10. Dental Anomalies Flashcards by J L

Anatomic Anomalies
n Developmental
n Changes during the formation of teeth
n Initiation to ____ week in utero

n Acquired
n Changes initiated after ____

6th

tooth formation

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Supernumerary teeth
n Teeth that develop in addition to the normal complement
n 1-4% of population
n 2:1 ____ to female
n Greater incidence in ____ and Native Americans

male

asians

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Supernumerary teeth
n Radiographic features
n Normal looking to ____ form, may be grossly deformed
n Size varies, but generally ____
n Easily identified by ____ the number of teeth

conical
smaller
counting

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Supernumerary teeth
n Mesiodens
n \_\_\_\_ region, \_\_\_\_ more common than
mandible
n Distodens, distomolar teeth
n \_\_\_\_ 
n Para...molars
n \_\_\_\_ region 
n Peridens
n \_\_\_\_ or \_\_\_\_ to normal arch

anterior
maxilla
distal to third
molar
buccal
lingual

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Supernumerary teeth
n Differential diagnosis

n ____
n Aplasia or hypoplasia of clavicles
n Craniofacial abnormalities
n Multiple supernumerary and unerupted teeth

n \_\_\_\_
n Intestinal polyposis
n Osteomas and odontomas
n Skin fibromas
n Epidermal cysts
n Impacted and supernumery teeth

cleidocranial dysplasia

gardner’s syndrome

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Missing teeth

n Result of pathologic mechanisms
n Disruption of formation of \_\_\_\_ 
n Failure of \_\_\_\_ development
n Lack of space in \_\_\_\_
n Genetics

lamina dura
tooth germ
malformed jaw

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Missing teeth
n Hypodontia
n Absence of one or a few \_\_\_\_
n Oligodontia
n Absence of \_\_\_\_ teeth
n Anodontia
n Absence of all \_\_\_\_

teeth
numerous
teeth

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Missing teeth Anodontia, Oligodontia

n Ectodermal Dysplasia
n ____ disorder
n missing two ____ derived structures (sweat glands, hair, skin, nails, teeth)

n Severity variable
n number of missing teeth, malformed teeth (usually ____ and ____)

inherited
ectoermally
conical
smaller

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Macrodontia
n ____ than normal teeth
n Relative macrodontia
n Normal size teeth in ____ than normal jaw
n Usually affect ____ of teeth rather than entire dentition

larger
smaller
group

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Macrodontia
n ____ may cause increase in size or advanced development of adjacent teeth
n Hemihypertrophy
n Pituitary ____

hemangioma

gigantism

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Macrodontia
Differential diagnosis n Gemination
n Evidence of a cleft on ____ or root segment

n Fusion
n There will be a ____ tooth

coronal

missing

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Microdontia
n \_\_\_\_ than normal teeth
n Altered morphology
n Extra \_\_\_\_ on molars 
n Peg \_\_\_\_
n Relative \_\_\_\_
n Usually affect \_\_\_\_ of teeth rather than entire dentition

smaller
cusps
lateral
microdontia
group

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Microdontia
n Consider syndromes such as ____ or progeria
n Generalized microdontia rare, but may occur in ____

congenital heart disease

pituitary dwarfism

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Transposition
n Two teeth have exchanged ____
n ____ dentition
n ____ and ____ most common

positions
permanent
canine
first premolar

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Fusion

n Union of developing teeth, adjacent tooth germs combined
n Deciduous and permanent
n ____ more common
n ____ fusion more common in both
n 1:1 ____ to female
n Higher incidence in ____ and Native Americans

deciduous
anterior
male
asians

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Fusion
n Total or partial depending on stage of odontogenesis
n Size varies from normal to ____ the size
n Bifid crown
n Two teeth joined by ____ or dentin
n Crowns can also be ____ and single, or have an ____ groove

twice
enamel
large
incisocervical

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Fusion
Differential diagnosis 
n \_\_\_\_
n \_\_\_\_
In fusion, there are \_\_\_\_ teeth

gemination
macrodontia
fewer

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Concrescence

n Two or more teeth united by \_\_\_\_
n Deciduous and permanent teeth 
n \_\_\_\_ most common
n (\_\_\_\_ molar and supernumerary)
n 1:1 \_\_\_\_ to female

