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Oral Diseases > Theme 4 - Dental Abnormalities > Flashcards

Theme 4 - Dental Abnormalities Flashcards

1
Q

What do we look at in the development of the ‘ideal’ dentition?

A
  • Number
  • Form
  • Structure
  • Eruption (position/delay)
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2
Q

List the abnormalities of number of teeth

A
  • Anodontia
  • Hypodontia
  • Hyperdontia
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3
Q

Define anodontia

A

Rare absence of all teeth

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4
Q

Define hypodontia

A

Absence of teeth less than 6

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5
Q

Define hyperdontia

A

Supernumerary or supplementary teeth

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6
Q

How do supernumerary teeth differ from supplementary teeth?

A
  • Supernumerary teeth are of abnormal form, supplementary teeth are normal copies of present dentition
  • Supernumerary more common in Females, supplementary teeth more common in males
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7
Q

Which teeth commonly have supplementary teeth?

A

Upper 2’s > Lower 5’s > Upper 5’s

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8
Q

List the syndromes associated with Hypodontia

A
  • Hypohidrotic ectodermal dysplasia
  • Cleft lip and palate
  • Down syndrome
  • Crouzon syndrome
  • Ellis-van Creveld syndrome
  • Orofacial digital syndrome
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9
Q

List the syndromes associated with Hyperdontia

A
  • Cleidocranial dysplasia
  • Cleft lip and palate
  • Orofacial digital syndrome
  • Gardner syndrome
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10
Q

Define hypohidrotic ectodermal dysplasia

A
  • Genetic skin disorder
  • X-linked recessive (rare in females)
  • Mutation in ectodysplasin A (ED1) gene
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11
Q

What are the general features of hypohidrotic ectodermal dysplasia?

A
  • Smooth dry skin with sparse hair
  • Partial/total absence of sweat glands
  • Nail abnormalities
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12
Q

What are the dental abnormalities of hypohidrotic ectodermal dysplasia?

A
  • Anodontia/Hypodontia
  • Delayed eruption
  • Deformed teeth
  • Conical crowns
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13
Q

Define cleidocranial dysplasia

A
  • Bone and teeth disorder
  • Autosomal dominant
  • Mutation in CBFA1/RUNX2 gene
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14
Q

What are the general features of cleidocranial dysplasia?

A
  • Absent/Hypoplastic clavicles
  • Fontanelles and sutures persist
  • Helmet-like skull
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15
Q

What are the dental abnormalities of cleidocranial dysplasia?

A
  • Hypoplastic maxilla
  • High, narrow palate
  • Retained deciduous teeth
  • Supernumerary teeth
  • Delayed/failure eruption
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16
Q

What conditions are associated with abnormalities of tooth form - size?

A
  • Microdontia

- Macrodontia

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17
Q

What syndromes are associated with size abnormalities?

A
  • Ehlers Danlos syndrome
  • Downs syndrome
  • Congenital heart disease
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18
Q

Define Ehlers Danlos syndrome

A

Inherited defect of collagen causing joint and skin issues

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19
Q

What are the dental abnormalities of Ehlers danlos?

A
  • Microdontia
  • Short roots
  • Pulp stones
  • Fragile mucosa
  • Juvenile periodontitis
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20
Q

What are the classifications of the abnormal shape/form of teeth?

A

Mesiodens, paramolar, distomolar, peg-shaped lateral

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21
Q

If a tooth is a mesiodens -what is it?

A
  • Supernumerary

- Positioned midline of central incisors

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22
Q

If a tooth is a paramolar - what is it?

A
  • Supernumerary

- Positioned buccal/palatal to maxillary molars

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23
Q

If a tooth is a distomolar - what is it?

A
  • Supernumerary

- Positioned distal to 3rd molars

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24
Q

Describe double teeth

A
  • Form abnormality of two single teeth becoming one

- Two causes: fusion and germination

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25
Q

How does double teeth form?

