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Dental Tissues > Tooth Development And Eruption Part 2 > Flashcards

Tooth Development And Eruption Part 2 Flashcards

1
Q

What is enamel hypoplasia?

A

Enamel hypoplasia is a type of enamel dysplasia resulting from a reduction in the quantity of enamel matrix.

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2
Q

How do teeth appear with enamel hypoplasia?

A

Teeth appear with pitting and grooves in the enamel surface or horizontal lines across the enamel of the crown.

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3
Q

What dental conditions are associated with enamel hypoplasia caused by syphilis?

A

Hutchinson incisors and mulberry molars are associated with enamel hypoplasia caused by syphilis.

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4
Q

What causes hutchinsons incisors and mulberry molars?

A

They are caused by the teratogenic effects of syphilis during development.

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5
Q

What is enamel hypocalcification?

A

Enamel hypocalcification is a type of enamel dysplasia that results in a reduction in the quality of enamel maturation.

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6
Q

How do teeth with enamel hypocalcification appear?

A

Teeth appear more opaque, yellower, or browner due to intrinsic staining of the enamel.

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7
Q

What is a Turner spot?

A

A Turner spot is a single affected area of enamel hypocalcification.

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8
Q

What is a Turner tooth?

A

A Turner tooth refers to a permanent crown entirely affected by hypocalcification.

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9
Q

How can the discoloration in Turner teeth vary?

A

The discoloration can range from white spots to darker overall staining.

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10
Q

What can cause both enamel hypoplasia and hypocalcification?

A

These conditions can occur together and are commonly seen in dental fluorosis.

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11
Q

What is dental fluorosis?

A

Dental fluorosis is a form of enamel hypomineralization caused by excessive systemic fluoride exposure.

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12
Q

What factors influence the severity of dental fluorosis?

A

The severity depends on the dose, duration, and age of the individual during fluoride exposure.

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13
Q

How does excessive fluoride affect ameloblasts?

A

Excess fluoride can cause oxidative stress to ameloblasts, disrupting enamel formation.

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14
Q

How does mild fluorosis appear on enamel?

A

Mild fluorosis appears as opaque white patches on the enamel.

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15
Q

What are the characteristics of severe fluorosis?

A

Severe fluorosis causes dark brown stains, rough pitted enamel, and difficulty in cleaning the teeth.

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16
Q

What is the cause of amelogenesis imperfecta and which dentitions does it affect?

A

Amelogenesis imperfecta is a hereditary condition affecting all teeth in both dentitions.

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17
Q

How does amelogenesis imperfecta affect enamel?

A

It results in very thin enamel, which may chip off easily or be absent entirely.

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18
Q

How do crowns appear in teeth affected by amelogenesis imperfecta?

A

The crowns are yellow because they consist mostly of softer dentin.

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19
Q

What problem arises from the soft dentin in amelogenesis imperfecta?

A

The softer dentin undergoes extreme attrition (wear).

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20
Q

What treatment is recommended for amelogenesis imperfecta?

A

Full-coverage crowns are recommended to improve esthetics and prevent further attrition.

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21
Q

What is dentin dysplasia?

A

Dentin dysplasia is the faulty development of dentin.

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22
Q

What causes dentin dysplasia?

A

It results from an interference with the metabolic processes of odontoblasts during dentinogenesis.

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23
Q

Is dentin dysplasia more common than enamel dysplasia?

A

No, dentin dysplasia is much rarer than enamel dysplasia.

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24
Q

Can dentin dysplasia result from local or systemic factors?

A

Yes, it can result from both local and systemic factors, similar to enamel dysplasia.

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25
Q

What disturbances can dentin dysplasia involve?

A

It can involve dentin hypoplasia, hypocalcification, or both disturbances simultaneously.

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26
Q

What is dentinogenesis imperfecta?

A

Dentinogenesis imperfecta is a type of dentin dysplasia with a hereditary basis.

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27
Q

How do teeth affected by dentinogenesis imperfecta appear color wise?

A

They appear blue-gray or brown with an opalescent sheen.

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28
Q

What happens to the enamel in teeth affected by dentinogenesis imperfecta?

A

The enamel chips off due to lack of support from the abnormal underlying dentin, leaving crowns composed mostly of dentin.

