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F - PAEDS > Developmental Dental Abnormalities > Flashcards

Developmental Dental Abnormalities Flashcards

1
Q

Give some conditions associated with hypodontia

A

Ectodermal dysplasia

Downs

Cleft palate

Hurlers syndrome

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2
Q

What is often a large restorative problem when maxillary laterals are missing

A

Overeruption of mandibular canines

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3
Q

What are some abnormalities of tooth shape and size?

A

Microdont - peg lateral

Macro don’t

Double teeth
- gemination - one tooth splits into two
- fusion - two teeth fuse into one

Odontomes

Taurodontism - flame shaped pulp

Dilaceration of crown or rooth

Talon cusp - extra cusp

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4
Q

What is dens in dente?

Tx?

A

‘Tooth within a tooth’

Invagination of the tooth enamel and dentine into the pulpal chamber

Treatment includes immediately sealing off invaginations to prevent bacterial ingress

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5
Q

What anomalies of root structure may occur?

A

Short root anomaly - permanent max incisors, often canines and premolars too

Radiotherapy

Dentine dysplasia

Accessory roots

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6
Q

What may cause some enamel defects?

A

Amelogenesis imperfecta

Environmental enamel hypoplasia

Localised enamel hypoplasia

MIH

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7
Q

What are the main forms of amelogenesis imperfecta?

A

Hypoplastic

Hypo calcified

Hypomaturational

Mixed forms

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8
Q

What is hypoplastic amelogenesis imperfecta

Presentations?

A

Thin or insufficient enamel formation leading to teeth that appear smaller and are more susceptible to toothwear and damage

Enamel is often roughed, pitted or grooved giving teeth a yellow or discoloured appearance

Enamel crystals do not grow to the correct length

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9
Q

What is hypocalcified amelogenesis imperfecta?

Presentations?

A

Enamel is formed but is soft but poorly calcified making it easily worn away

Tooth typically chalky and susceptible to wear and pathology

Enamel crystals do not grow to correct thickness or width

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10
Q

What is hypomaturational amelogenesis imperfecta?

A

Enamel not matured properly leading to translucent/opaque or cloudy enamel with white or brown discolourations

Enamel generally harder than in hypocalcified

Enamel crystals grow to correct length, but incorrect width or thickness and have poor mineralisation

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11
Q

What is mixed form amelogenesis imperfecta?

A

Characteristics of multiple types of AI are presenting

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12
Q

Give some possible causes of enamel hypoplasia

A

Systemic illness such as liver or kidney failure

Poor nutrition during development

Infection - measles

Turners hypoplasia
- periapical infection or trauma
- to primary tooth

CONGENITAL SYPHILLIS!
- HUTCHINSONS incisors

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13
Q

What are the main causes of localised hard tissue defects?

A

1 - trauma

2 - caries

3 - abscess of primary tooth

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14
Q

How would one treat fluorosis?

A

Micro abrasion therapy

Veneers

Vital bleaching

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15
Q

Give some prenatal causes of generalised environmental enamel defects

A

Rubella

Thalidomide

Fluorosis

Congenital syphilis

Cardiac and kidney disease

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16
Q

Give some neonatal causes of generalised environmental enamel defects

A

Premature birth

Meningitis

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17
Q

Give some postnatal causes of generalised environmental enamel defects

A

Measles
Chickenpox
TB
Pneumonia
/ infectious diseases

Vitamin deficiency

Heart disease

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18
Q

How would make a diagnosis of AI?

A

Familial inheritance - take a family history

Generally affects both dentitions

Affects all teeth and their size, structure and colour

Take radiographs

19
Q

Problems / signs / symptoms of AI?

A

Sensitivity

Caries / acid susceptibility

Poor aesthetics

Poor oral hygiene

Delayed eruption

Anterior open bite

20
Q

3 types of dentinogenesis imperfecta?

A

Type 1 - with osteogenesis imperfecta ‘brittle bone disease’

Type 2 - autosomal dominant - gene linked - not on sex chromosome

Brandywine

21
Q

What is type 1 dentinogenesis imperfecta?

Problems?

