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Radiographic Interpretation > Lecture 2- Dental Anomalies I > Flashcards

Lecture 2- Dental Anomalies I Flashcards

1
Q

Dental anomalies can be divided into: (3)

A
  1. congenital
  2. developmental
  3. acquired
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2
Q

Dental anomalies that are genetically inherited:

A

congenital

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3
Q

Dental anomalies that occur during tooth formation:

A

developmental

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4
Q

Dental anomalies that occur after teeth formation:

A

acquired

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5
Q

Developmental abnormalities of teeth involve: (5)

A
  1. number of teeth
  2. size of teeth
  3. eruption of teeth
  4. enamel pearl or enameloma
  5. altered morphology
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6
Q

Developmental abnormalities involving the NUMBER of teeth: (2)

A
  1. supernumerary teeth
  2. missing teeth
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7
Q

Developmental abnormalities involving SIZE of teeth: (2)

A
  1. macrodontia
  2. microdontia
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8
Q

Developmental abnormality involving the ERUPTION of teeth: (1)

A

Transposition

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9
Q

Enamel pearl or enameloma is considered a ____ abnormality

A

developmental

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10
Q

Developmental abnormalities involving ALTERED MORPHOLOGY of teeth: (8)

A
  1. Fusion
  2. Gemination
  3. Concrescence
  4. Taurodontism
  5. Dilaceration
  6. Supernumerary roots
  7. Dens in vaginatus & dens in dente
  8. Dens evaginatus & talon cusp
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11
Q

Acquired abnormalities include: (3)

A
  1. attrition
  2. abrasion
  3. erosion
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12
Q

Presence of extra-erupted or unerupted teeth:

A

Supernumerary teeth

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13
Q

Supernumerary teeth are also known as:

A

hyperdontia

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14
Q

The 2nd most common dental anomaly involving 1-4% of the population:

A

supernumerary teeth

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15
Q

What can be seen in this image?

A

supernumerary tooth in between lateral & canine (mesiodens)

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16
Q

A supernumerary tooth located in between the lateral & canine:

A

mesiodens

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17
Q

Most common supernumerary teeth that are single:

A

mesiodens

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18
Q

4th molars (supernumerary teeth) more commonly seen in the maxillary dentition:

A

distodens (distomolar)

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19
Q

What is more common, hyperdontia or hypodontia?

A

HYPOdontia

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20
Q

What can be seen in this image?

A

distodens (distomolar)

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21
Q

Most common single supernumerary tooth is:

A

mesiodens or distodens

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22
Q

Multiple supernumerary teeth are most commonly found in:

A

mandibular premolar region

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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)

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24
Q

What type images should be taken if you suspect supernumerary teeth (multiple)?

A

CBCT

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25
Q

What can be seen in the following CBCT?

A

supernumerary teeth

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26
Q

What can be seen in this pano?

A

multiple supernumerary teeth (common for mandibular premolar area)

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27
Q

What is a risk of leaving an impacted tooth in the oral cavity?

A

dentigerous cyst risk

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28
Q

What can be seen in the following image?

A

mesiodens

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29
Q

What can be seen in the following image?

A

distodens (distomolar)

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30
Q

Top differential diagnosis associated with multiple SUPERNUMERARY TEETH:

A
  1. Cleidocranial dysplasia
  2. Gardner syndrome
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31
Q

List some characteristics of Cleidocranial dysplasia:

A
  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)
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32
Q

What can be seen in this image? (cleidocranial dysplasia)?

A
  1. prognathic mandible
  2. open cranial suture
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33
Q

What can be seen in this image? (cleidocranial dysplasia)

A
  1. open cranial suture
  2. hypoplastic paranasal sinuses
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34
Q

What can be seen in this image? (cleidocranial dysplasia)

A

hypoplastic clavicles

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35
Q

Given the following images, what disease can be suspected?

A

cleidocranial dysplasia

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36
Q

In addition to the prognathic mandible, what also can be seen in this image?

A

multiple supernumerary teeth in mandible (giving it a very radiopaque appearance)

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37
Q

A water’s radiograph is used to evaluate the:

A

maxillary sinus

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38
Q

What type of radiograph can be seen? What is this used for?

A

Waters radiograph; visualization of maxillary sinus

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39
Q

What can be seen in the following image? What disease do we suspect?

