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Paediatrics > Dental Anomalies > Flashcards

Dental Anomalies Flashcards

1
Q

What is hypodontia?

A

Congenital absence of one or more teeth.

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2
Q

What is the most common tooth to be congenitally missing?

A

Third molar.
Then upper laterals
Mandibular premolars

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3
Q

Which teeth are least likely to be congenitally missing?

A

First permanent molars and upper centrals.

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4
Q

What conditions are associated with hypodontia?

A

Ectodermal dysplasia
Down’s syndrome
Cleft lip and palate
Hurler’s syndrome
Incontinentia Pigmentii

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5
Q

What restorative issues can occur in hypodontia?

A

Over-eruption of canine into upper lateral space
Loss of space- drifting of adjacent teeth
Too much space
Infra-occluded primary tooth if no permanent successor
Abnormal shape and abnormal form
Deep overbite
Reduced LFH

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6
Q

What is the chronology go dental management of hypodontia?

A

Diagnosis
Removable prosthesis in mixed dentition stage
Orthodontics to open or close spaces +/- restorative work
Composite build ups
Porcelain veneers
Crowns and bridges
Implants
- when the child has stopped growing.
Preventative treatment throughout- don’t want the child losing any more teeth.

Hypotonia children would be classed as high caries risk- follow the enhanced prevention pathway.

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7
Q

What is hyperdontia?

A

Patient has extra teeth

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8
Q

Where is hyperdontia most common?

A

In the maxilla

Higher frequency in cleidocranial dysplasia

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9
Q

What are the four types of supernumerary?

A

Conical- cone shaped
Tuberculate- barrel shaped, has tubercles
Supplemental- looks like a tooth of normal series
Odontome- irregular mass of dental hard tissues
- Compound or complex

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10
Q

What is a microdont?

A

Smaller than normal tooth/teeth- peg shaped laterals

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11
Q

What is a macrodont?

A

Larger than normal tooth.

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12
Q

What is the difference between gemination and fusion?

A

Gemination- tooth splits into two
Fusion- 2 teeth fuse together

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13
Q

What is taurodontism?

A

Crown is enlarged but the roots are reduced- pulp extends high occlusally.

Flame shaped pulp

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14
Q

What is dilaceration?

A

Crown or root deviates from the other part of the tooth.

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15
Q

What is an accessory cusp?

A

Additional cusp found on a tooth- talon cusp.

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16
Q

What is Dens in Dente?

A

Tooth within a tooth- invaginations within the tooth which have their own pulp system.

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17
Q

Why is prevention important in teeth that are dens in dente?

A

If bacterial ingress occurs, it is impossible to perform root treatments- only option would be to extract.

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18
Q

Why might a tooth have short roots?

A

Radiotherapy
Dentine dysplasia
Accessory roots
Ortho treatment

19
Q

Why might localised enamel hypoplasia have occurred?

A

Trauma to primary tooth which has impacted the permanent tooth

Infection of the primary tooth

20
Q

What would be the treatment for localised enamel hypoplasia/hypomineralisation?

A

Composite restorations.

21
Q

If someone has generalised enamel hypoplasia, what is it important to determine?

A

If the cause is environmental or hereditary.

22
Q

What causes might cause generalised environmental enamel hypoplasia?

A

Fluorosis- symmetrical, diffuse white patches on the teeth, some patients may have brown patches.
- treat with micro abrasion/veneers/ vital bleaching

MIH- molar incisor hypo mineralisation

23
Q

What periods of development might cause a generalised enamel defect?

A

Prenatal- rubella, congenital syphillis, thalidomide, cardiac and kidney disease, drug use
- focussing on the pregnancy

Neonatal- prematurity, meningitis, difficult delivery (starved of oxygen).

Postnatal- otitis media, measles, chickenpox, TB, pneumonia, diphtheria, long term heart problem.
- focus on first year of life.

24
Q

What cause could be generalised hereditary?

