Radiographic Abnormalities Flashcards
The patient has had orthodontic XLA of their maxillary first premolars. What developmental condition do they have that relates to the number of their teeth?
Hyperdontia - UR small supplimental supernumery tooth. (Microdont)
What is a supplimental supernumerary tooth?
A tooth with the same morphology as at typical tooth.
What is another term for a supernumerary tooth distal to the dentition?
Distodens
This patient has hypodontia - what permanent teeth are missing?
13, 23, 35
What is unusual about this pattern of hypodontia?
It is rare for the canines to be developmentally absent.
Exlcuding third molars, which two teeth are most commonly developmentally absent?
Maxillary incisors
Mandibular second premolars
List all of the dental development abnormalities this 15 year old patient has.
Hypodontia - 12, 35, 42 45
Peg shaped lateral - 22
Delayed erruption of 17
What is the normal range of eruption of second molars?
11-13 years
Assuming the patient has had no dental extractions, which secondary teeth are developmentally absent?
12, 35, 45, and a mandibular incisor
What is the relationship between peg-shaped laterals and hypodontia?
Peg shaped lateral incisors are more common in patients with hypodontia.
15 looks abnormal on this radiograph, but upon eruption it is not malformed - what is the reasoning for this radiographic appearance?
Its buccally or palatally tilted, resulting in superimposition of the crown and root.
What age range to third molars begin to calcify and therefore appear on radiographs?
8-10 years.
Are there any developmentally missing teeth in this radiograph of an 8 year old patient?
No.
What is the main developmental abnormality here?
Infra-occluded 85.
What is unusual about tooth 45?
It is ectopic, it should be located inferior to root furcation - but in reality it is located distal to 85.
Is there any evdience of third molar development in this 10 year old patient?
No - you would expect to see the intial development of dental follicles at this age.
Which other secondary teeth are develomentally absent?
15, 13, 23, 25, and two mandibular incisors
Other than the hypodontia, what is the most significant abnormaility in this case - and what is the prognosis of the tooth related to it?
Dens in dente
Reduced prognosis due to increased risk of caries and pulp necrosis.
Which two secondary teeth have been extracted, and how can you tell?
16 and 26
There is increased inter-radicular spcaes between the upper 5-7s, the upper 7s are mesially tilted
List all of the dental developmental abnormalities present.
Ectopic 13, angled mesially
Peg shaped 12
Dens in dente 22
What developmental abnormalities does this 13 year old have?
Ectopic 43
Retained 83
Delayed euption of the 17
A viable option for this 43 would be to leave in situ, what are the risks of this option?
External root resoprtion of the adjacent teeth
Dentigerous cyst formation
What dental development abnormality can you spot in this periapical radiograph?
Ectopic tooth in the right ramus
Located inferior to the sigmoid notch
What type of tooth can be found in the ramus of the patient?
Supernumary - 49
Erupted molar is likely 48, and tooth has odd morphology.
Identify the abnormality in this OPT.
Inverted 22
Unerupted
Abnormal morphology
What dental abnormality can you identify here?
13 and 14 are transposed
(Switched positions)
What are the dental development abnormailities in the maxilla of this 19 year old patient?
Supernumary microdonts distal to 18 and 28
List two developmental abnormalities in the mandibular region of this OPT.
48 mesio-angularly impacted
38 - Germinated/fused tooth (with supernumerary)
What is the difference between the germination abnormalities and fusion abnormalities?
Germination is the development of two conjoined teeth from a single germ, fusion results from the from the joining of two tooth germs.
What dental developmental abnormaility does this patient have?
Fusion of 11 and 12
You can rule out germination, as there would be another incisor present in that quadrant.
This 13 year old patient lost their tooth 21 as a result of trauma - what developmental abnormality do they have?
Abnormally tall pulp chambers
Root furcations are position relatively far apically.
Also know as taurodontism
What restorative challenge do teeth with taurodontism pose?
Endo is hard because root canal orifices will be abnormally deep within the access cavity.
