Primary Tooth Morphology Flashcards
describe gingival cysts
- found on the palate and gingiva
- these are developmental collections of keratin that can be ignored
- they seem concerning to parents and sometimes are misdiagnosed as erupting teeth but they will resolve by themselves
- no actual treatment, just reassure the parents and the child that it is nothing to be concerned about
describe congenital epulis
this is a growth in the mucosa of a newborn and can progress and interfere with feeding
if it interferes can be managed via surgery but otherwise it will be left to resolve on its own
describe neonatal teeth
these are teeth present at birth or those that develop soon after birth and they are very common
usually the primary incisors will develop ectopically when neonatal, they should not be removed unless they threaten the airway by wiggling around or if they are causing ulcerations
if there are issues with feeding because of them they can be smoothed down
due to erupting early they are not always fully formed
describe eruption cysts
the tooth develops in a follicle and blood can sometimes end up in the follicle which gives a blue hue
when the tooth erupts the cyst will resolve
describe the use of notation for primary teeth
the quadrants are called 5, 6, 7 and 8 and can be referred to as letters or numbers but never both at the same time
use FDI notation in the exam
is there more variation in primary or permanent dentition
primary
when should tooth calcification stop
a month and half after birth
what are some examples of systemic disturbances that can lead to enamel defects
infections and reduced oxygenation
when does tooth eruption stop
when the teeth contact something - this is usually the opposing arch gingiva or teeth
what are the differences between primary and permanent dentition
primary is smaller due to smaller jaws, both the roots and crowns are smaller
the primary molars are wider mesiodistally and more bulbous which is an important note for restorations
they are whiter in colour due to the enamel and dentine being thinner due to less space
identifying feature of upper first primary molar
prominent mesiobuccal tubercle
identifying feature of lower first primary molar
prominent mesiobuccal tubercle - not as prominent as the upper first primary molar
identifying feature of the upper right second molar
transverse ridge
explain the roots of primary teeth
narrower than permanent teeth
flat, and ribbon shaped
thin and flare apically
why do the roots of primary teeth flare apically
due to the permanent tooth germ growing in the middle of the root
describe the pulp chambers of the primary teeth
smaller than permanent, but in proportion to the size of the actual tooth they are large
the horns are closer to enamel than in permanent dentition so it is more likely that the pulp will be exposed
the canals are often ribbon shaped and have many accessory canals
primary enamel description
consistently thin around the tooth rather than varying in thickness like in the permanent dentition
is it good if there is little spacing between primary teeth
no
why is it difficult to completely clean out the root canal of primary teeth
they are flat and ribbon shaped when the end files are conical
in what direction does the face grow
Down and outward
when does mixed dentition last until
the final tooth exfoliates
what does exfoliate mean
the natural process of shedding the primary teeth
describe how the path of eruption between primary and permanent dentition differs
the angulation is different
primary are upright
permanent are inclined backward to increase the length of the arch
they develop palatal to the primary teeth
how can the age of a child be determined from their dental radiograph
whether the roots are formed or not
for permanent teeth, roots are formed at three years of age
for primary tech, roots are formed at 1.5 years
what are some early problems that can occur in the dentition of children
gingival cysts
congenital epulis
natal or neonatal teeth
eruption cysts
what are epsteins pearls an example of
gingival cysts
what are bohns nodules examples of
gingival cysts
how are the quadrants numbered in primary dentition
5 6
8 7
when do teeth start to form
week 5 of inter uterine life
when does hard tissue formation begin
week 13 of inter uterine life
when can teeth be detected on ultrasounds
after week 13 because this is when hard tissue formation begins
when does the maxillary central incisor begin to calcify
between weeks 13 and 16
when does the crown of the maxillary central incisor completely calcify
1.5 months after birth
in what month post birth will the maxillary central incisor erupt in a child
8-12 months
when does the root completely calcify for the maxillary central incisor in primary dentition
33 months
describe the chronology of the maxillary second primary molar
hard tissue formation at 16-23 weeks i.u.l
crown formation complete at 11 months after birth
eruption between 25-33 months after birth
complete root formation at 47 months
what can lead to defects in the enamel
systemic disturbances during calification
what are defects in primary dentition that are non hereditary most likely the result of
difficult pregnancy for the mother or complications at birth
how calcified are central incisors at birth
a half
how calcified are lateral incisors at birth
a third
how calcified are primary canines at birth
just the tip
how calcified are primary molars at birth
a half
how calcified are second primary molars at birth
a third
how calcified are cusps of permanent molars
the tips
what are some theories of how teeth erupt
- cellular proliferation at the apex of the tooth
- localised change in blood pressure
- metabolic activity in the periodontal ligament
- resorption of overlying hard tissue
describe the resorption of overlying hard tissue in teeth
- due to enzymes in the dental follicle
- the follicle is best seen on the radiograph as a dark halo around the unerupted tooth
- the remodelling of bone or primary tooth tissue is essential to the process of tooth eruption
- animal models have shown that resorption processes can be uncoupled from the eruption process meaning it is not necessary for the tooth to erupt to cause the bone to resorb
describe the role of the dental follicle in tooth eruption
the follicle plays an essential role in active tooth eruption
activated to initiate the osteoclastic activity in the alveolar bone ahead of the tooth and clear a path for tooth eruption
once the crystal bone has been breached the follicle plays a lesser role
does eruption ever end
- it stops when the tooth comes into contact with something
- however it will continue throughout life to compensate for the vertical growth of the jaws and tooth wear
- teeth have to constantly have something opposing them or they will continue to erupt
what is the order of eruption
a b d c e
central incisor
lateral incisor
first molar
second molar
canine
what is the general rule to primary tooth eruption and what is the exception to this rule
lower teeth erupt before the upper teeth
the lateral incisors are the exception, the upper will erupt before the lower