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29
Q

When does the process of root development take place?

A

Root development takes place after the crown is completely shaped and the tooth is starting to erupt into the oral cavity.

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30
Q

What structure is responsible for root development?

A

The structure responsible for root development is the cervical loop.

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31
Q

Where is the cervical loop located?

A

The cervical loop is the most cervical part of the enamel organ.

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32
Q

What does the cervical loop consist of?

A

It consists of a bilayer rim made up of the inner enamel epithelium (IEE) and outer enamel epithelium (OEE).

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33
Q

What role does the cervical loop play in root formation?

A

The cervical loop begins to grow deeper into the surrounding ectomesenchyme of the dental sac to form the Hertwig epithelial root sheath (HERS).

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34
Q

What is the function of Hertwig Epithelial Root Sheath (HERS)?

A

HERS shapes the root(s) of the tooth and induces dentin formation in the root area, so it is continuous with coronal dentin.

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35
Q

What does HERS determine about the tooth root?

A

HERS determines if the root will be curved or straight, short or long, and whether it will be single or multiple.

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36
Q

What do the outer cells of the dental papilla in the root area do when induced by the HERS?

A

They are induced by HERS to undergo differentiation into odontoblasts.

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37
Q

Why is enamel absent in the root area?

A

Enamel is absent in the root area because HERS lacks the stellate reticulum and stratum intermedium, which are necessary for enamel formation.

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38
Q

What happens after odontoblast differentiation in the root area?

A

These odontoblasts begin dentinogenesis, producing predentin.

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39
Q

What happens when root dentin formation is completed?

A

The basement membrane disintegrates, as does the entire Hertwig epithelial root sheath (HERS).

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40
Q

What can the disintegrated cells of HERS become?

A

They may become the epithelial rests of Malassez (ERM).

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41
Q

When does cementogenesis begin?

A

Cementogenesis begins when HERS disintegrates.

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42
Q

What happens after the disintegration of HERS during cementogenesis?

A

The disintegration allows the dental sac cells to come into contact with the dentin surface.

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43
Q

What is the result of this contact between dental sac cells and dentin?

A

The contact induces these cells to become immature cementoblasts.

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44
Q

What do cementoblasts produce?

A

Cementoblasts lay down cementoid, a matrix of cementum.

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45
Q

What happens to cementoblasts during appositional growth?

A

Some cementoblasts become trapped in the cementoid and mature into cementocytes.

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46
Q

When does cementoid become cementum?

A

Cementoid becomes cementum when it is fully mineralized.

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47
Q

What junction is the result of the apposition of cementum over the dentin?

A

The dentinocemental junction (DCJ) is formed.

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48
Q

What is concrescence?

A

Concrescence is a rare condition where the cementum of two or more teeth fuses together at their roots.

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49
Q

In which teeth does concrescence most commonly occur?

A

It most commonly occurs with permanent maxillary molars.

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50
Q

What causes concrescence?

A

It occurs due to excessive cementum deposition on one or more teeth after eruption.

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51
Q

How do the teeth involved in concrescence start?

A

The teeth are originally separate but become joined by their cementum.

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52
Q

How do multirooted premolars and molars begin their development?

A

They originate as a single root on the base of the crown.

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53
Q

What is the part of these posterior teeth at the base of the crown called?

A

It is called the root trunk.

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54
Q

What happens to the root trunk during the development of a multirooted tooth?

A

The root trunk divides into the correct number of root branches for the tooth type.

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55
Q

What causes the division of the root trunk into multiple roots?

A

Differential growth of Hertwig epithelial root sheath (HERS) causes the root trunk to divide into two or three roots.

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56
Q

What happens during the formation of the enamel organ in a multirooted tooth?

A

The cervical loop elongates, allowing the development of long, horizontal extensions or flaps within it.

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57
Q

How is the cervical opening divided in a multirooted tooth?

A

Horizontal extensions divide the cervical opening into two or three openings.

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58
Q

What forms on the pulpal surfaces of the openings formed by horizontal extentions?

A

Dentin formation starts after the induction of odontoblasts.

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59
Q

What do cementoblasts do in multirooted teeth?

A

Cementoblasts form cementum on the newly formed dentin only at the periphery of each opening.

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60
Q

How does root development proceed in multirooted teeth?