cementum
maxillary molars
third molar
male

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Concrescence
n Differential diagnosis
n Radiographically difficult to determine, roots may be ____
n If treatment necessary, take radiographs from different ____
n Check if PDL space ____ around tooth

superimposed
angles
continuous

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Gemination
n Rare, ____ attempts to divide
n Common in ____, but may occur in permanent
n ____ most common
n 1:1 ____ to female
n Enamel or dentin may be ____ or hypocalcified

tooth bud
deciduous
incisors
male
hypoplastic

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Gemination

n Invagination of crown with \_\_\_\_
n Rarely, \_\_\_\_ division
n Radiographic features
n Cleft and \_\_\_\_ in crown
n Enlarged or partially divided \_\_\_\_

partial division
complete
invaginations
pulp chamber

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Gemination
Differential diagnosis
n ____
(less teeth in fusion)

fusion

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Taurodontism
n \_\_\_\_ enlarged pulp chambers 
n Crown normal shape and size
n \_\_\_\_ and permanent
n More common in \_\_\_\_
n Single or \_\_\_\_ teeth

longitudinally
deciduous
molars
multiple

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Taurodontism
n Radiographic finding, clinically normal
n Extension of \_\_\_\_ into
elongated body of tooth
n Associated with \_\_\_\_

rectangular pulp chamber

trisomy 21 syndrome

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Dilaceration n Disturbance in tooth formation that results in ____ or sharp ____ in tooth n May occur in ____ or root

curve bend crown

``` Dilaceration n Differential diagnosis n ____ roots n Condensing ____ n ____ ``` Radiograph from different ____

fused osteitis enostoses angles

Dens in dente (invaginatus) n Infolding of the ____ surface into the interior of the tooth n Occurs in ____ or root, may involve ____ or root canal n Most common in ____ n 1:1 ____ to female

``` outer crown pulp chamber crown male ```

``` Dens in dente n Coronal invaginations n anomalous infolding of enamel organ into ____ n ____ lining in fold ```

dental papilla | enamel

Dens in dente n Root invaginations (radicular dens invaginatus) n Invaginations of ____ n Lined with ____ n Can retract and cut off leaving remnants of ____ in canal n Mandibular first and second ____

hertwig's epithelial cementum PDL premolars

Coronal dens in dente n Clinically- pit at incisal edge or ____ n Prominent ____ and cingulum n ____ >maxillary centrals > premolars > canines n Rare on ____

cingulum lingual ridges maxillary lateral mandibulars

Dens in dente n Clinically n Risk of ____ disease n Pit difficult to clean, prone to caries n Difficult to detect, may quickly involve ____ n ____ restoration

pulpal pulp prophylactic

Dens evaginatus n Outfolding of the ____ organ n Enamel-covered tubercle on occlusal surface of ____, less commonly molar n Higher frequency in ____ and Native Americans

enamel premolar asians

``` Dens evaginatus n Tubercle of enamel on ____ surface n Usually in ____, may be bilateral n Tubercle has ____, slender pulp horn n If worn by ____ teeth, appears as ____ facet with black pit ```

``` occlusal mandible dentin core opposing circular ```

``` Dens evaginatus n Occlusal interference or marked abrasion n Remove ____ n Pulp ____ n (prevent ____) ```

aseptically capped infection

Amelogenesis Imperfecta n Developmental disturbance that interferes with ____ formation n Enamel lacks normal pristine structure n ____ and root form usually normal n 14 or more variants, 4 general types

enamel | dentin

``` Amelogenesis imperfecta n Hypoplasia n Defect in ____ n Thin enamel, ____ shows through n ____ color n Undersized n No ____ contact n Low, flat cusps n ____ common ```

``` ameloblasts dentin yellowish-brown interproximal anterior open bite ```

Amelogenesis imperfecta ``` n Hypomaturation n Enamel has normal ____ with mottled appearance n Enamel soft (similar to dentin) n Radiopacity of enamel same as ____ n Enamel may crack away n Clear to ____, yellow or brown ```

