Odontogenesis- Clinical considerations Flashcards

1
Q

What are some initiation stage disturbances? Where do they occur?

A

Occur in the dental lamina

Anodontia (hypodontia)

Supernumerary Teeth (hyperdontia)

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2
Q

What is anodontia?

A

Absence of one or more teeth
Max laterals and third molars most often affected

Complete anodontia= rare, absence of all teeth

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3
Q

What are supernumerary teeth?

A

Extra teeth in the permanent dentition

More than 32 teeth, often smaller in size

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4
Q

What are some bud stage disturbances?

A

Microdontia (partial or complete)

Macrodontia (partial or comeplete)

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5
Q

What is microdontia?

A

Teeth are smaller in size

affects permanent max lateral incisors/ 3rd molars w/ partial microdontia

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6
Q

What is macrodontia?

A

Teeth are larger in size

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7
Q

What are some cap stage disturbances?

A

Dens in Dente

Germination

Fusion

Tubercle

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8
Q

What is dens in dente?

A

Enamel organ invaginates into the dental papilla

Forms a tooth within a tooth

Affects permanent anteriors

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9
Q

What is germination?

A

Forming tooth germ tries to divide causing incomplete formation of 2 teeth

Large crown with twinning and one large root

Affects permanent and primary anteriors

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10
Q

What is fusion?

A

Union of 2 separate teeth. Common in primary anteriors

Pressure or physical force produces contact between forming tooth germs

Complete= one large single tooth
Incomplete= Union of ROOTS ONLY (2 crown)
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11
Q

What is a tubercle?

A

Enamel extension forming an extra cusp

Found on facial/lingual anteriors and buccal/occlusal posteriors

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12
Q

What are some apposition & maturation disturbances?

A
Enamel dysplasia
Concrescence
Supernumerary root
Accessory canals
Dilaceration
Enamel pearls
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13
Q

What is enamel dysplasia?

A
Faulty enamel development ameloblasts
Enamel pitting (hypoplasia)
Intrinsic color changes (hypocalcification) w/ changes in enamel thickness
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14
Q

What is concrescence?

A

A form of fusion that occurs after root formation is complete

Caused by trauma/crowding, causing roots to contract

Roots united by cementum only- two crowns, one large root

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15
Q

What are supernumerary roots?

A

Additional roots, usually with 3rd molars

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16
Q

What are accessory canals?

A

Additional pulp canals that form when parts of HERS breaks down before dentin formation is complete.

Canals become innervated with blood vessels and sensory nerves

Apical 3rd of root

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17
Q

What is dilaceration?

A

Occurs in the molars

Sever, sharp curving or bending of the roots

Caused by trauma– difficult to perform root canal or do extractions

18
Q

What are enamel pearls?

A

Ectodermal disturbance

HERS does not break down. Cementoblasts cannot pass through, causing ameloblasts to form from IEE layer of HERS, producing enamel instead of cementum

Found at CEJ & in furcation areas

19
Q

What type of tissue is affected by amelogenesis imperfecta? Which cells are disturbed?

A

Affects enamel. Ectodermal disturbance

20
Q

What are the different types of amelogenesis imperfecta?

A

Hypoplastic
Hypocalcification
Hypomaturation
Hypoplasia/taurodontism

21
Q

What is hypoplastic amelogenesis imperfecta?

A

Affects the matrix- enamel is thin to absent

22
Q

Hypo-calcification amelogenesis imperfecta

A

Affects mineralization of matrix

Enamel is soft and wears away easily (may abrade easily by prophy)

23
Q

Hypo-maturation amelogenesis imperfecta

A

Causes incomplete crystallization

Enamel may be easily pierced w/ an explorer and/or chipped away

24
Q

Hypoplasia/taurodontism amelogenesis imperfecta

A

Enamel is slightly thin w. LARGE PULP CHAMBERS and enamel is hyper-mineralized

25
Q

Appearance of amelogenesis imperfecta

A

May/may not show discoloration

Texture is chalky to cheesy (very soft to relatively hard)

Open contacts w/ severely abraded occlusal and incisal edges

Open anterior bite common

26
Q

What type of tissue is affected by dentinogenesis imperfecta? Which cells are disturbed?

A

Affects the dentin. Ectomesenchymal disturbance

27
Q

How many types of dentinogenesis imperfecta are there? What are they?

A

3 types

Type 1: W/ osteogenesis imperfecta
Type2: Hereditary opalescent dentin (MOST COMMON)
Type 3: Brandywine type- rare & isolated to MD

28
Q

What is the appearance of dentinogenesis imperfecta?

A

Gray to brownish violet- translucent opalescent hue

Enamel may chip away- abnormal interlocking between enamel and dentin

Exposed dentin wears away, especially on incisal and occlusal surfaces

29
Q

What is dentin dysplasia?

A

Hereditary, ectomesenchymal disorder

Normal enamel w/ atypical dentin and abnormal pulp morphology

2 types

30
Q

Characteristic appearance of dentin dysplasia type 1

A

Radicular- “w” pattern in roots that is lost early on- pulp chamber is obliterated

“Rootless teeth”

Abnormally short roots, blunt shape, conical or malformed

31
Q

Characteristic appearance of dentin dysplasia type 2

A

Coronal- relatively normal roots/pulp chambers but pulp chambers can be large and contain an increased # of generalized pulp stones

32
Q

Appearance of dentin dysplasia

A

Crowns appear normal, may have an amber color

Normal eruption

Increased mobility, early exfoliation & high incidence of tooth loss due to trauma

33
Q

What are dentigerous cysts?

A

A developmental cyst that forms over an unerupted tooth.

Ectodermally derived from cell rests of Serres, Malassez or reduced enamel epithelium

34
Q

Cellular characteristics of dentigerous cysts

A

Cysts are lined with non-keratinized squamous epithelium

Fluid forms between the reduced enamel epithelium and the formed enamel

35
Q

Appearance of dentigerous cysts

A

Varying sizes, and may be asymptomatic

Clinically may exhibit a palpable mass w/ displaced teeth

Often found on routine radiographs- radiolucency surrounding unerupted tooth

36
Q

What is the treatment for dentigerous cysts?

A

Complete removal of the cyst and involved tooth

Marsupialization: drain fluid, allow bone growth, then enucleate cyst. This may be used to allow the tooth to erupt

37
Q

What are eruption cysts?

A

Less serious dentigerous cyst.

Associated with erupting primary and permanent teeth

Forms over the crown, resolves w/ eruption

38
Q

What is an ameloblastoma and what do they originate from?

A

Large ectodermal tumor of odontogenic origin that forms in the jaw near the molars and is usually associated with impacted teeth and dentigerous cysts

Forms from cell rests; Serres, Malassez, REE

Central bone lesion

39
Q

What is the appearance and treatment of an ameloblastoma?

A

Expands the alveolar ridge causing asymmetry
Asymptomatic
On radiographs will have a translucent, compartmentalized appearance.

Treatment is complete surgical removal of the lesion and involved teeth

40
Q

What is an odontoma?

A

Tumor of odontogenic origin

Contains mixed tissues- enamel, dentin, pulp, cementum
Associated with impacted teeth and unerupted teeth

Causes are unknown but may be from localized trauma, infection, inheritance, or genetic mutation

41
Q

What are the two types of odontomas?

A

Compound: calcified dental tissues, resemble teeth

Complex: Calcified dental tissues; amorphous

42
Q

Appearance and treatment of odontomas

A

Expansion of alveolar ridge
Found in both arches
Asymptomatic

Situated btw roots of teeth, usually does not cause resorption

Treatment is surgical excision