teeth occurs _____, very early

A

in utero

104
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 months
Root completion: 1.5 years

105
Q

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

A

Tooth: Maxillary lateral incisor
Initial calcification: 16 week IU
Crown completion: 2.5 months
Root completion: 2 years

106
Q

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

A

Tooth: Maxillary canine
Initial calcification: 17 weeks IU
Crown completion: 9 months
Root completion: 3.25 years

107
Q

Tooth: Maxillary first molar
Initial calcification:
Crown completion:
Root completion:

A

Tooth: Maxillary first molar
Initial calcification: 15.5 weeks IU
Crown completion: 6 months
Root completion: 2.5 years

108
Q

Tooth: Maxillary second molar
Initial calcification:
Crown completion:
Root completion:

A

Tooth: Maxillary second molar
Initial calcification: 19 weeks IU
Crown completion: 11 months
Root completion: 3 years

109
Q

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

A

Tooth: mandibular central incisors
Initial calcification: 14 weeks IU
Crown completion: 1.5 months
Root completion: 1.5 years

110
Q

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

A

Tooth: mandibular lateral incisors
Initial calcification: 16 weeks IU
Crown completion: 3 months
Root completion: 1.5 years

111
Q

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

A

Tooth: mandibular canine
Initial calcification: 17 weeks IU
Crown completion: 9 months
Root completion: 3.25 years

112
Q

Tooth: mandibular first molar
Initial calcification:
Crown completion:
Root completion:

A

Tooth: mandibular first molar
Initial calcification: 15.5 weeks IU
Crown completion: 5.5 months
Root completion: 2.5 years

113
Q

Tooth: mandibular second molar
Initial calcification:
Crown completion:
Root completion:

A

Tooth: mandibular second molar
Initial calcification: 18 weeks IU
Crown completion: 10 months
Root completion: 3 years

114
Q

Tooth formation begins at:

A

7 weeks in utero

115
Q

Mineralization begins at the:

A

4th month of fetal development

116
Q

Describe the eruption pattern of primary teeth:

A

symmetrical

117
Q

_____ primary teeth erupt first

A

mandibular

118
Q

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

A

False- sequence is more important than timing

119
Q

Favorable eruption sequence for primary teeth:

A

ABDCE

120
Q

Favorable eruption sequence for maxillary permenant teeth:

A

61245378

121
Q

Favorable eruption sequence for mandibular permanent teeth:

A

61234578

122
Q

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

A

6 months

123
Q

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

A

12 months

124
Q

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

A

16 months

125
Q

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

A

18 months

126
Q

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

A

22 months

127
Q

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

A

26 months

128
Q

The following conditions are all considered:

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

anomalies of eruption

129
Q

Inclusion cysts may also be called:

A

Epstein’s pearls

130
Q

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

A

palatal midline

131
Q

Was is the treatment for inclusion cytsts (epsteins pearls)?

A

Self-limiting without intervention

132
Q

Diagnose the following image:

A

Inclusion cyst (Epstein’s pearls)

133
Q

Most likely ectopic mucous glands that occur on the buccal and lingual aspect of the alveolus:

A

Bohn’s nodules

134
Q

What treatment is indicated for Bohn’s Nodules?

A

No tx indicated

135
Q

Diagnose the following image:

A

Bohn’s Nodules

136
Q

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

A

Dental lamina cysts

137
Q

Diagnose the following image:

A

Dental lamina cysts

138
Q

Teeth present at birth:

A

natal teeth

139
Q

Teeth present within the first 30 days of life:

A

neonatal teeth

140
Q

Most natal and neonatal teeth are:

A

actual primary teeth

141
Q

Natal/ neonatal teeth may be associated with:

A

syndrome

142
Q

What treatment is indicated for natal/neonatal teeth?

A

possible extraction if aspiration risk or malformed

143
Q

Diagnose the following image:

A

natal/neonatal teeth (dependent on time of development)

144
Q

Traumatic ulceration from feeding:

A

Riga Fede disease

145
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
146
Q

For permanent dentition, typically root formation is completed:

A

2-3 years after eruption

147
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
148
Q
  • bluish swelling
  • asymptomatic
  • treatment 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

149
Q

Diagnose the following image:

A

eruption hematoma

150
Q

Delayed exfoliation of primary teeth can be due to:

A
  1. lack of permeant successor
  2. ankylosis
151
Q

Delayed exfoliation of primary teeth commonly occurs with:

A

primary 1st and 2nd molars

152
Q

How should you evaluate for an ankylosed or submerged tooth?

A

evaluate marginal ridges in mouth and on radiograph

153
Q

For ankylosed tooth it is important to make that:

A

successor tooth is present

154
Q

Occurs when a tooth erupts outside the typical path of eruption

A

Ectopic eruption

155
Q

Diagnose the following image:

A

ectopic eruption

156
Q

Ectopic eruption commonly occurs in:

A

maxillary permanent first molars

157
Q

Systemic conditions causing delayed eruption of permanent teeth:

A
  1. cleidocranodysplasia
  2. hypothyroidism
  3. hypopituitarism
158
Q

Systemic conditions causing premature exfoliation of primary teeth:

A
  1. Hypophosphotasia
  2. Langerhans histocytosis
  3. Hyperthryoidism
159
Q

With time, the frenum attachment will typically migrate:

A

apically

160
Q
  • somewhat controversial among practicioners
  • may be performed by other professionals including ENT, plastic surgeons, and pediatricians
  • surgical intervention may be needed if impacting neutron and feeding and/or speech
A

Frenectomy

161
Q

Non-nutritive sucking habits spontaneously develop between:

A

2-4 years of age or earlier

162
Q

Non-nutritive sucking habits may cause:

A

protrusion of maxillary incisors

163
Q

When considering non-nutritive sucking habits, evaluates:

A

frequency, intensity, and duration of habit

164
Q

Most non-nutritive sucking habits are:

A

self-limiting

165
Q

Most common types of non-nutritive sucking habits:

A
  1. digit sucking
  2. pacifier sucking
166
Q

non-nutritive sucking habit usually ceases at:

A

4-6 years of age

167
Q

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

A

readiness of child

168
Q

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

A
  1. primary crown is wider M-D
  2. primary crown width at cervical 1/3 is greater
  3. root-to-crown ratio is greater
169
Q

Describe the primary molar roots:

A

long, slender, flaring

170
Q

Describe the occlusal table of primary teeth:

A

narrow

171
Q

Describe the cervical ridges on primary teeth:

A

pronounced

Pediatric Dentistry (3 decks)

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