A

multiple supernumerary teeth; cleidocranial dysplasia

(note that there are multiple deciduous teeth in the dentition, not all of these are supernumerary)

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40
Q

What are some characteristics of Garner Syndrome:

A
  1. MULTIPLE supernumerary teeth
  2. osteomas
  3. epidermoid cysts of skin
  4. colorectal polyps with malignant potential
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41
Q

If suspect Gardner Syndrome in an undiagnosed patient, it is important to refer them to their physician as this:

A

may prevent them from developing cancer (colorectal polyps with malignant potential)

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42
Q

What are the arrows indicating in this image? What disease is this a characteristic of?

A

multiple osteomas; gardner syndrome

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43
Q

Bony outgrowths attached to the mandible & maxilla

A

osteomas

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44
Q

If a patient comes in, and radiographically you determine they have multiple osteomas, you should be thinking:

A

gardner syndrome

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45
Q

What is the treatment of supernumerary teeth?

A

conservative treatment (monitoring) or removal of supernumerary teeth

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46
Q

Why might we choose to extract supernumerary teeth?

A

To reduce likelihood of complications such as:
1. resorption of adjacent teeth
2. crowding/ malocclusion
3. periodontal problems
4. development of pathology (dentigerous cyst)

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47
Q

What can be seen in this pano?

A

multiple supernumerary teeth

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48
Q

If you decide to leave supernumerary teeth alone (conservative treatment), you should still:

A

monitor radiographically overtime to make sure dentigerous cyst doesn’t develop

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49
Q

How many supernumerary teeth can be seen in this image?

A

4 or 5 (upper right unsure if 1 or 2)

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50
Q

When do supernumerary teeth pose a threat to periodontal health?

A

When fully erupted into oral cavity

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51
Q

What is a potential risk associated with the supernumerary teeth in this image?

A

periodontal health concerns

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52
Q

Missing teeth may also be called:

A

hypodontia

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53
Q

absence of erupted tooth or dental follicle without history of extraction:

A

hypodontia

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54
Q

the most commonly missing teeth are the:

A

3rd molars > mandibular 2nd PM > maxillary lateral & central incisors

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55
Q

Excluding abscence of 3rd molars, hypdotnai affects:

A

3-10% of the population

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56
Q

Lack of development of one or more teeth:

A

hypodontia

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57
Q

total lack of development of teeth:

A

anodontia

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58
Q

What can be seen in the following image?

A

hypodontia (missing permeant successor)

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59
Q

Lack of development of 6 or more teeth (excluding 3rd molars)

A

oligodontia

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60
Q

How can you tell that this is ankylosed tooth?

A

due to the lower occlusal & absence of PDL space

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61
Q

What can you see in this image? Is the tooth ankylosed?

A

Hypodontia (no the tooth is not ankylosed due to same occlusal level and PDL space present)

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62
Q

Etiology of missing teeth or hypotonia: (3)

A
  1. absence of dental lamina
  2. environmental factors that may damage dental lamina prior to tooth formation
  3. genetics
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63
Q

What are some environmental factors that can lead to missing teeth or hypodontia?

A
  1. trauma
  2. infection
  3. chemo
  4. radiation
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64
Q

What is a risk of children getting radiation at a very early age (before teeth develop)?

A

destroys the dental lamina so the tooth will never develop

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65
Q

What should be the FIRST differential diagnosis if a patient presents with multiple missing teeth with NO history of tooth loss?

A

Ectodermal dysplasia

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66
Q

Ectodermal dysplasia affects all tissues of the body that originate from the:

A

ectoderm

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67
Q

List some characteristics of ectodermal dysplasia: (4)

A
  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
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68
Q

What can you see in this image? What disease might you suspect?

A

Hypodontia, abnormal crown shape in teeth that are present; ectodermal dysplasia

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69
Q

Patient presents to clinic with these conical shaped teeth and multiple missing teeth. What condition do you suspect?

A

ectodermal dysplasia

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70
Q

Larger than normal tooth, seen clinically or radiographically:

A

Macrodontia

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71
Q

Macrodontia often affects:

A

single tooth

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72
Q

Macrodontia may be associated with:

A

crowding and malocclusion

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73
Q

T/F: With macrodontia, the shape of the tooth is usually normal

A

true

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74
Q

What can be seen in the following image?

A

macrodontia

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75
Q

What can be seen in the following image?

A

macrodontia

76
Q

In the following radiograph, what can be seen?

A

macrodontia- mandibular 2nd premolars

77
Q

smaller than normal tooth the can be seen clinically or radiographically:

A

microdontia

78
Q

microdontia might involve:

A
  • all teeth
  • single tooth
  • group of teeth
79
Q

What teeth are commonly affected by microdontia?

A

3rd molars & maxillary lateral incisorsW

80
Q

hat is the treatment for microdontia?

A

restorative treatment if needed

81
Q

What can be seen in the following image?