What surgical challenge do teeth with taurodontism pose - if an XLA is required?
The root furcation might be too far apically for the beaks to engage properly.
What is abnormal about these radiographs of an 8 year old patient?
The enamel on this patient is remarkably thin
This patient has amelogenesis imperfecta
What are the dental issues that a patient with amelogenesis imperfecta may experience?
Aesthetic concerns
Dentine hypersensitivity
Increased caries
Increased toothwear
What are the potential causes for dilaceration?
Damage during development from trauma/infection
Impeded tooth development by a supernumerary tooth, cysts, tumour.
What developmental abnormality does this patient have?
16, 26, 37, 36, 35 have been previously extracted.
38 and 48 are both mesio-angularly horizontal
There is an additional tooth superior to 38
'’39’’ can also be termed:
Supernumerary
Supplimental
Distodens
What dental development condition does this 18 year old patient?
Hyperdontia - with multiple unerupted supernumerary teeth.
There are 9 supernumeraries in total.
Based on this radiograph, what abnormality would be evident clinically in this 12 year old patient? What is the reason for this abnormality?
Retained 51 and 61
Unerrupted 11 and 21
They are being mpacted by two supernumeraries.
What is the radiopaque structure between the apices of 11 and 21?
Inferior border of the nose
What abnormality has caused the chaotic dentition in the mandible?
Cleidocranial Dysplasia
What other key characteristic of cleidocranial dysplasia, not related to the craniofacial region, is associated with this coniditon?
Underdeveloped/hypoplastic clavicles
What dental development abnormalities does this 12 year old patient have in their left maxillary quadrent?
Infra-occluded 65
Impacted ectopic 25
What features indicate that the 65 is in fact a primary tooth, not a supernumerary secondary tooth?
It has characteristic morphology of a primary second molar (bulbous crown, pronounced cervical constriction, thin splayed roots)
What anatomical structure is 65 now in close proximity to, that may complicate extraction? What would be the risks of extracting this tooth?
Left maxillary sinus
Risk of displacement of tooth or roots into sinus, risk of creation of oro-antral communication.
What is abnormal about this 9 year old patients dentition?
Multiple teeth have abnormal enamel, which is either incomplete or very thin.
This is likely caused by amelogenisis imperfecta.
Why would you suspect this patient to have amelogenisis imperfecta, and not rampant caries?
17, 13, 23, 27 are affected, despite being partially erupted.
The lost enamel is not in characterstic caries shapes (trianlgular/conical, exteneding towards pulp)
Not at characterstic sites for caries (not at fissures, apical to contact points)
What is unusual about the dentition of this patient?
Obliterated pulp chambers
Sclerosed canals
Dentinogenisis imperfecta
Other than the missing permolars, what is abnormal about this dentition?
Multiple round radiopacities around the roots of several molar teeth.
Enamel pearls
What are the clinical implications of enamel pearls?
Increased risk of periodontal disease, as can be plaque retentive factors
Complicated extraction for tooth, difficult application point, may prevent instrumentation.
Chart the teeth of this 5 year old patient. What is abnormal about their oral morphology?
51, 61, 11, 12
Lower incisor
Conlical crowns
This patient has a genetic condition which has led to severe hypodontia and conical teeth. What condition do they have?
Ectodermal dysplasia
What are ectodermal dysplasias?
Ectodermal dysplasias (ED) are disorders that affect the skin, sweat glands, hair, teeth, and nails.
Some individuals with ED may also have cleft lip and/or palate. ED can additionally cause problems with the immune system as well as hearing and vision.
Ectodermal dysplasias occur when the outer layer of tissue (ectoderm) of the embryo does not develop normally.
What is dentinogenesis imperfecta?
Translucent and discoloured teeth, caused due to an abnormalitiy during dentine development.
The teeth are more prone to caries and damage, due to impaired structure.
What are the types of dentinogenesis imperfecta?
Type I: Patient also has osteogenesis imperfecta
Type II: Patient has no other development abnormalities
Type III: Occurs in people with other disorders
