Anomalies in Ortho Flashcards
(30 cards)
Supernumeray
- definition
- incidence
- classification
additional teeth
2:1 males
maxilla 5:1 mandible
classification
1. form
- supplemental - extra normal tooth
- conical - early forming and peg-shaped
- tuberculate - late forming and barrel shapes
- odontome - compound - many small separate teeth (usually anterior) or complex - compound mass of enamel and dentine (usually posterior)
- site
- mesiodens - midline
- paramolar - adjacent to the molars
- distodens - distal to the arch
Conical Supernumerary
- where is the usual site
- when does it form?
- are they likely to cause damage?
usually mesiodens
- the root formation is usually ahead or with the permanent incisor
not likely to cause damage
Tuberculate Supernumerary
- shape
- when does it form?
- where it the usual site
- tx
barrel shappel
forms palatal
root formation is delayed compared to the permanent incisor
- likely to empede eruption
- usually needs to be removed
Supernumeries
- 3 associated condition CCG
Cleft Lip and Palate
Gardener Syndrome
- multiple polyps in the colon and tumours elsewhere
Cleidocranial Dysplasia
- collarbones to be partly or completely missing
- hypoplastic maxilla
what are the issues with supernumeraries?
can:
- impede eruption of the teeth
- cause displacement
- produce spacing
- contribute to crowding
- cause cysts
Hypodontia
- definition
- commonly affected teeth between L1, U2, U5 and L5
- treatment
developmental absence of 1+ teeth
common:
L5, U2, U5, L1
treatment:
- open space and replace missing space
- orthodontics to close the teeth
define hypodontia, oligodontia and anodontia
hypodontia
- absence of 1+ teeth
oligodontia
- absence of 6+ teeth
anodontia
- absence of all teeth
Hypodontia
- 3 associated conditions
cleft lip and palate
downs syndrome
ectodermal dysplasia
Microdontia
- definition
- aetiology
- most common affected
- treatment
teeth are smaller than average
aetiology - genetic
commonly affected - upper 2’s = peg laterals
treatment options
- leave it
- create a space for comp build-up
- xla and replace missing space
Macro/Megadontia
- definition
- commonly affected teeth
- treatment
teeth larger than average
commonly affected
- upper 1 and lower 5
treatment
- do nothing
- xla and replace missing space
- xla and close missing space
- restoratively camouflage to appear as 2 teeth
Double Teeth
- aetiology
- associated conditions
- treatment
aetiology
- Fusion - 2 tooth germs fuse together
- Gemination - single tooth germ developmentally separates
associated condition
- Concrescence - cementum of 2 adjacent teeth fuse together = only the roots fuse together - make xla tricky
treatment
- no intervention in primary dentition but be aware of anomalies in the permanent dentition
- may be interdental caries - fill with comp
- can surgically divide if separate root canals
- veneers if not aesthetic
- xla and close space
Invagination
- definition
- epidemiology
- commonly affected
- the mild and severe forms
enamel folds into the tooth during development
epi- 1-5% of people
commonly affected - upper 2 then upper 1
mild form - dens invagination - deep cingulum pit
severe form - dens in dente - looks like there is a tooth inside a tooth
Invagination
- symptoms
- management
symptoms
- enamel is poor quality and thin
- high caries risk
management
- restorations over pits
- RCT can be hard due to abnormal morphology
- xla and replace missing space
Accessory Cusps
- cusp of carabelli
- talon cusp
cusp of carabelli
- extra palatal cusp on upper 6
talon cusp
- extra on upper 1
Dilaceration
- definition
- commonly affected teeth
- management
- sharp bend in root due to injury during development
commonly affected - upper incisors
management
- little divergence - expose, bond traction and ortho alignment
- complicated xla
Dilaceration
- aetilogy and signs
traumatic
- primary incisor has been pushed up into the germ
- the position of the dilaceration corresponds to the stage of development when it was traumatised
signs - crown is angled palatal and hypoplasia seen
developmental
- can be obstruction of the eruption path
signs - crown is angled labially, no hypoplasia is seen
delayed eurption
- when does it need to be investigated
generalise delay doesnt need to be investigated
localised delays often need intervention
if the tooth hasn’t erupted 6months after its contact-lateral = investigate
factors leading to delayed eruption
define ectopic and impacted
ectopic - abnormal place or position
impacted - physical impediment to eruption by other structures such as bone, teeth and tissues
ectopic - tooth has developed in the wrong place
impacted - tooth is being stopped from developing into the right place
what is the common reason for the delay of upper 1s?
dilaceration or obstruction
if upper 3’s are delayed, how do they erupt?
2% ectopic
- 60% palatal - usually ectopic
- 4% buccal - usually due to crowding
what is the common reason for the delay of upper and lower 5s?
lack of space if the E has exfoliated/xla early and the 6 has drifted forward
what is the common reason for the delay of upper 6s?
if the E has made it become impacted
what is the order of eruption for the permanent upper and lower arch?
upper - 6, 1, 2, 4, 5, 3, 7, 8
lower - 6, 1, 2, 3, 4, 5, 7, 8