A

microdontia

82
Q

What can be seen in the following image?

A

microdontia

83
Q

Microdontia affecting a lateral incisor:

A

peg lateral

84
Q

What can be seen in the following image?

A

microdontia

85
Q

What can be seen in the following image?

A

microdontia- peg lateral

86
Q

condition in which two typically adjacent teeth have exchanged position sin the dental arch:

A

transposition

87
Q

the most frequently transposed teeth are:

A

permanent canine and first premolar

88
Q

T/F: transposition may occur in the primary dentition:

A

false- no reported cases

89
Q

What can be seen in the following image?

A

transposition of permanent canine & first PM

90
Q

What can be seen in the following pano?

A

transposition, mandibular right lateral incisor and right canine

91
Q

A small formation of enamel 1-3 mm in diameter that occurs not eh roots of molars:

A

enameloma or enamel pearl

92
Q

What can be seen in the following image?

A

transposition of maxillary right canine and 1st premolar

93
Q

What percent of the population has enamelomas (enamel pearls)?

A

3%

94
Q

What can be seen in the following images?

A

enamelomas or enamel pearls

95
Q

What location is most common for enamelomas (enamel pearls)?

A

furcation of the molars

96
Q

Why can you not just automatically cut off an enameloma or enamel pearl?

A

some contain pulp & dentin inside

(pulp exposure risk)

97
Q

Most enamel pearls form ___ to the ____ are are not detected during clinical examination

A

apical to the gingival crest

98
Q

Enamelomas (enamel pearls) typically develop in the furcal areas of molar teeth, often lying at or just apical to the:

A

CEJ

99
Q

Enamel pearls (enamelomas) may be a predisposing factor to formation of:

A

periodontal pocket and subsequent periodontal disease

100
Q

What is a differential diagnosis for enamel pearls? (enamelomas)

A

calculus

101
Q

Describe the treatment of enamel pearls (enamelomas):

A

Removal if it is a risk factor to periodontal disease, the possibility must consider data tit may contain a pulp horn

102
Q

Results from the union of germs of developing teeth:

A

Fusion

103
Q

Fusion results in a:

A

REDUCED number of teeth

104
Q

T/F: Fusion is more commonly seen in deciduous dentition but may also occur in the permanent dentition

A

true

105
Q

Where fusion most commonly seen?

A

anterior teeth

106
Q

What can be seen in the following image?

A

fusion

107
Q

The degree of fusion is dependent on:

A

which stage the teeth fuse

108
Q

What can be seen in the following image?

A

fusion

109
Q

How do you differentiate between fusion and gemination?

A

fusion may be differentiated from gemination when the number of teeth is reduced by 1

110
Q

How do we treat fusion?

A
  1. conservatively
  2. RCT+ restorative
111
Q

Label which image is fusion and which image is gemination:

A

Left: fusion

Right: Gemination

112
Q

Clinically, fusion and gemination are both prone to:

A

caries (due to groove in middle)

113
Q

If we see a much larger tooth, however have the correct number of teeth this is a sign of:

A

gemination

114
Q

What can be seen in the following image?

A

fusion (missing a tooth)

115
Q

What can be seen in the following image?

A

gemination (appropriate number of teeth)

116
Q

Arises when a single tooth bud attempts to divide:

A

gemination

117
Q

Gemination arises when a single tooth bud attempts divide. The result may be an:

A

invagination of the crown with partial clefting

118
Q

Gemination may occur in both dentitions but ____ are the most affected and typically in the ____region

A

primary teeth; incisor

119
Q

Describe the pulp chamber with a tooth that has undergone gemination:

A

Pulp chamber is usually single and enlarged and may be partially divided

120
Q

What can be seen in the following image?

A

gemination

121
Q

Common differential diagnosis for gemination:

A
  1. macrodontia
  2. fusion
122
Q

What is the treatment for a tooth that has undergone gemination?

A
  1. restorative (cleft is a caries susceptible site)
  2. extraction (only when needed)
123
Q

What can be seen in the following image?

A

gemination

124
Q

What can be seen in the following image?

A

gemination

125
Q

Occurs when the roots of TWO or more primary or permanent teeth are fused through CEMENTUM:

A

Concresence

126
Q

What is the cause of concrescence?

A

Unknown but could be:
1. space restriction during development
2. local trauma
3. excessive occlusal force
4. local infection after development

127
Q

What teeth are most commonly affected by concrescence?

A

maxillary molars (esp. third molars & supernumerary tooth)

128
Q

What is a risk involving eruption of teeth that have been affected by concrescence?

