Lecture 2- Dental Anomalies I Flashcards
1
Q
Dental anomalies can be divided into: (3)
A
- congenital
- developmental
- acquired
2
Q
Dental anomalies that are genetically inherited:
A
congenital
3
Q
Dental anomalies that occur during tooth formation:
A
developmental
4
Q
Dental anomalies that occur after teeth formation:
A
acquired
5
Q
Developmental abnormalities of teeth involve: (5)
A
- number of teeth
- size of teeth
- eruption of teeth
- enamel pearl or enameloma
- altered morphology
6
Q
Developmental abnormalities involving the NUMBER of teeth: (2)
A
- supernumerary teeth
- missing teeth
7
Q
Developmental abnormalities involving SIZE of teeth: (2)
A
- macrodontia
- microdontia
8
Q
Developmental abnormality involving the ERUPTION of teeth: (1)
A
Transposition
9
Q
Enamel pearl or enameloma is considered a ____ abnormality
A
developmental
10
Q
Developmental abnormalities involving ALTERED MORPHOLOGY of teeth: (8)
A
- Fusion
- Gemination
- Concrescence
- Taurodontism
- Dilaceration
- Supernumerary roots
- Dens in vaginatus & dens in dente
- Dens evaginatus & talon cusp
11
Q
Acquired abnormalities include: (3)
A
- attrition
- abrasion
- erosion
12
Q
Presence of extra-erupted or unerupted teeth:
A
Supernumerary teeth
13
Q
Supernumerary teeth are also known as:
A
hyperdontia
14
Q
The 2nd most common dental anomaly involving 1-4% of the population:
A
supernumerary teeth
15
Q
What can be seen in this image?
A
supernumerary tooth in between lateral & canine (mesiodens)
16
Q
A supernumerary tooth located in between the lateral & canine:
A
mesiodens
17
Q
Most common supernumerary teeth that are single:
A
mesiodens
18
Q
4th molars (supernumerary teeth) more commonly seen in the maxillary dentition:
A
distodens (distomolar)
19
Q
What is more common, hyperdontia or hypodontia?
A
HYPOdontia
20
Q
What can be seen in this image?
A
distodens (distomolar)
21
Q
Most common single supernumerary tooth is:
A
mesiodens or distodens
22
Q
Multiple supernumerary teeth are most commonly found in:
A
mandibular premolar region
23
Q
What type of images should be taken if you suspect a supernumerary tooth (singular)?
A
PA or Pano
(but she would still recommend CBCT as image of choice)
24
Q
What type images should be taken if you suspect supernumerary teeth (multiple)?
A
CBCT
25
What can be seen in the following CBCT?
supernumerary teeth
26
What can be seen in this pano?
multiple supernumerary teeth (common for mandibular premolar area)
27
What is a risk of leaving an impacted tooth in the oral cavity?
dentigerous cyst risk
28
What can be seen in the following image?
mesiodens
29
What can be seen in the following image?
distodens (distomolar)
30
Top differential diagnosis associated with multiple SUPERNUMERARY TEETH:
1. Cleidocranial dysplasia
2. Gardner syndrome
31
List some characteristics of Cleidocranial dysplasia:
1. absent or hypoplastic clavicles
2. high palate or cleft palate
3. open cranial sutures (can see on CBCT)
4. hypoplastic paranasal sinuses
5. mandibular prognathism (due to hyperplastic maxilla)
6. multiple unerupted supernumerary teeth (or erupted)
32
What can be seen in this image? (cleidocranial dysplasia)?
1. prognathic mandible
2. open cranial suture
33
What can be seen in this image? (cleidocranial dysplasia)
1. open cranial suture
2. hypoplastic paranasal sinuses
34
What can be seen in this image? (cleidocranial dysplasia)
hypoplastic clavicles
35
Given the following images, what disease can be suspected?
cleidocranial dysplasia
36
In addition to the prognathic mandible, what also can be seen in this image?
multiple supernumerary teeth in mandible (giving it a very radiopaque appearance)
37
A water's radiograph is used to evaluate the:
maxillary sinus
38
What type of radiograph can be seen? What is this used for?
