incomplete of defective enamel formation
enamel hypoplasia
what are some reasons for enamel hypoplasia?
ENVIRONMENTAL
- turner hypoplasia
- antineoplastic agents
- fluorosis
- syphillis
how do you tx enamel hypoplasia?
restore as needed
*pitting enamel
“physiological” wear due to tooth to tooth contact during occlusion
attrition
tooth structure loss secondary to external agent (variety of patterns)
abrasion
cupped-out depression of occlusal surfaces or cusp tips; associated with regurgitated gastric acid or dietary acid
erosion
wedge-shaped defect limited to cervical area; bruxism associated
abfraction
what are some tx options for attrition, abrasion, erosion, and abfraction?
- early dx and intervention
- construction of mouth guards
- inform pts regarding tooth loss from acidic foods, reflux
- lost tooth structure - replaced with variety restorative procedures
relativeley rare condition of the destruction of tooth structure accomplished by cells located in the DENTAL PULP that may be idiopathic or subsequent to trauma
internal resorption
what color do the teeth show if they are internally resorbed?
pink
what is the tx for internal resorption?
endo therapy prior to perforation
*once communication with PDL there is a poorer prognosis
relatively common destruction of tooth structure accomplished by cells located in the PDL
external resorption
what causes external resorption
- chronic inflammation
- cysts/neoplasms
- trauma
- re-implantation of avulsed teeth
- impactions
- ortho forces
- idiopathic
what is the tx for external resorption
depends on extent, extraction may be necessary
surface accumulation of EXOGENIOUS pigment which can typically be removed by prophy (food, tobacco, beverages, bacterial meds)
extrinsic stains
ENDOGENOUS materail is incorporated into developing teeth (deposition of circulating substances including drugs (tetracycline) and blood pigments (Rh incompatability)
instrinsic stains
*CANNOT be removed by prophy
MOST COMMON dental developmental anomaly that is UNCOMMON in deciduous dentition. it is the reduced number of teeth
hypodontia
*post teeth more likely to be missing
what teeth does hypodontia most commonly affect?
- 3rds
- second PMs
- lateral incisors
lack of 6 or more teeth (type of hypodontia)
oligodontia
total lack of tooth development (type of hypodontia)
anodontia
what is the tx of hypodontia?
restorative tx as needed
presence of supernumerary teeth
hyperdontia
how common is hyperdontia?
1-3% of population
which dentition (permanent/deciduous) is hyperdontia more common
permanent
where do teeth associated with hyperdontia usually erupt?
95% max, usually anterior
*mesiodens, distodens, paramolar
what is the tx for hyperdontia?
removal may be indicated to avoid complications related to normal eruption and occlusion
condition in which the teeth are smaller than usual (may also affect shape), most commonly affects max laterals and 3rds
microdontia
what is the tx for microdontia?
restorative tx as needed
2 tooth buds merge to form single large tooth RESULTING IN LESS TEETH IN THE ARCH
fusion
what do the two teeth share in fusion?
share cementum and dentin
HAVE SEPARATE root canals
uncommon condition, characterized by the fusion of two teeth by the cementum alone
concresence
where does concresence usually occur?
posterior maxilla
*clinically significant if one of the teeth needs to be extracted
rare condition that primarily affects the max incisors that is basically an exaggerated cingulum
talon cusp
severe talon cups may interfere with what?
occlusion
condition of an extra cusp in central developmental groove. tooth often becomes NON-VITALpresumably due to attrition or trauma to cusp
dens evaginatus
where is dens evaginatus most likely to occur?
mandib premolar teeth
uncommon condition that is a “tooth within a tooth”
dens invaginatus (dens in dente)
which teeth are most commonly affected by dens invaginatus (dens in dente)
max lateral incisors
what causes dens invaginatus (dens in dente)
invagination of blood
*affected tooth often becomes non-vital shortly after eruption
droplets of ectopic enamel usually around the furcations of max or mandib molars
enamel pearls
*may be deteted by probing, if mistaken for calculus may lead to exposure
what might enamel pearls have?
dentin and pulp horns
uncommon radiographic finding and the enlargement of the body and pulp chamber of a multirooted tooth leading to apical displacement of pulpal floor and furcation
taurodontism
*similar to bovine dentition
what causes taurodontism
chromosomal alterations associated with various syndromes
unusual incidental radiographic finding in ADULTS that is asymptomatic deposition of excessive cementum
hypercementosis
what causes hypercementosis?
local and systemic factors
-strong association with piaget’s disease of bone
is tx needed for hypercementosis?
no
*complications with extractions
unusual radiographic finding of curvature/bend of tooth roots
dilaceration
what causes dilaceration?
trauma in developing tooth
*extraction or RCT may be difficult
group of uncommon genetic disorders affecting enamel of teeth, weak enamel is easily lost, varied pattern of inheritance, and affects both primary and permanent teeth
amelogenesis imperfecta
what are the three main divisions of amelogenesis imperfecta?
- hypoplastic
- hypomaturation
- hypocalcified
division of amelogenesis imperfecta that is insufficient deposition of enamel matrix
hypoplastic
division of amelogenesis imperfecta that is the enamel matrix is laid down but not mature
hypomaturation
divison of amelogenesis imperfecta in which zero maturation in ECM but the ECM is laid down correctly
hypocalcified
what are the clinical findings of amelogenesis imperfecta?
rough, smooth, pitted, pigmented or “snow-capped” enamel
what are the radiographic findings of amelogenesis imperfecta?
thin enamel of normal or decreased density normal root and pulp morphology
uncommon abnormality of dentin formation that affects BOTH the permanent and primary dentition
dentinogenesis imperfecta
what kind of disease is dentinogenesis imperfecta?
autosomal dominant inheritance
- due to mutation of the DSPP gene
- “dentin sialophosphoprotein”
what are the clinical findings of dentinogenesis imperfecta?
- teeth appear transleucent “opalescent teeth”
- enamel is normal but poorly supported, rapid attrition of dentition is often seen
what are the radiographic findings of dentinogenesis imperfecta?
bulbous crowns and obliteration of pulps
*similar changes may be seen with osteogenesis imperfecta
what is the tx of dentinogenesis imperfecta?
management depends on the severity of gene expression
-may require little restorative care, however implants and/or overdentures are necessary in many cases
what are the two types of dentin dysplasia
type I: radicular dentin dysplasia
type II: coronal dentin dysplasia
what type of inheritance is dentin dysplasia?
autosomal dominant inheritance
type of dentin dysplasia that involves radicular roots that are very short “rootless” teeth, obliteration of pulp canal, and periapical radioleucencies
type I: radicular dentin dysplasia
type of dentin dysplasia that involves enlarged pulps with “thisle tube” appearance and pulp stones
type II: coronal dentin dysplasia
clinically, how do teeth with dentin dysplasia appear?
normal