A

involved teeth may fail to erupt of may erupt incompletely

129
Q

T/F: An imaging examination will always reveal concrescence

A

False- an imaging examination may not always reveal concrescence. (teeth may be in close contact or are simply superimposed)

130
Q

If you suspect concrescence what radiographic option may be a good choice?

A

small field of view; CBCT

131
Q

What can be seen in the following image?

A

concrenscence

132
Q

Concrescence involves fusion of ____ but NOT ___ or ___

A

cementum; enamel or dentin

133
Q

What is the risk of extraction of teeth that have undergone concrescence?

A

VERY hard to extract

134
Q

What can be seen in the following image?

A

concrescence

135
Q

What can be seen in the following image?

A

concrescence

136
Q

What do we mean by “2D limitation” in regards to concrescence?

A

In a 2D image, the teeth may just look superimposed, when in reality their cementum is fused together through concrescence

137
Q

Elongation of pulp chamber in multirooted teeth with apical discpacement of the pulpal floor:

A

Taurodontism

138
Q

What teeth may be affected by taurodontism?

A

primary or permanent dentition; single or multiple teeth may be affected

139
Q

How must taurodontism be detected?

A

ONLY radiographically, not clinically

140
Q

Describe how a tooth affected by taurodontism appear radiographically:

A

elongated pulp chamber; more apically positioned furcation; short roots

141
Q
A

taurodontism

142
Q
A

taurodontism

143
Q
A

taurodontism

144
Q
A

taurodontism

145
Q
A

taurodontism

146
Q
A

taurodontism

147
Q

What is a differential interpretation for a taurodont?

A

none- taurodont easily recognized and distinguished

148
Q

What treatment is required for a taurodont?

A

no treatment needed

149
Q

Sharp bend or curve in the tooth, anywhere in the crown or the root:

A

dilaceration

150
Q

Dilaceration most often affects what teeth?

A

maxillary premolars

151
Q
A

dilaceration

152
Q
A

dilaceration

153
Q
A

dilaceration

154
Q
A

dilaceration

155
Q
A

dilaceration

156
Q

A bulls eye root is an example of:

A

dilaceration

157
Q

Increased number of roots compared to usual anatomic number:

A

Supernumerary roots

158
Q

Extra lingual root on mandibular molars:

A

radix entomolaris

159
Q

Extra buccal root on mandibular molars:

A

radix paramolaris

160
Q

What teeth can be affected by supernumerary roots?

A

any tooth

161
Q

T/F: With supernumerary roots, extra roots may be fully developed or smaller than normal

A

true

162
Q

The presence of supernumerary roots may affect treatments such as:

A
  1. orthodontics
  2. endodontics
  3. extractions
163
Q

What may be a benefit of supernumerary roots?

A

prosthodontics (great abutments)

164
Q
A

supernumerary roots

165
Q
A

supernumerary roots

166
Q
A

supernumerary roots

167
Q
A

supernumerary roots

168
Q

Represent varying degree of invagination or infolding of the enamel surface into the interior of the tooth:

A

Dens invaginatus & Dens in dente

169
Q

What teeth are most commonly affected by dens invaginatus/dens in dente?

A

maxillary lateral incisor

170
Q

Dens invaginatus/dens in dente is rarely seen in:

A

deciduous dentition & mandibular teeth

171
Q

What is a risk associated with dens invaginatus/dens in dente?

A

high caries risk (prophylactic restoration often performed)

172
Q
A

dens invaginatus/dens in dente

173
Q
A

dens invaginatus/dens in dente

174
Q
A

dens invaginatus/dens in dente

175
Q
A

dens invaginatus/dens in dente

176
Q
A

dens invaginatus/dens in dente

177
Q
A

dens invaginatus/dens in dente

178
Q
A

dens invaginatus/dens in dente

179
Q

is a result of an evagination or outpouching of the enamel organ:

A

dens evaginatus/talon cusp

180
Q

In dens evaginatus/talon cusp, the resultant enamel covered tubercle usually occurs in or near the:

A

middle of the occlusal or incisal surface of the tooth

181
Q

In dens evaginatus/talon cusp, the tubercle often has a _____ and a ______ frequently extends into the evagination

A

dentin core; very slender pulp horn

182
Q
A

dens evaginatus/talon cusp

183
Q
A

dens evaginatus/talon cusp

184
Q
A

dens evaginatus/talon cusp

185
Q

In dens evaginatus/talon cusp, when might treatment be necessary?

A

If the tubercle causes any occlusal interference or shows evidence of marked abrasion it probably should be removed

186
Q
A

Radiographic Interpretation (10 decks)

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