A

Amelogenesis Imperfecta

25
Q

What are the 4 types of Amelogenesis Imperfecta?

A

Hypoplastic
Hypomineralised
Hypomaturation
Mixed with taurodontism

26
Q

Describe the 4 types of Amelogenesis Imperfecta.

A

Hypoplastic- enamel crystals do not grow to the correct length

Hypomineralised- crystallites fail to grow in thickness and width

Hypomaturational- enamel crystals grow incompletely in thickness or width but normal length with incomplete mineralisation.

27
Q

What gene mutations are found in Amelogenesis Imperfecta?

A

Kalikrein 4
Enamelin
Enamel extracellular matrix molecules amelogenin

28
Q

How would you diagnose Amelogenesis Imperfecta?

A

Ask about family history- hereditary
Generally affects both dentitions- but worse in the permanent dentition
Affects all teeth
Affects tooth size, structure and colour
Radiographs- fail to see an obvious radiolucency between enamel and dentine.

29
Q

What are the potential problems in amelogenesis Imperfecta?

A

Sensitivity- no hard enamel over the dentine, can lead to poor PH if it is sore to brush.

Caries/acid susceptibility

Poor aesthetics

Poor oral hygiene

Delayed eruption

Anterior open bite

30
Q

What solutions may be available to combat the problems seen in Amelogenesis Imperfecta?

A

Enhanced prevention
- fluoride varnish, bond, composite for sensitivity.

Composite veneers

Fissure sealants

SSC

Orthodontics

31
Q

What systemic disorders are associated with enamel defects (not amelogenesis imperfecta)?

A

Down’s syndrome
Prader Willi Syndrome
Porphyria
Epidermolysis Bullosa

32
Q

What is Dentinogenesis Imperfecta?

A

Hereditary disorder of dentine development and formation.

33
Q

What are the 3 types of dentinogenesis Imperfecta?

A

Type I- osteogenesis Imperfect (issues with bones as well)

Type II- autosomal dominant- patient tends to not have any underlying medical conditions, only DI.

Brandywine.

34
Q

How would you diagnose Dentinogeneis Imperfecta?

A

Teeth appear abnormal shape and darker colour.

Ask about family history

Associated with osteogenesis imperfecta- wheelchairs, multiple bone fractures, blue sclera of the eye

Affects both dentitions

Radiographs- bulbous crowns, obliterated pulps, abscess formation.

Enamel loss

35
Q

What problems might arise from dentinogenesis Imperfecta?

A

Aesthetics

Caries/acid susceptibility

Spontaneous abscess

36
Q

How would you combat the problems seen in Dentinogenesis Imperfecta?

A

Prevention

Composite veneers

Over dentures

RPD

Stainless steel crowns

37
Q

What other hereditary dentine defects can occur?

A

Dentine dysplasia type I and type II
Fibroud dysplasia of dentine

38
Q

What other hereditary dentine defects can occur that are associated with a general disorder?

A

Ehler’s Danlos syndrome
Osteogenesis Imperfecta
Rickets
Hypophosphatasia

39
Q

What might cause premature eruption of teeth?

A

Neonatal/natal tooth
High birth weight
Precocious puberty

40
Q

What might cause delayed eruption of teeth?

A

Malnutrition
Pre-term and low birth weight children
Down’s syndrome, hypothyroidism, cleidocranial dysplasia.
Gingival hyperplasia

41
Q

Why might neonatal/natal teeth need to be extracted?

A

Inhalation risk
Issues with feeding

42
Q

Why might premature exfoliation occur?

A

Trauma
Following pulootomy
Hypophosphatasia
Immunological deficiency- cyclic neutropenia

43
Q

Why might there be a delay in exfoliation?

A

Trauma to primary tooth
Ectopic succesor
Lack of successor- hypodontia
Infra-occlusion
“Double” primary teeth

Paediatrics (13 decks)

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