Waters radiograph; visualization of maxillary sinus
39
What can be seen in the following image? What disease do we suspect?
multiple supernumerary teeth; cleidocranial dysplasia
(note that there are multiple deciduous teeth in the dentition, not all of these are supernumerary)
40
What are some characteristics of Garner Syndrome:
1. MULTIPLE supernumerary teeth
2. osteomas
3. epidermoid cysts of skin
4. colorectal polyps with malignant potential
41
If suspect Gardner Syndrome in an undiagnosed patient, it is important to refer them to their physician as this:
may prevent them from developing cancer (colorectal polyps with malignant potential)
42
What are the arrows indicating in this image? What disease is this a characteristic of?
multiple osteomas; gardner syndrome
43
Bony outgrowths attached to the mandible & maxilla
osteomas
44
If a patient comes in, and radiographically you determine they have multiple osteomas, you should be thinking:
gardner syndrome
45
What is the treatment of supernumerary teeth?
conservative treatment (monitoring) or removal of supernumerary teeth
46
Why might we choose to extract supernumerary teeth?
To reduce likelihood of complications such as:
1. resorption of adjacent teeth
2. crowding/ malocclusion
3. periodontal problems
4. development of pathology (dentigerous cyst)
47
What can be seen in this pano?
multiple supernumerary teeth
48
If you decide to leave supernumerary teeth alone (conservative treatment), you should still:
monitor radiographically overtime to make sure dentigerous cyst doesn't develop
49
How many supernumerary teeth can be seen in this image?
4 or 5 (upper right unsure if 1 or 2)
50
When do supernumerary teeth pose a threat to periodontal health?
When fully erupted into oral cavity
51
What is a potential risk associated with the supernumerary teeth in this image?
periodontal health concerns
52
Missing teeth may also be called:
hypodontia
53
absence of erupted tooth or dental follicle without history of extraction:
hypodontia
54
the most commonly missing teeth are the:
3rd molars > mandibular 2nd PM > maxillary lateral & central incisors
55
Excluding abscence of 3rd molars, hypdotnai affects:
3-10% of the population
56
Lack of development of one or more teeth:
hypodontia
57
total lack of development of teeth:
anodontia
58
What can be seen in the following image?
hypodontia (missing permeant successor)
59
Lack of development of 6 or more teeth (excluding 3rd molars)
oligodontia
60
How can you tell that this is ankylosed tooth?
due to the lower occlusal & absence of PDL space
61
What can you see in this image? Is the tooth ankylosed?
Hypodontia (no the tooth is not ankylosed due to same occlusal level and PDL space present)
62
Etiology of missing teeth or hypotonia: (3)
1. absence of dental lamina
2. environmental factors that may damage dental lamina prior to tooth formation
3. genetics
63
What are some environmental factors that can lead to missing teeth or hypodontia?
1. trauma
2. infection
3. chemo
4. radiation
64
What is a risk of children getting radiation at a very early age (before teeth develop)?
destroys the dental lamina so the tooth will never develop
65
What should be the FIRST differential diagnosis if a patient presents with multiple missing teeth with NO history of tooth loss?
Ectodermal dysplasia
66
Ectodermal dysplasia affects all tissues of the body that originate from the:
ectoderm
67
List some characteristics of ectodermal dysplasia: (4)
1. decreased number of sweat glands
2. sparse hair, eyelashes & eyebrows
3. dystrophic or malformed nails
4. hypodontia with abnormal crown shape in teeth that are present
68
What can you see in this image? What disease might you suspect?
Hypodontia, abnormal crown shape in teeth that are present; ectodermal dysplasia
69
Patient presents to clinic with these conical shaped teeth and multiple missing teeth. What condition do you suspect?
ectodermal dysplasia
70
Larger than normal tooth, seen clinically or radiographically:
Macrodontia
71
Macrodontia often affects:
single tooth
72
Macrodontia may be associated with:
crowding and malocclusion
73
T/F: With macrodontia, the shape of the tooth is usually normal
true
74
What can be seen in the following image?
macrodontia
75
What can be seen in the following image?
macrodontia
76
In the following radiograph, what can be seen?
macrodontia- mandibular 2nd premolars
77
smaller than normal tooth the can be seen clinically or radiographically:
microdontia
78
microdontia might involve:
- all teeth
- single tooth
- group of teeth
79
What teeth are commonly affected by microdontia?