A

It proceeds in the same way as described for a single-rooted tooth.

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61
Q

What is an enamel pearl?

A

An enamel pearl is a small, spherical enamel projection on the root surface.

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62
Q

What causes an enamel pearl?

A

It is caused by misplaced ameloblasts.

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63
Q

Where do enamel pearls most commonly occur?

A

They most commonly occur at the cementoenamel junction (CEJ) or in the furcation areas of molars where roots divide.

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64
Q

What is the appearance of an enamel pearl?

A

It appears as a small, rounded enamel projection that can sometimes include dentin and pulp.

65
Q

How do enamel pearls appear on radiographs?

A

They appear radiopaque (light) on radiographs.

66
Q

What can occur if amelogenesis is not turned off after crown formation?

A

The enamel organ may continue to produce enamel over the root dentin.

67
Q

What is the shape of additional enamel formed in cases where the ameloblasts of the crown are not turned off a proceed to root dentin?

A

It often takes the shape of enamel projections or enamel spurs.

68
Q

Where are enamel projections or spurs typically located?

A

They project into the furcation areas of multirooted teeth.

69
Q

What is a potential complication of enamel projections or spurs?

A

They may increase the risk of periodontal lesions in the affected furcation areas.

70
Q

What is dilaceration?

A

Dilaceration is a disturbance during root development that results in distorted roots or severe crown angulation in a formed tooth.

71
Q

What causes dilaceration?

A

It is caused by distortion of Hertwig epithelial root sheath (HERS) due to injury or pressure.

72
Q

Which teeth can be affected by dilaceration?

A

Dilaceration can affect any tooth or group of teeth during development.

73
Q

What are accessory roots?

A

Accessory roots, also known as supernumerary roots, are extra roots on a tooth.

74
Q

What causes accessory roots to form?

A

They may form due to trauma, pressure, or metabolic disease affecting Hertwig epithelial root sheath (HERS).

75
Q

Which teeth are most commonly affected by accessory roots?

A

Accessory roots occur most commonly in permanent third molars.

76
Q

Are accessory roots common in incisors?

A

No, they are rare in incisors.

77
Q

Can accessory roots occur in any tooth?

A

Yes, any tooth may be affected by accessory roots.

78
Q

What happens as the crown and root develop?

A

The surrounding supporting tissue types of the tooth also develop from the dental sac.

79
Q

From where does the periodontal ligament (PDL) form?

A

The PDL forms from ectomesenchyme within the dental sac.

80
Q

What occurs during PDL formation?

A

The ectomesenchymal cells in the dental sac begin to differentiate into fibroblasts.

81
Q

What do fibroblasts produce during PDL formation?

A

They produce collagen fibers that become organized into bundles.

82
Q

How do the collagen fibers produces by fibroblasts during periodontium development become structured?

A

They thicken and mature, becoming arranged in a structured manner to support the tooth.

83
Q

What do the ends of these collagen fibers become embedded in?

A

They become embedded in the outer layers of the cementum and surrounding alveolar bone.

84
Q

What are these embedded fibers called?

A

They are called Sharpey fibers.

85
Q

What does the ectomesenchyme of the dental sac form in addition to forming the PDL?

A

It mineralizes to form the tooth sockets or alveoli of each alveolar process.

86
Q

How does the eruption of primary and permanent teeth occur?

A

Eruption occurs in chronological order for both primary and permanent dentitions.

87
Q

What is active eruption?

A

Active eruption is the actual vertical movement of the tooth.

88
Q

How is passive eruption different from active eruption?

A

Passive eruption occurs with aging when the gingival tissue recedes, uncovering more of the clinical crown.

89
Q

What is more important than the dates of eruption?

A

The sequence of eruption is more important than the actual dates.

90
Q

Why are the actual dates of eruption less significant?

A

Because there can be a great deal of variation in the actual eruption dates, but the sequence tends to be uniform.

91
Q

What happens after enamel appositional growth ceases in the crown?

A

The ameloblasts place an acellular dental cuticle on the newly formed outer enamel surface.

92
Q

What do the layers of the enamel organ become compressed into?

A

They become compressed into the reduced enamel epithelium (REE).

93
Q

How does the reduced enamel epithelium (REE) appear?

