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Paediatrics > Dental Anomalies > Flashcards

Dental Anomalies Flashcards

0
Q

What happens in the enamel secretory phase?

A

Enamel matrix is produced and there is some initial mineralisation

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1
Q

What are the two stages to enamel development?

A

Secretory phase

Maturation phase

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2
Q

What happens in the enamel maturation phase?

A

The mineral content is increased

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3
Q

What are the stages of tooth development?

A

Initiation
Morphogenesis
Crytodifferentiation
Matrix secretion

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4
Q

What happens in the initiation phase?

A

Dental placode is produced

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5
Q

What happens in morphogenetic?

A

Bud stage leading to cap stage
The bud stage is where the enamel knot and enamel organ are formed and there is corned station of the ectomesenchyme forming the dental papilla
The cap stage the enamel organ starts to enclose the dental papilla and the internal and external epithelium form

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6
Q

What happens in Crytodifferentiation ? What is the cervical loop?

A

Bell stage
In the early bell stage you can see the EEE, IEE, SR, DL and bud for tooth
In the late bell stage the enamel and dentine of cusps and IEE and EEE fuse to form cervical loop.
Advanced bell stage IEE induces odontobalsst to differentiate and dentine formation induces Ameloblastic differentiation. Predintine is laid

Cervical loop forms hertwigs sheath to map out shape of root and when broken down centrum forms and remanants are epithelial cell rests of malassez

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7
Q

Defects in enamel can be caused by

A

Local or generalised factors

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8
Q

The local and gernalised causes of enamel defects can lead to which two categories?

A

Hypoplastic

Hypo mineralised

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9
Q

T/F
Hypoplastic enamel is thinner
Hypolplasia of enamel results from failure or maturation

A

T

F failure of normal volume of matrix produced

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10
Q

T/F

Hypo mineralised enamel results from failure of calcification

A

T

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11
Q

Severe hypominerlaistion leads to what?

A

Hypocalcification

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12
Q

Less severe enamel hypominerlaistion leads to what type of enamel defect?

A

Hypomaturation

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13
Q

What are the local causes of enamel defects?

A

Infection
Idiopathic
Irradiation
Trauma

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14
Q

What two things can lead to hypominerlaistion of the permanent tooth germ? And which teeth are most commonly affected?

A

Trauma and infection of primary tooth
Permanent maxillary incisors
Mandib and max premolars

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15
Q

What is the name of a tooth which is damaged by an infection to primary tooth?

A

Turner tooth

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16
Q

What are the two causes of generalised enamel defects?

A

Genetic

Environmental/chronological/systemic

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17
Q

T/F genetic diseases can affect the body and well as the teeth?

A

T

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18
Q

What is an example of a genetic tooth only disease?

A

AI

This is a generalised enamel defect affecting all or most teeth of the primary and permanent dentition

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19
Q

How can AI be inherited?

A

AD
AR
X linked
Sporadic

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20
Q

If AI has been inherited in an AD fashion, what would this mean ?

A 
Each generation affected 
50% chance of passing to kids
M=F
Primary and sedondary dentition affected 
Wide variety of presentations
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21
Q

If AI is inherited in an X linked fashion, what would this mean?

A

Males more severely and uniformly affected

Females show vertical grooves and ridges

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22
Q

If AI is inherited in an AR fashion, what does this mean?

A

Parents are close relatives eg first cousins

Enamel Hypoplasia and hypominerlaistion

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23
Q

Which type of inheritance of AI is rare?

A

AR

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24
Q

How can we classify AI?

A

Based on phenotype

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25
Q

What are the three phenotypic variations of AI?

A

Hypoplasia
Hypocalcification
Hypomaturation

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26
Q

How do you manage AI?

A

Severely affected teeth may need cast restorations and crowns

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27
Q

What are the genetic generalised caused of enamel defects?

A

Down’s syndrome
Ectodermal dysplasia
Epidermolysis bullosa
Occulo-dento-osseous dysplasia

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28
Q

What are the generalised (non teeth only) environmental causes of enamel defects? How will this appear clinically?

A

Prenatal: rubella, syphylis
Neonatal: prem birth, hypocalcaemia
Postnatal: measles,chicken pox, Vit a c d def, chemical agents eg fluoride
There will be a horizontal band that affects all the teeth that were developing at that time

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29
Q

How much fluoride intake would lead to fluorosis?

A

> 0.05mg/kg/day

Drinking water with more than 2ppm is associated with high risk

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30
Q

What are the problems will develop following fluorisis ?

A

Aesthetics
Thermal osmotic stimuli
Poor OH
Comprised occlusion

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31
Q

How can you distinguish between fluorisis and AI?

A

Fluorosis will show sings of chronological development whereas AI does not

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32
Q

Which enamel defect affects the molars and incisors?

A

MIH

33
Q

What are the causes of dentine defects?

A

Genetic

Environmental

34
Q

What are the genetic causes of dentine defects?

A

Dentinogenesis imperfecta
Dentinal dysplasia
Vitamin D resistant rickets

35
Q

What are the environmental causes of dentine defects?

A

Drugs
Infection
Trauma
Deficiency

36
Q

T/F

Dentinogenesis is AD inheritance

A

T

37
Q

T/F DI only occurs in isolation?