3rd molars & maxillary lateral incisorsW
80
hat is the treatment for microdontia?
restorative treatment if needed
81
What can be seen in the following image?
microdontia
82
What can be seen in the following image?
microdontia
83
Microdontia affecting a lateral incisor:
peg lateral
84
What can be seen in the following image?
microdontia
85
What can be seen in the following image?
microdontia- peg lateral
86
condition in which two typically adjacent teeth have exchanged position sin the dental arch:
transposition
87
the most frequently transposed teeth are:
permanent canine and first premolar
88
T/F: transposition may occur in the primary dentition:
false- no reported cases
89
What can be seen in the following image?
transposition of permanent canine & first PM
90
What can be seen in the following pano?
transposition, mandibular right lateral incisor and right canine
91
A small formation of enamel 1-3 mm in diameter that occurs not eh roots of molars:
enameloma or enamel pearl
92
What can be seen in the following image?
transposition of maxillary right canine and 1st premolar
93
What percent of the population has enamelomas (enamel pearls)?
3%
94
What can be seen in the following images?
enamelomas or enamel pearls
95
What location is most common for enamelomas (enamel pearls)?
furcation of the molars
96
Why can you not just automatically cut off an enameloma or enamel pearl?
some contain pulp & dentin inside
(pulp exposure risk)
97
Most enamel pearls form ___ to the ____ are are not detected during clinical examination
apical to the gingival crest
98
Enamelomas (enamel pearls) typically develop in the furcal areas of molar teeth, often lying at or just apical to the:
CEJ
99
Enamel pearls (enamelomas) may be a predisposing factor to formation of:
periodontal pocket and subsequent periodontal disease
100
What is a differential diagnosis for enamel pearls? (enamelomas)
calculus
101
Describe the treatment of enamel pearls (enamelomas):
Removal if it is a risk factor to periodontal disease, the possibility must consider data tit may contain a pulp horn
102
Results from the union of germs of developing teeth:
Fusion
103
Fusion results in a:
REDUCED number of teeth
104
T/F: Fusion is more commonly seen in deciduous dentition but may also occur in the permanent dentition
true
105
Where fusion most commonly seen?
anterior teeth
106
What can be seen in the following image?
fusion
107
The degree of fusion is dependent on:
which stage the teeth fuse
108
What can be seen in the following image?
fusion
109
How do you differentiate between fusion and gemination?
fusion may be differentiated from gemination when the number of teeth is reduced by 1
110
How do we treat fusion?
1. conservatively
2. RCT+ restorative
111
Label which image is fusion and which image is gemination:
Left: fusion
Right: Gemination
112
Clinically, fusion and gemination are both prone to:
caries (due to groove in middle)
113
If we see a much larger tooth, however have the correct number of teeth this is a sign of:
gemination
114
What can be seen in the following image?
fusion (missing a tooth)
115
What can be seen in the following image?
gemination (appropriate number of teeth)
116
Arises when a single tooth bud attempts to divide:
gemination
117
Gemination arises when a single tooth bud attempts divide. The result may be an:
invagination of the crown with partial clefting
118
Gemination may occur in both dentitions but ____ are the most affected and typically in the ____region
primary teeth; incisor
119
Describe the pulp chamber with a tooth that has undergone gemination:
Pulp chamber is usually single and enlarged and may be partially divided
120
What can be seen in the following image?
gemination
121
Common differential diagnosis for gemination:
1. macrodontia
2. fusion
122
What is the treatment for a tooth that has undergone gemination?
1. restorative (cleft is a caries susceptible site)
2. extraction (only when needed)
123
What can be seen in the following image?
gemination
124
What can be seen in the following image?
gemination
125
Occurs when the roots of TWO or more primary or permanent teeth are fused through CEMENTUM:
Concresence
126
What is the cause of concrescence?