A
  • Fusion -> union between dentine and/or enamel of 2+ separate teeth
  • Germination -> partial development of 2 teeth from single tooth bud due to incomplete division
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26
Q

Describe concrescence

A
  • Form abnormality

- Roots of 2+ teeth unite by cementum alone after crown formation

27
Q

Describe taurodontism

A
  • Form abnormality
  • Pulp chamber height is greater than normal with no cervical constriction
  • Root canals are smaller and so are the roots
  • Present in permanent molars
  • Associated with Kilinefelter syndrome (XXY)
28
Q

Describe dilaceration

A
  • Form abnormality
  • Crown of tooth displaced from normal alignment with root
  • Present in permanent upper incisors
29
Q

List disorders with abnormalities of tooth structure affecting enamel

A
  • Amelogenesis imperfecta
  • Chronological hypoplasias
  • Congenital syphilis
  • Fluorosis
30
Q

State the different causes of enamel abnormalities

A
  • Local causes -> trauma/infection, idiopathic enamel opacity
  • Genetic -> amelogenesis imperfecta
  • Systemic -> infections, chronic diseases, nutritional deficiencies, chemotherapy, excess fluoride
31
Q

Describe congenital syphilis

A
  • Rare disease affecting structure of tooth
  • Infection of tooth germ by T.pallidum
  • Creates -> hutinsons incisors (screw-driver shaped with notch), mulberry molars (nodular cusps), moons molars (dome shaped crowns)
32
Q

Describe fluorosis

A
  • Excess fluoride causing structural abnormalities in dentition
  • Causes hypoplastic/hypomineralised enamel
  • Severity depends on dosage, duration and timing
  • Usually affects permanent dentition
  • Shows -> white flecks, patches, stations, discolourations on teeth
33
Q

Why is permanent dentition affected and not primary in fluorosis?

A

Excess fluoride at the time permanent teeth are developing will affect the enamel structure - primary teeth are no longer developing

34
Q

Describe amelogenesis imperfecta

A
  • Hereditary enamel defect
  • AD or X-linked
  • Causes either Hypoplasia or Hypomineralisation/Hypomaturation of enamel
35
Q

How do we determine whether a patient has hypoplastic or hypomineralised/hypomaturation AI?

A
  • Hypoplastic AI -> hard enamel (defective matrix) with varied thickness, generalised thinning of enamel with grooving and pitting, smaller crowns with abnormal cusp morphology
  • Hypomineralised AI -> soft enamel (defective mineralisation) with normal thickness, normal morphology when erupt, soft/chalky enamel that chips easily to expose dentine (severe attrition)
36
Q

State AI classification (1988)

A
  • Type I Hypoplastic
  • Type II Hypomaturation
  • Type III Hypocalcified
  • Type IV Hypomaturation-Hypoplastic with taurontism
37
Q

How is AI inherited?

A
  • AD
  • AR
  • X-linked
  • Isolated trait
38
Q

What components of enamel are affected in AI?

A
  • Amelogenin
  • Ameloblastin and Enamelin
  • Tuftelin
39
Q

What do we base AI classification off of?

A
  • Mode of inheritance
  • Gene defect
  • Biochemical consequences
  • Clinical features
40
Q

What are the causes of dentine abnormalities?

A
  • Local -> trauma/infection
  • Hereditary -> Dentinogenesis imperfecta, dentinal dysplasia
  • Environmental -> Rickets, hypophosphatasia, juvenile hypoparathyroidism
41
Q

How do we classify DI?

A
  • Type I DI in osteogenesis imperfecta
  • Type II in teeth only (shell teeth)
  • Type III Brandywine isolate
42
Q

How do we classify dentinal dysplasia?

A
  • Type I Radicular dentine dysplasia (rootless teeth)

- Type II Coronal dentine dysplasia

43
Q

Describe Type I DI - Osteogenesis Imperfecta

A
  • Rare hereditary disease causing a defect in Type I collagen
44
Q

What are the clinical features of osteogenesis imperfecta?