A

F

It can occur in isolation but can also occur in association with Osteogenesis imperfecta

38
Q

T/F DI only affects secondary teeth

A

F

Primary and secondary

39
Q

What are the three types of DI?

A

Type 1: dental manifestations of OI
Type 2: classic hereditary opalescent dentine
Type 3: brandy wine isolate opalescent dentine

40
Q

How do you manage DI?

A

Remove pain and infection
Protect posterior teeth from wear
Restore aesthetics
Prevention + OHI + diet advice

41
Q

What is dentinal dysplasia?

A

AD disease which affects both dentitions

42
Q

What are the features of dentinal dysplasia?

A

Normal enamel but atypical dentine with abnormal pulp morphology

43
Q

What are the types of dentinal dysplasia ?

A

Type 1: Radicular type: short roots with almost absent pulp chamber
Type 2: coronal type that has enlarged pulps

44
Q

What type of inheritance is vitamin D resistant rickets?

A

X linked

45
Q

What skeletal features do people with vitamin D def rickets have?

A

Males
Short
Bowed legs

46
Q

What dental features with people with vir D def rickets have?

A

Abscesses in the absence of caries
Large pulp space
Large amounts of inter globular dentine
Pulp horns may be exposed due to attrition

47
Q

Can females be affected in Vit D def rickets?

A

Yes

They are heterozygous and they aare less severely affected with few dental anomalies

48
Q

Which drugs may interfere with dentine formation?

A

Chemotherapy
Nutritional def
Cytotoxic drugs
Tetracycline

49
Q

Which cementum defects are there?

A

Affected in many genetic disorders and the effect can be quite bad

Hyperxementosis; Periapical inflam, mechanical stimulation
Hypocementosis: cleidocrwnial dysplasia, hypophosphotasia

50
Q

Which disease can affect all dental tissues?

A

Regional odontodysplasia

This is where the tooth germ development is arrested

51
Q

Disturbances in eruption can be caused be…

A

Local and generalised factors

52
Q

Name the three types of disturbances in eruption?

A

Premature
Delayed
Impacted

53
Q

What are examples of premature tooth eruption?

A

Natal teeth

Neonatal teeth

54
Q

What is a tooth that is presnt at birth?

A

Neonatal

55
Q

What is a tooth that erupts after birth within the first month?

A

Neonatal

56
Q

What is the prevelence of natal teeth?

A

1:2000-3000 live births

57
Q

Which teeth are most commonly natal teeth?

A

Primary mandibular incisors

58
Q

T/f natal teeth are usually supernumerary?

A

F

59
Q

T/F neonatal and natal teeth are commonly mobile?

A

T because of limited root development

60
Q

Which syndromes can natal and neonatal teeth be related to?

A

Pachyonychia
Ellis van crevald
Soto syndrome

61
Q

How do you manage neonatal and natal teeth?

A

Monitor
Smooth edge
Or xla

62
Q

When would you xla a neonatal or natal tooth and what technique would you perform?

A

If it is markedly loose

Use spencer wells forceps and use slight local curettage to remove the rest of the remnants of the developing tooth germ

63
Q

What are the causes of delayed tooth eruption?

A

Local: traumatic displacement of tooth germ
Dilacerated permanent tooth
Presence of Supernumary or cyst
Impacted

Systemic 
Prematurity and low birth rate
Downs and Turner syndrome 
Hypothyroidism and hypopituarism
Hereditary gingivofibromatosis
64
Q

What happens when teeth are impacted? And what are the causes?

A

They remain unerupted of partially erupted beyond normal eruption time

Cause: abnormal position of tooth germ, supernumerary, cyst, tumour

65
Q

T/F impaction is rare in primary teeth?

A

T

66
Q

Which teeth are most commonly impacted?

A

8’s
Mandib premolars
Max canines

67
Q

Teeth can exfoliate…

A

Prematurely or

Delayed

68
Q

What are the local and systemic causes of premature exfoliation?

A

Local: tooth: arch discrepancy
Systemic: hypophosphotasia, cyclic neutropenia, chronic perio

69
Q

What are the local and systemic causes of delayed exfoliation?

A

Usually due to failure of eruption of permanent tooth

Local: infra occluded teeth
Gen: rare! Cherubim and cleidocranial dysplasia

70
Q

How do you manage problems with exfoliation and eruption?

A

Refer to paediatric dentist

But make sure good medical history since some conditions very serious.

71
Q

Infra occluded teeth can be different severities. What are they?

A

Mild: 1mm below occlusal place
Moderate: level with the contact point of one or more adjacent teeth
Severe: at level of interproximal gingival tissue of one or both adjacent teeth

72
Q

What is infra occlusion caused by?

A

Fusion of the cementum to bone

73
Q

Which teeth are most commonly affected by infraocclusion?

A

Primary molars

1.5-9%

74
Q

How do you manage infraocclusion?

A

Monitor
Early extraction and space maintenance
Restore occlusal height
Xla when exfoliation unlikely

75
Q

What is the prev of hypodontia in primary and secondary?

A

0.1-0.7 primary

2-9 perm

76
Q

T/F Microdontia is more common in permanent dentition?

A

T

77
Q

T/f microdontia is more common in Females?

A

T

78
Q

Which teeth are most commonly microdeents?

A

8 and 2

79
Q

T/f generalised Microdontia is common?

A

T

Paediatrics (31 decks)

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