Hypodontia and Supernumerary Teeth Flashcards

1
Q

Hypodontia

A

less than 6 congenitally missing teeth

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2
Q

Oligodontia

A

more than 6 congenitally missing teeth

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3
Q

Anodontia

A

Absence of all teeth

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4
Q

Hyperdontia

A

Extra teeth

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5
Q

◼ Missing:
 Hypodontia -
 Oligodontia -
 Anodontia - ◼ Excess:
 Hyperdontia -

A

less than 6 congenitally missing teeth
6 or more missing teeth
failure of teeth to develop (agenesis of teeth), very rare

extra teeth (Supernumerary teeth)

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6
Q

Congenitally Missing Teeth
(7)

A

◼ Ectodermal dysplasia
◼ Hypothyroidism
◼ Down Syndrome
◼ Cleft palate
◼ Genetic
◼ Radiation
◼ Random – no other associations

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7
Q

◼ Ectodermal dysplasia:

A

group of syndromes, missing or peg shaped teeth,
thin sparse hair, absence of sweat glands

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8
Q

◼ Hypothyroidism: (3)

A

thyroid, pituitary, hypothalamus abnormalities

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9
Q

◼ Down Syndrome:

A

trisomy 21

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10
Q

◼ Cleft palate :

A

one in 600-800 births

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11
Q

Congenitally Missing Teeth
◼ Congenital absence of teeth results from

A

disturbances during
the initial stages of tooth formation – INITIATION AND
PROLIFERATION.

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12
Q

◼ Since primary tooth buds give rise to permanent tooth buds, if a
primary tooth is missing…

A

there can’t be a successor

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13
Q

◼ Can have missing permanent teeth even when …

A

primary was present

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14
Q

Hypodontia◼ Incidence
 —% of general population (excluding third molars)
 —% - Congenitally missing primary teeth
 —% - 3rd molars missing in
 Hypodontia is higher in females on a – ratio
 Commonly runs in families

A

2 – 10
0.1% to 0.4%
20% to 25%
3:2

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15
Q

 As a general rule, if only one or a few teeth are missing, the absent tooth will be

A

the most distal
tooth of any given type

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16
Q

Hypodontia
Etiology
 Missing teeth can be inherited as part of a syndrome or a polygenic multifactorial model of etiology
(4)

A

 Genes –MSX1, PAX9, AXIN2
 Cytotoxic drugs
 Radiotherapy
 Random

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17
Q

If primary tooth missing –

A

can’t have permanent tooth

18
Q

The most commonly missing permanent
teeth are the

A

second premolars (more
than 40% of all missing teeth)

19
Q

— 2nd premolars missing more
often than —

A

Mandibular
maxillary

20
Q

Mandibular 2nd premolars missing more
often than maxillary
◼ Followed by —
◼ Followed by —

A

maxillary lateral incisors
upper second molars

21
Q

Treatment Options
(4)

A

▪ Replacement
▪ Extraction of the primary tooth and allowing permanent teeth to drift
▪ Extraction followed by orthodontic treatment
▪ Maintain tooth or teeth, will have occlusal problems since second
deciduous tooth is not same size as 2nd premolar

22
Q

▪ Replacement
(3)

A

▪ Prosthetically
▪ Transplantation
▪ Implant – retain 1° tooth till close to time of implant for bone

23
Q

Canine substitution - Ideal
(5)

A

◼ Similar color to central incisor
◼ Narrow width at the CEJ
◼ Relatively flat labial surface
◼ Narrow mid-crown buccolingual width
◼ Enameloplasty !!!

24
Q

Order of Enameloplasty
(5)

A
  1. Cusp tip
  2. Mesial and distal (often underperformed)
  3. Labial ridge
  4. Mesial composite
  5. Line angles
25
Q

Supernumerary teeth –

A

disturbances during the initiation and
proliferation stages of dental development

26
Q

Extra tooth obviously has great potential to

A

disrupt normal occlusion

27
Q

— to remove them is indicated

A

Early intervention

28
Q

Incidence of hyperdontia much — than hypodontia

A

lower

29
Q

◼ Primary dentition - —%
◼ Permanent dentition - —%
◼ Upper jaw (Pre-maxilla) - —%

A

0.5
1.0
85

30
Q

Maxillary midline = most common location called a —

A

mesiodens

31
Q

(3) can also appear

A

Laterals, premolars and 4th molars

32
Q

Supernumerary tooth - (2) in shape

A

Typical or atypical

33
Q

Supernumerary teeth - Mesiodens
(3)

A

◼ Often exist singularly, but sometimes
in combination
◼ Most common cause of unerupted
upper central incisor
◼ Can deflect tooth

34
Q

Supernumerary teeth
◼ Treatment aimed at extraction before problems arise, or
minimizing effect on other teeth
◼ General rule:

A

 More supernumeraries, more abnormal, higher their
position, harder to manage

35
Q

Conical supernumerary teeth
Remove
(5)

A

◼ If it erupts
◼ Inverted – won’t erupt
◼ Displacing adjacent teeth
◼ Producing diastema
◼ Delaying eruption of
permanent tooth

36
Q

Conical supernumerary teeth
Don’t remove
(2)

A

◼ If well above the apices of
the permanent tooth
◼ Observe

37
Q

Supernumerary teeth - Typical
(2)

A

◼ Resembles a normal tooth in morphology & commonly
produces crowding or displacement
◼ Extract the tooth most dissimilar to the contralateral tooth,
unless it is severely displaced

38
Q

Impactions & Ectopic Eruptions
◼ Estimated incidence at –%
◼ Twice as common in …
◼ –% bilateral impactions
◼ Mandibular canine impaction is –%

A

1.7
females (1.17%) as in males (0.51%)
8
0.35

39
Q

Etiology
(4)

A

◼ Local hard tissue obstruction
◼ Local pathology
◼ Disturbance of normal development of the incisors
◼ Hereditary or genetic factors

40
Q

Canine impaction considerations
◼ It is unerupted after –% of its root development
◼ The contralateral tooth has erupted for at least – months
with complete root formation
◼ — years after the adolescent growth spurt were passed
◼ – months after canine root completion was passed
◼ –% of palatal impactions had sufficient space for eruption
◼ –% of labial impactions showed an arch length deficiency

A

75
6
Two
6
85
83

41
Q

Diagnosis
(3)

A

◼ Periapical radiographs
◼ Occlusal radiographs
◼ CBCT imaging

42
Q

Periapical radiographs
(2)

A

◼ Clark’s Technique
◼ SLOB rule