Unknown but could be:
1. space restriction during development
2. local trauma
3. excessive occlusal force
4. local infection after development
127
What teeth are most commonly affected by concrescence?
maxillary molars (esp. third molars & supernumerary tooth)
128
What is a risk involving eruption of teeth that have been affected by concrescence?
involved teeth may fail to erupt of may erupt incompletely
129
T/F: An imaging examination will always reveal concrescence
False- an imaging examination may not always reveal concrescence. (teeth may be in close contact or are simply superimposed)
130
If you suspect concrescence what radiographic option may be a good choice?
small field of view; CBCT
131
What can be seen in the following image?
concrenscence
132
Concrescence involves fusion of ____ but NOT ___ or ___
cementum; enamel or dentin
133
What is the risk of extraction of teeth that have undergone concrescence?
VERY hard to extract
134
What can be seen in the following image?
concrescence
135
What can be seen in the following image?
concrescence
136
What do we mean by "2D limitation" in regards to concrescence?
In a 2D image, the teeth may just look superimposed, when in reality their cementum is fused together through concrescence
137
Elongation of pulp chamber in multirooted teeth with apical discpacement of the pulpal floor:
Taurodontism
138
What teeth may be affected by taurodontism?
primary or permanent dentition; single or multiple teeth may be affected
139
How must taurodontism be detected?
ONLY radiographically, not clinically
140
Describe how a tooth affected by taurodontism appear radiographically:
elongated pulp chamber; more apically positioned furcation; short roots
141
taurodontism
142
taurodontism
143
taurodontism
144
taurodontism
145
taurodontism
146
taurodontism
147
What is a differential interpretation for a taurodont?
none- taurodont easily recognized and distinguished
148
What treatment is required for a taurodont?
no treatment needed
149
Sharp bend or curve in the tooth, anywhere in the crown or the root:
dilaceration
150
Dilaceration most often affects what teeth?
maxillary premolars
151
dilaceration
152
dilaceration
153
dilaceration
154
dilaceration
155
dilaceration
156
A bulls eye root is an example of:
dilaceration
157
Increased number of roots compared to usual anatomic number:
Supernumerary roots
158
Extra lingual root on mandibular molars:
radix entomolaris
159
Extra buccal root on mandibular molars:
radix paramolaris
160
What teeth can be affected by supernumerary roots?
any tooth
161
T/F: With supernumerary roots, extra roots may be fully developed or smaller than normal
true
162
The presence of supernumerary roots may affect treatments such as:
1. orthodontics
2. endodontics
3. extractions
163
What may be a benefit of supernumerary roots?
prosthodontics (great abutments)
164
supernumerary roots
165
supernumerary roots
166
supernumerary roots
167
supernumerary roots
168
Represent varying degree of invagination or infolding of the enamel surface into the interior of the tooth:
Dens invaginatus & Dens in dente
169
What teeth are most commonly affected by dens invaginatus/dens in dente?
maxillary lateral incisor
170
Dens invaginatus/dens in dente is rarely seen in:
deciduous dentition & mandibular teeth
171
What is a risk associated with dens invaginatus/dens in dente?
high caries risk (prophylactic restoration often performed)
172
dens invaginatus/dens in dente
173
dens invaginatus/dens in dente
174
dens invaginatus/dens in dente
175
dens invaginatus/dens in dente
176
dens invaginatus/dens in dente
177
dens invaginatus/dens in dente
178
dens invaginatus/dens in dente
179
is a result of an evagination or outpouching of the enamel organ:
dens evaginatus/talon cusp
180
In dens evaginatus/talon cusp, the resultant enamel covered tubercle usually occurs in or near the:
middle of the occlusal or incisal surface of the tooth
181
In dens evaginatus/talon cusp, the tubercle often has a _____ and a ______ frequently extends into the evagination
dentin core; very slender pulp horn
182
dens evaginatus/talon cusp
183
dens evaginatus/talon cusp
184
dens evaginatus/talon cusp
185
In dens evaginatus/talon cusp, when might treatment be necessary?
If the tubercle causes any occlusal interference or shows evidence of marked abrasion it probably should be removed
186