thickness dentin cloudy white

Amelogenesis imperfecta n Hypocalcification n Enamel normal thickness n Enamel poorly ____ (less dense than dentin) n Fractures as soon as in ____ n Enamel and dentin abrade rapidly, often to ____ level n Enamel ____, tends to stain dark brown n ____ not common

``` mineralized function gingival permeable caries ```

Amelogenesis imperfecta n Hypomaturation/ hypocalcification n Dominant defect is ____ n Mottled enamel, yellow/brown teeth n Hypocalcification/hypomaturation n Dominant defect is ____ n ____ enamel

hypomaturation hypocalcification thin

Amelogenesis imperfecta n Diagnosis primarily ____ n Radiographic features n Hypoplastic n ____ crown n Thin opaque layer of enamel n Low or absent ____ n Enamel density normal n ____ mottled density in enamel (pitted enamel)

clinical square cusps localized

Amelogenesis imperfecta n Radiographic features n Hypomaturation n ____ enamel thickness n Enamel density same as ____ n Hypocalcified n ____ enamel thickness n Enamel density more ____ than dentin

normal dentin normal radiolucent

Amelogenesis imperfecta n Differential diagnosis n Dentinogenesis imperfecta n Advance abrasion with secondary dentin obliterating ____, AI similar to DI ``` n Dentinogenesis imperfecta n ____ crowns n Narrow roots n ____ density of remaining enamel n Obliteration of ____ and root canals ```

pulp chambers bulbous normal pulp chambers

``` Dentinogenesis imperfecta n Developmental disturbance primarily in ____ n Autosomal ____ n 1:1 ____ to female n Enamel may be ____ ```

dentin dominant male thinner

``` Dentinogenesis imperfecta n Type I n Associated with ____ n Pulp chambers and roots small and ____ n ____ affected more severely than permanent ``` n Type II n Similar to Type I but no ____ defects n Expression ____

``` osteogenesis imperfecta underdeveloped deciduous skeletal variable ```

Dentinogenesis imperfecta n Teeth have ____ translucency n Yellow to blue-gray n Enamel ____ easily n Crowns wear down easily, often to level of gingiva n Exposed ____ stains easily, dark brown to black

amber-like fractures dentin

Dentinogenesis imperfecta n Radiographic features n Crowns normal ____ n Cervical constriction gives bulbous appearance to crown n Slight to marked ____ n Roots short and slender n Initially normal ____, eventually obliterated or threadlike by secondary dentin

size attrition pulp chambers

Osteogenesis imperfecta n Hereditary, autosomal ____ n Inborn error in ____ collagen, “brittle bones” n 25% have dentinogenesis imperfecta ``` n Clinical findings n ____ sclera n Skeletal deformities n Progressive ____ n Class III malocclusion n Increased incidence ____ ```

dominant type I blue osteopenia impacted first and second molars

Dentin dysplasia n Clinically similar to DI, but is more rare n Type I (radicular) n Normal ____ and shape, sometimes ____ n Often ____, drifting teeth n Exfoliate with little ____ n Type II (coronal) n ____ teeth similar to DI

size bluish-brown misaligned trauma deciduous

Dentin dysplasia ``` n Radiographic features n Type I n Roots ____, abnormally shaped n ____ obliterated prior to eruption n 20% have associated ____ n ____ of residual pulp n ____ on noncarious teeth a distinguishing feature ```

``` short pulp chambers periapical pathology microcommunication PAP ```

Dentin dysplasia n Type II n Pulp chambers ____ after eruption n Pulp chambers appear ____-shaped due to hypertrophic dentin n Pulp stones n ____ shaped pulp chambers on anterior and premolar teeth

obliterated flame-shaped thistle-tube

Dentin dysplasia ``` n Differential diagnosis n Need to distinguish from DI n ____ shape pulp chambers n Generally ____ morphology n Normal or no ____ n ____ on noncarious teeth ```

thistle-tube normal roots apical rarefying osteitis

Odontodysplasia n Rare condition, typically localized to adjacent teeth in quadrant n Enamel and dentin hypoplastic and ____ n Clinically n ____ n Mottled brown due to staining n ____ n Susceptible to ____, fractures, and pulpal infections

hypocalcified small brittle caries

``` Odontodysplasia n Radiographic features n ____ appearance n Pulp chambers and root canals large due to thin ____ layer n Poorly outlined ____, short roots n Enamel ____, or absent ```

ghostlike dentin roots thin

``` Odontodysplasia n Differential diagnosis n Distinguish from DI n Not ____ n Enamel is hypoplastic n Usually only ____ of arch affected ```

hereditary | segment

Enamel pearl n Small globule of enamel, usually on ____ of molars n 3% population n From ____ prior to losing enamel forming potential n Core of ____, rarely pulp horn

roots hertwig's epithelial root sheath dentin

Enamel pearl n Trifurcation of ____ and bifurcation of mandibular molars n Apical to CEJ n (below gingival crest, not detected clinically) n Radiographically- ____, round radiopacity ``` n Differential diagnosis n ____ (detected clinically) n Pulp stone (change vertical angulation) n Superimposition of molar roots at ____ (change ____ angulation) ```

