Developmental Dental Anomalies
- Alterations in size of teeth = due to problem in morphology stage
- Alterations in shape of teeth = due to problem during appositional (calcification) stage
- Abnormalities on position of teeth = due to problems during stage of eruption
- Messing clinically + radiographically → true anodontia
- Messing clinically but not radiographically → pseudo-partial anodontia
- Messing clinically & radiographically with history of extraction → false anodontia
- Like normal teeth → supplemental (impacted or normally erupted)
- Abnormal structure→
→ Bt. Ant. Teeth = mesiodens
→ Distal to teeth = distomolar = paramolar (most commonly distal to the wisdom)
→ Buccal or lingual = paradent (mostly in premolar region)
- Supernumerary tooth may erupt in inverted direction.
- Cleidocranial dysplasia → multiple impacted + supernumerary teeth
- Gardner’s syndrome→ multiple impacted + supernumerary teeth
- Retained = under occlusion
- Submerged = lower level than occlusal plane (of the other teeth)
→ The difference bt. Retained & submerged teeth are ……………….
- Partial anodontia→ found a lot in ectodermal dysplasia (=thertus syndrome << not sure of the spelling) & in papillary –something- syndrome… how to differentiate?
→Ectodermal dysplasia is associated with absence of sweat & sebaceous glands, loss of hair, fragile nails… etc & the partial anodontia is due to the absence of teeth (no formed) .. if he had 2 teeth → these are the only teeth formed
→Papillary –something- syndrome; partial anodontia is associated with continuous shedding of teeth (eruption & shedding), hyperkeratosis in hand & leg
Variations are Size:
- Either macro or micro, true or relative:
→True = in comparison to the adjacent teeth, involving 1 tooth
→ Relative = in comparison to the jaw (large jaw →relatively teeth look small), involving all teeth.
- Microdontia is commonly seen in Dwarfism cases, & most common affected teeth = 2nd & 8th
- Macrodontia is commonly seen in Gigantism.
- Fusion may lead to macrodontia
Variation of morphology:
- Dilacerations (bending of root near apex)→problem during extraction (fracture)
- Clinically; same as normal
- Pulp chamber become rectangular or square
- Bifurcation is located near apex (in apical 1/3 of the root)
→ Bt. 2 normal teeth→1 messing tooth clinically
→ Bt. 1 normal tooth + 1 supernumerary tooth→ normal # of teeth clinically.
- Enamel pearl (enameloma);
- sometimes, it has small pulp chamber (small radiolucency)
- located in bifurcation areas
- Pulp stone (denticle); causes problems in RCT
- Turner tooth: trauma in deciduous tooth affecting the mineralization of the underlying permanent tooth
- Congenital syphilis: moon (mulberry) molar.
- Dense indente (tooth inside another tooth) → causes problems in RCT
- Concrescence: causes problems during extractions (of u tried to extract a tooth, the other tooth fused to it would be pulled out too)
- Fusion: might happen in the coronal region only or in the entire tooth.
- Gemintaion = 2 germs join together resulting in macrodontia.
Variations on structure:
- Odontome = disarrangement of tooth structure
- It’s surrounded mostly by radiolucent (fibrous) line.
a) Compound = denticle or tooth haphazardly distributed… (mostly in upper central incisor & upper & lower 3th molar regions)
b) Complex = calcified matrix associated with unerupted (impacted) tooth.
- Dentinogenesis imperficta:
- we’ll find all the following in all teeth:
a) Bulbous crown
b) Constriction CEJ
c) Short roots
d) Obliteration in pulp
- Associated sometimes with ……….. (known by blue sclera)
- Enamel is normal, but sometimes it becomes pitted (due to the abnormal dentine beneath)
- Associated with osteogenesis imperficta
- Dentinal dysplasia (type 1), we commonly see:
- Rootless teeth (poorly developed roots)
- Absence of pulp chamber
- Associated with periapical lesion
- Amelogenesis imperficta:
- Severe alterations in all teeth
- Defect in enamel, while dentin is normal.
- No contour of tooth (e.g. no contact areas)… due to absence of enamel that forms the shape & contour of the crown.
- Severe attrition
- Resorption, hypocalcification, very thin enamel
- Turner’s hypoplasia: hypomineralization
- Cleidocranial dysplasia:
- MCQ: most commonly, dentigerous cysts are associated with Cleidocranial dysplasia
- Normal deciduous teeth
- Developmentally formed permanent teeth, but they fail to erupt →clinically messing teeth but seen radiographically → pseudo-partial anodontia.
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