A

The REE appears as a few layers of flattened cells overlying the new enamel surface.

94
Q

When does the primary tooth begin to erupt into the oral cavity?

A

It begins to erupt after the formation of the REE.

95
Q

What must the REE first do to allow for eruption?

A

The REE must fuse with the oral epithelium lining the oral cavity.

96
Q

What enzymes do cells from the REE release during eruption?

A

They release enzymes that disintegrate the central part of the fused tissue.

97
Q

What does disintegration of the central part of the fused tissue of the REE and OE create?

A

It creates a protective epithelial-lined eruption tunnel for the tooth.

98
Q

What inflammatory response may accompany tissue disintegration during eruption?

A

The response is known as ‘teething,’ which may include tenderness and swelling of the local tissue.

99
Q

What happens to the fused epithelial tissue as the tooth erupts?

A

The coronal part of the tissue peels back from the crown, leaving the cervical part attached to the neck of the tooth.

100
Q

What happens to the fused tissue that remains near the CEJ after eruption?

A

It serves as the initial junctional epithelium of the tooth.

101
Q

What is the role of the initial junctional epithelium?

A

It creates a seal between the tissue and the tooth surface.

102
Q

What happens to the initial junctional epithelium over time?

A

It is later replaced by a definitive junctional epithelium as the root becomes fully formed.

103
Q

What happens to a primary tooth as the succedaneous permanent tooth develops?

A

The primary tooth is shed, also known as exfoliation.

104
Q

Where does the succedaneous permanent tooth develop relative to the primary tooth?

A

It develops lingual to the roots of the primary tooth.

105
Q

What process causes the shedding of a primary tooth?

A

Shedding involves the differentiation of multinucleated osteoclasts.

106
Q

From where are osteoclasts derived?

A

Osteoclasts are derived from the fusion of macrophages in the surrounding area.

107
Q

What do osteoclasts do during shedding?

A

They absorb the alveolar process between the roots of the primary tooth and the developing permanent tooth.

108
Q

What other type of resorption occurs during shedding?

A

Odontoclasts resorb the roots of the primary tooth, removing dentin and cementum.

109
Q

What role do fibroblasts play during the shedding process?

A

Fibroblasts destroy any remaining collagen fibers connecting the primary tooth to the PDL.

110
Q

How do succedaneous permanent teeth erupt in relation to the primary teeth?

A

They erupt in a position lingual to the roots of the shedding primary teeth.

111
Q

What is the exception to the usual lingual eruption pattern?

A

The exception is permanent maxillary incisors, which move to a more facial position as they erupt.

112
Q

What process is the same for permanent and primary teeth during eruption?

A

The process of eruption is the same, beginning with the widening of the gubernacular canal (GC).

113
Q

What happens after the reduced enamel epithelium (REE) fuses with the oral epithelium?

A

The REE degenerates, leaving an epithelial-lined eruption tunnel.

114
Q

How does the eruption of nonsuccedaneous teeth compare to succedaneous teeth?

A

The process is similar for nonsuccedaneous teeth.

115
Q

What teeth are classified as nonsuccedaneous?

A

Nonsuccedaneous teeth include the permanent molars.

116
Q

How do nonsuccedaneous and succedaneous teeth erupt?

A

Both erupt in chronological order.

117
Q

What happens if a permanent tooth starts to erupt before the primary tooth is fully shed?

A

This can create challenges with spacing.

118
Q

What can be done to address the spacing issues caused when permanent teeth erupt before primary teeth shed?

A

Interceptive orthodontic therapy can help prevent or manage these situations.

119
Q

What should be done if a child has prolonged retention of primary teeth?

A

Early dental consultation is important for managing such cases.

120
Q

What is the Nasmyth membrane?

A

The Nasmyth membrane is a residue that may form on newly erupted teeth of both dentitions.

121
Q

How does the Nasmyth membrane appear?

A

It appears as a green-gray residue on the teeth.

122
Q

What does the Nasmyth membrane consist of?

A

It consists of fused tissue from the reduced enamel epithelium (REE) and oral epithelium, as well as the dental cuticle placed by ameloblasts.

123
Q

How does the Nasmyth membrane pick up stains?

A

It easily picks up coloring from food debris.

124
Q

Can the Nasmyth membrane be removed?