A

Associated with osteogenesis imperfecta

  • translucent blue / grey hue of teeth
  • normal enamel but discoloured and poorly formed dentine beneath

Rapid wear, chipping and breaking of tooth and also bulbous crown appearance

22
Q

What is type 2 dentogenesis imperfecta

A

Dentin formation affected due to mutations in odontoblasts

No association to OI

Brown / blue opalescence of teeth

Defects in structure of dentine leading to teeth susceptible to wear, bulbous crowns, pulpal obliterations etc

23
Q

Give some abnormalities of cementum and what they are

A

Cleidocranial dysplasia
- hypoplasia of cellular component of cementum

Hypophosphatasia
- hypoplasia or aplasia of cementum
- early loss of primary teeth

24
Q

Why may delayed eruption of teeth occur?

A

Malnutrition

Low birth weight

Downs

Hypothyroidism

Gingival hyperplasia

25
Q

Why may premature exfoliation occur?

A

Trauma

Following pulpotomy

Hypophosphatasia

26
Q

Why may delayed exfoliation occur?

A

Infra occlusion of teeth

‘Double’ primary teeth

Hypodontia

Ectopic permanent successor

Trauma

27
Q

Diagnose

A

Taurodontism

  • body of tooth enlarged at expense of root
28
Q

Diagnose

A

Dens in dente

29
Q

What is MIH?

A

Molar Incisor Hypomineralization (MIH) is a qualitative developmental dental defect that affects the enamel of permanent molars and incisors

30
Q

What is mild MIH?

A

Demarcated opacities located at non-stress bearing areas

No caries associated with affected enamel

No hypersensitivity

Very mild or no incisor involvement

31
Q

What is moderate MIH?

A

Demarcated opacities present on both molars and incisors

Post-eruptive enamel breakdown is limited to one or two surfaces without cuspal involvement

Normal dental sensitivity

May require atypical restorations

32
Q

What is severe MIH?

A

Post eruptive enamel breakdown

Crown destruction

Caries associated with affected enamel

History of dental sensitivity and aesthetic concerns

33
Q

What is enamel hypoplasia?

A

Quantitative defect with reduced enamel thickness

  • smooth borders of enamel indicating developmental and pre-eruptive lack of enamel
34
Q

Most common clinical problems with MIH?

A

Enamel breakdown leading to dentine exposure - risk of pulpal involvement

Tooth sensitivity - can lead to poor oral hygiene as less likely to perform measures

Aesthetic issues on incisors

Dental fear / anxiety from tx

Sharp enamel due to shearing of poorly mineralised enamel

35
Q

What are thought to be the causes of MIH?

A

Acute or chronic illness during eruption

Exposure to environmental pollutants

Genetically impacted

Frequent childhood illness

36
Q

What defects occur at the bud stage?

A

Congenitally missing teeth

Supernumerary teeth

  • dependant on number of placodes
37
Q

Which DDAs occur at the cap stage?

A

Cyst

Odontoma

Gemination

Fusion

Dens in dente

38
Q

What occurs at the bell stage? What DDAs occur at the bell stage?

A

HISTODIFFERENTIATION
- formation of ameloblasts and odontoblasts
- from inner and outer enamel organ

Morphodifferentiaiton - crown shape and size
- macro/microdontia

Apposition - ameloblasts and odontoblasts start depositing
- enamel hypoplasia, enamel pearls

Amelogenesis imperfecta

Dentogenesis imperfecta

39
Q

What occurs after cap stage?

Which DDA’s?

A

Maturation (4-5 years to complete) - long time so illness can affect these ones

  • deposition of enamel and dentin
  • calcification of crown

DDAs
- enamel hypomineralisaiton
- fluorosis
- tetracycline staining

40
Q

What are the cells of the tooth germ?

A

Enamel organ
- ameloblasts

Dental papilla
- odontoblasts
- pulp cells

Dental follicle
- cementoblasts
- Osteoblasts - alveolar bone
- fibroblasts - PDL

41
Q

What is AI?

A

Intrinsic alteration of enamel

  • hereditary
  • autosomal dominant, recessive or X-linked
  • effects both dentitions
  • thin to no enamel
42
Q

What is DI?

A

Autosomal dominant intrinsic alteration of dentine
- resulting in bulbous crowns
- short roots
- obliterated pulps

43
Q

What is enamel pearl?

A

Chunk of enamel blocking attachment of sharpens fibers
- automatic periodontal pocket
- wont remove with PMPR
- only in molars

F - PAEDS (23 decks)

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