A
  • Slender bones (mechanically weak)
  • Deformity/Fractures/Deafness
  • Lax ligaments, thin translucent skin, blue sclera
  • Dentinogenesis imperfecta
45
Q

Describe Type II DI

A
  • Hypomineralised dentine of hereditary defect equal in males and females
46
Q

What are the clinical features of Type II DI?

A
  • Discoloured teeth (brown/grey tint)
  • Bulbous crowns
  • Rapid attrition
47
Q

What are the radiological features of Type II DI?

A
  • Thin, short, blunt roots

- Pulp chamber becomes obliterated

48
Q

What are the histopathological features of Type II DI?

A
  • Thin layer of normal mantle dentine
  • Circumpulpal dentine has reduced number of tubules (sometimes tubular) that are abnormally wide
  • Cellular and vascular inclusions
  • Straight ameldodentinal junction
49
Q

Define dentinal dysplasia

A

Abnormal dentine formation with additional abnormal pulp chamber morphology

50
Q

Describe Type I Radicular Dentine Dysplasia (Rootless teeth)

A
  • Normal crowns
  • Short roots
  • Obliterated pulp
  • Roots composed of dysplastic dentine
  • Disorganised dentinal tubules
  • Calcified globules of abnormal dentine
51
Q

Describe Type II Coronal dentinal dysplasia

A
  • Deciduous teeth look like DI
  • Normal permanent teeth
  • Obliterated pulp
  • Pulp stones
  • Thistle shaped pulp
52
Q

One environmental cause of dentinal defects is Rickets. Describe Rickets.

A
  • Failure of calcification due to lack of Vitamin D

- Body has a deficiency or resistance to Vitamin D action

53
Q

What are some reasons as to why the body has a deficiency or resistance to Vitamin D action?

A
  • Diet
  • Absorption (GIT)
  • Lack of UV light
  • Renal disease (Vit D resistant rickets)
  • Drugs (Phenytoin)
54
Q

What are the clinical/dental features of Rickets?

A
  • Short statute
  • Bow legs
  • Bone deformity and fractures
  • Delayed eruption
  • Enamel hypoplasia
  • Dentine abnormalities
55
Q

Describe regional odontodysplasia (Ghost teeth)

A
  • Idiopathic condition affecting primary and permanent dentition causing defective enamel and dentine
  • Unilateral and anterior maxilla commonly affected
56
Q

Describe the clinical features of regional odontodysplasia (ghost teeth)

A
  • Hypoplastic teeth
  • Abnormal form (look very small and pointed)
  • Delayed eruption
57
Q

What are the enamel and dentine effects in ghost teeth?

A
  • Enamel -> irregular mineralisation
  • Dentine -> thin, wide pulp chamber, open apices, wide predestine zone and interlobular dentine, increased pulp stones, calcification of follicle
58
Q

What are three abnormalities of cementum?

A
  • Hypercementosis
  • Ankylosis
  • Hypocementosis
59
Q

What can cause hypercementosis/Ankylosis?

A
  • Idiopathic
  • Infections
  • Overcrowding
  • Functionless/uneruption
  • Paget’s disease
60
Q

Describe a condition that is associated with hypocementosis

A
  • Cleidocranial dysplasia
  • Hypophosphatasia causing hypocementosis
  • Defective mineralisation causing skeletal and dental defects
  • Can cause premature tooth loss of deciduous teeth
61
Q

What problems can cause premature eruption?

A
  • Hypoplastic enamel
  • Rootless teeth
  • Mobile (risk to airway)
  • Interfere with feeding
62
Q

What problems can cause localised delayed eruption?

A
  • Primary teeth retention
  • Hyperdontia
  • Abnormal crypt position
  • Reduced space
  • Dentigerous/eruption cyst
63
Q

What problems can cause generalised delayed eruption?

A
  • Hypothyroidism (cretinism)
  • Rickets
  • Cleidocranial dysplasia
  • Down syndrome

Oral Diseases (1 decks)

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