A

Yes, it can be removed by selective polishing.

125
Q

Why is it important to prevent traumatic injury to developing permanent teeth?

A

Because the crown forms before the root, permanent teeth are vulnerable until they are fully anchored in the jaws.

126
Q

What is recommended to prevent traumatic injury in children?

A

Mouthguards are recommended for children active in all types of sports.

127
Q

What is an avulsed tooth?

A

An avulsed tooth is a tooth that has been completely removed from its socket due to trauma.

128
Q

What should be done immediately if a tooth is avulsed?

A

The patient should seek immediate examination by a dental professional in a dental setting or emergency hospital unit.

129
Q

How should the avulsed tooth be transported?

A

It should be placed in a wet handkerchief, milk, water, or in the buccal vestibule (preferred for hydration with saliva).

130
Q

Should primary teeth be replanted after avulsion?

A

No, primary teeth will not be placed back in the mouth.

131
Q

What is the prognosis for an avulsed tooth?

A

The prognosis is better when there is a short time between avulsion and reimplantation.

132
Q

What treatments might be required for an avulsed tooth?

A

Treatments may include pulp canal therapy, splint placement, and observation for other trauma.

133
Q

What additional medical care might be needed for an avulsed tooth?

A

A tetanus booster may be indicated in some cases.

134
Q

What is a dentigerous cyst?

A

A dentigerous cyst is an odontogenic cyst that forms from the reduced enamel epithelium (REE) after the crown has fully formed and matured.

135
Q

What is another name for a dentigerous cyst?

A

It is also called a follicular cyst.

136
Q

dentigerous cyst typically present initially with what symptoms?

A

It is initially asymptomatic.

137
Q

Where does a dentigerous cyst form?

A

It forms around the crown of a nonerupted or developing tooth.

138
Q

Which teeth are most commonly associated with dentigerous cysts?

A

The permanent third molars are most commonly affected.

139
Q

What complications can arise from a large dentigerous cyst?

A

It may cause displaced teeth, jaw fractures, and pain.

140
Q

How is a dentigerous cyst treated?

A

It must be completely removed surgically to prevent it from becoming neoplastic.

141
Q

What is an eruption cyst?

A

An eruption cyst is a type of dentigerous cyst that forms on a partially erupted tooth.

142
Q

How does an eruption cyst appear clinically?

A

It appears as a fluctuant blue vesicle-like gingival lesion.

143
Q

What happens to an eruption cyst during tooth eruption?

A

The eruption cyst disintegrates as the tooth erupts.

144
Q

Is treatment needed for an eruption cyst?

A

No further treatment is usually needed as it resolves naturally.

145
Q

What results from the disintegration of the dental lamina after eruption?

A

Disintegration results in the formation of discrete clusters of epithelial cells that usually degenerate.

146
Q

What can some clusters of epithelial cells form if they persist?

A

They may form epithelial pearls.

147
Q

What can epithelial pearls give rise to?

A

They can form small cysts or eruption cysts over a developing tooth, delaying eruption.

148
Q

What are other potential outcomes of epithelial pearls?

A

They may give rise to odontomas or be activated to form supernumerary teeth.

149
Q

What is an odontoma?

A

An odontoma is a benign neoplasm of odontogenic origin, linked to tooth development.

150
Q

What may odontomas arise from?

A

They may arise from the presence of epithelial pearls.

151
Q

What tissues make up an odontoma?

A

An odontoma consists of dental tissues like enamel, dentin, cementum, and pulp.

152
Q

How does an odontoma appear?

A

It may look like an oddly shaped tooth or a calcified tumor.

153
Q

What is the recommended treatment for an odontoma?

A

It should be surgically removed before it interferes with tooth eruption in the area.

154
Q

What are Bohn nodules?

A

Bohn nodules are large, sometimes multiple, white bumps present on the maxillary alveolar ridge.

155
Q

What is the exact cause of Bohn nodules?

A

The exact etiology is unknown.

156
Q

From what are Bohn nodules thought to arise?

A

They are thought to arise from remnants of the dental lamina.

157
Q

Are Bohn nodules harmful?

A

No, they are a benign finding.

158
Q

What happens to Bohn nodules over time?

A

They will disappear with time.

Dental Tissues (20 decks)

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