``` maxillary molars smooth calculus furcation horizontal ```

``` Talon cusp n Hyperplasia of ____ of incisor n Supernumerary cusp n ____ are caries prone n Radiographically, cusp superimposed over crown ``` n Differential diagnosis n May simulate a ____ tooth n Use ____ object technique to distinguish

cingulum grooves supernumerary buccal

Turner’s hypoplasia n Term to describe a permanent tooth with a localized ____ defect on crown n Caused by ____ (deciduous) or trauma n Severity depends on severity of insult n Affects developing ____ n Disturbs matrix formation and calcification n Hypocalcified with ____ to pitting and changes in morphology of crown

hypoplastic infection ameloblasts staining

Congenital syphilis n 30% of patients with congenital syphilis n Direct infection of developing tooth, n Dental hypoplasia (permanent) n Hutchinson’s teeth- incisors n ____ shaped crown n Incisal edge no wider than ____ portion of tooth n Mulberry molars Constricted ____ third of crown, occlusal no wider than ____ portion of tooth n Cusps ____ and poorly formed n Enamel ____, globular- like a mulberry

screwdriver cervical occlusal cervical small hypoplastic

``` Acquired anomalies n ____ n Abrasion n ____ n Resorption n Secondary ____ n Pulp stones n Pulpal ____ n Hypercementosis ```

attrition erosion dentin sclerosis

Attrition n Physiologic wear of dentition n Wear ____ n Dentinal exposure- staining n ____ as dentin wears faster than enamel

facets | cupping

``` Abrasion n Non-____ wear of teeth due to contact with foreign substances n Tooth ____ n Dental floss n Pipe ____ n Denture clasps ```

physiologic brushing smoking

Erosion n Teeth are eroded by a ____, commonly an acid n Chronic vomiting or acid reflux n Acidic diet n ____ defects on crown n Diagnosis by history and clinical exam n Edges of defect more ____ than abrasion defects

chemical radiolucent rounded

Resorption n Removal of tooth structure by ____ n Possible sequelae of infection, excessive ____ or function, local tumors or cysts

odontclasts | pressure

Internal resorption n Resorption within pulp chamber/canal of the surrounding dentin n ____ trauma, direct/indirect pulp cap, pulpotomy, enamel invagination n ____ radiolucent lesion in crown or root n Differential n ____ n External resorption Distinguish by ____ exam, changing horizontal angulation of beam

acute homogenous caries clinical

External resorption n Resorption of ____ surface of tooth n Possible sequelae of infection, reimplanted ____, excessive ____ or occlusal forces, impacted teeth

outer teeth orthodontic

External resorption n Apical region n ____ resorption n ____ roots n Pulp canal visible at apex, wide n Cervical region n Commonly caused by ____ adjacent tooth n Differential n ____ n ____ External resorption- normal intact pulp chamber/canal

``` smooth blunted unerupted caries internal resorption ```

Secondary dentin ``` n Dentin deposited in ____ after primary dentin formation completed n Normal aging process- stimuli such as ____ or minor trauma n (Tertiary) due to pathology n ____ n Trauma n ____ n Erosion n Dental ____ ```

``` pulp chamber chewing caries abrasion restorations ```

``` Pulp stones n Foci of ____ in dental pulp n Radiographic finding n Microscopically apparent after ____yo n Vary in size and shape ``` ____- amorphous and unorganized form of calcification

calcification 50 pulpal sclerosis

Hypercementosis n Excessive deposition of ____ on tooth roots n Radiographically see irregular enlargement of roots, more evident on apically n ____ n Hyperocclusion n ____ n Hyperpituitarism- gigantism, acromegaly n Differential diagnosis n Other radiopacities near ____ n Distinguishing feature- presence of ____ in hypercementosis

``` cementum inflammation paget's disease root PDL space ```

10. Dental Anomalies Flashcards

(70 cards)