Non carious diseases of teeth Flashcards
Local factors of acquired disorders
trauma – dilacerated incisor/turner teeth
infection –turner teeth
radiotherapy
idiopathic – regional odontodysplasia/enamel opacities
Systemic factors of acquired disorders
tetracycline disorders
serious systemic disease or malnutrition
fluorosis
dilacerated incisor
trauma displaces the crown of the developing tooth
root development continues but at an angle
tooth fails to erupt often with retention of the deciduous predecessor
turner teeth
arises due to local trauma/infeection
due to issues with primary predecessor
range of disorders from yellow-brown pigmentation of enamel to extensive pitting and irregularity of the crown
regional odontodysplasia
ghost teth
local development eg vascular defect causing ischaemia, local infection
enamel opacities
1 in 3 children
histologically hypomineralised
tetracycline staining
tetracycline becomes incorporated in the teeth mineralising at the same time
teeth normal when erupt – gradually grey colour
hereditary conditions
teeth only
- absent teeth/additional teeth
- connations
- dens-in-dente
- amelogenesis imperfecta and dentinogenesis imperfecta
affecting other tissues in addition to teeth
- osteogenesis imperfecta
- cleidocranial dysplasia
- anhidrotic ectodermal dysplasia
- down’s syndrome
Connation
Union of 2 teeth during development involving enamel, dentine and pulp
Concrescence
Union of teeth at roots by deposition of cementum
always affect roots
Connations classified
fusion : union between 2 initially separate tooth germs
germination : the union by incomplete separation of 2 teeth developing from single tooth germ
connation present in population
0.5-1% of population have deciduous tooth connation
0.1% of population have permanent tooth connation
inherited as an autosomal dominant trait
clinical features of connation
enlarged crowns with apparent partial separation
cause crowding/delayed eruption of adjacent teeth
concrescence
multiple teeth fused at root
molar teeth
pathology concrescence
inflammatory/space-occupying lesion
union via cementum deposition
treatment for both connations and concrescence
depends on aesthetic/function factors
endo and restorative procedures with permanent incisor connations
extractions for impacted and unerupted 3rd molars
dens in dente
localised disturbance of tooth development
deep penetrating pit extending into the tooth from the crown
invaginated odontome
general features of dens in dente
1-5% population
maxillary lateral incisors
bilateral
clinical features dens in dente
tooth crown may be distorted
invagination arises in crown
base of pit will have a thin layer of enamel/dentine
HPC dens in dente
incidental finding
morphological abnormality
periodontal pain
radiolographical features of dens in dente
affected tooth may show intracoronal radiolucency
extend to involve root
associated with periapical radiolucency
pathology of dens in dente
deeply penetrating pit lined by enamel
distortion of underlying dentine
enamel and dentine may be defective
treatment of dens in dente
endodontic tx
extraction
amelogenesis imperfecta
produce inherited congenital defects primarily of enamel formation with/without defects in tooth morphology and/or eruption
clinical features amelogenesis imperfecta
hypoplastic - thin enamel. surface rough and discoloured.
hypomature - abnormal thickness. opaque/discoloured
hypocalcified - abnormal thickness of enamel
radiological features of amelogenesis imperfecta
thin layer of enamel of normal radiodensity in hypoplastic AI
reduced radiodensity of enamel in hypomature and hypocalcified AI
may have been unerupted teeth or delayed eruption
pathology of amelogenesis imperfecta
variety of morphological changes in enamel substructure as well as hardness and thickness
dentinogenesis imperfecta
congenital defects in primarily in dentine formation, which may be associated with osteogenesis imperfecta
dentinogenesis imperfecta general features
1 in 6k livebirths
variety of inheritance patterns
variety of molecular and biochemical defects affecting collagen
dentinogenesis imperfecta HPC
present in childhood
discolouration or rapid wear of teeth
detinogenesis imperfecta clinical features
amber or blue
bulbous crown
easy fracturing of enamel with rapid attrition
dentinogenesis imperfecta radiological features
teeth have short roots
rapid obliteration of pulp chambers and canals after eruption
dentinogenesis imperfecta pathology
enamel normal
mantle dentine formation
later formed dentine abnormal
pulp cavity obliterated
cleidocranial dysplasia
rare genetic condition that affects teeth and bones such as skull etc
Cleidocranial dysplasia HPC
failure in eruption of permanent teeth
Cleidocranial dysplasia clinical features
short stature
prominence of frontal,parietal,occipital bones
absent of clavicles
delayed shedding of deciduous teeth
cleidocranial dysplasia radiological features
absent clavicle
broad skull
cleidocranial dysplasia pathology
bone show trabeculation and thick collagen bundles
teeth with thin roots with deficient or absent secondary cellular cementum
treatment of cleidocranial dysplasia
combination of surgery and ortho
surgery to remove deciduous teeth and expose permanent successors
ortho to encourage eruption and align teeth
Hypodidrotic ectodermal dysplasia
x-linked recessive condition characterised by a developmental failure of ectodermal structures, particularly skin/hair/sweat glands
hypohidrotic ectodermal dysplasia general features
x linked recessive
detected first in early childhood
hypohidrotic ectodermal dysplasia clinical features
absent/malformed teeth
cone shaped teeth
few teeth
down’s syndrome
congenital condition characterised by intellectual disability, trisomy of chromosome 21
general features of down’s syndrome
characterised facies with prominent epicanthic folds, downwardly slanted palebral fissures, mid-facial hypoplasia
short stature
