Dental Anomalies 🦷 Flashcards

1
Q

CONCRESCENCE

A

Linked to HYPERCEMENTOSIS

Concrescence is a condition of teeth where the CEMENTUM overlying the roots of at least two teeth JOIN together. It usually involves only two teeth. The most commonly involved teeth are UPPER SECOND AND THIRD MOLARS The prevalence rate is 0.04%.

  • Occlusion problems causing cheek biting and traumatic ulcers.
  • Involved teeth may have DIFFICULTY ERUPTING or may not erupt completely.
  • May possibly cause localized periodontal destruction due to aetiological factors.
  • May cause FRACTURE of the tuberosity or floor of the MAXILLARY SINUS.
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2
Q

GEMINATION

🦷➡️🦷🦷

A

MORPHODIFFERENTIATION

(Gemini - sign) ONE TOOTH/TWO BODIES

“Twinning”

Gemination, also called DOUBLE TOOTH , is an anomaly exhibiting two joined crowns and usually a SINGLE ROOT. It may have LARGE PULP It represents an incomplete attempt of a SINGLE TOOTH GERM 🦷 to split. It is considered multifactorial in etiology, with genetic and environmental causes.

** In geminated teeth, division is usually incomplete and results in a large tooth crown that has a single root and a single canal. **

The NUMBER of the teeth in the arch will be NORMAL.

Gemination more frequently affects the PRIMARY teeth, but it may occur in permanent dentitions, usually in the INCISORS region

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3
Q

FUSION

🦷🦷 ➡️🦷

A

MORPHODIFFERENTIATION

Most common: PRIMARY ANTERIOR

Tooth count: ONE LESS than normal

Tooth fusion arises through UNION of TWO normally separated TOOTH 🦷 🦷 GERMS.

🦷🦷➡️🦷

and depending upon the stage of development of the teeth at the time of union, it may be either complete or incomplete. On some occasions, TWO independent PULP CHAMBERS and ROOT CANALS can be seen.

the union of two adjacent teeth at the crown level (enamel and dentin), causing the formation of a tooth with an enlarged clinical crown.

Incidence of this anomaly is approximately 0.1% in the permanent and 0.5% in the primary dentition.

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4
Q

What Disorders have deficient Cementum?

A

Anomalies of APPOSITION

  • Hypophosphatasia
  • Vitamin D resistant Rickets
  • Cleidocranial Dysplasia
  • Epidermolysis Bullosa (acellular, excess)
  • Sickle Cell Anemia (hypercementosis)

C is for “CHEVyS” to “APPO hill”

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5
Q

If a tooth is Ankylosed what type of resorption is most likely to have occurred?

A

REPLACEMENT RESORPTION

Replacement resorption refers to resorption of the root surface and its SUBSTITUTION by BONE resulting in ankylosis.

Replacement resorption accompanies dentoalveolar ankylosis due to extensive TRAUMA to the tooths attachment apparatus (PDL DAMAGE).

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6
Q

DENTIN that is OVERMINERALIZED is called?

A

SCLEROTIC DENTIN

AKA

  • REPARATIVE
  • TERTIARY

Deposition of CALCIUM in TUBULES as a result of TRAUMA, CARIES, or normal AGING

GLASSY, TRANSLUCENT appearance

noted by ABSENCE of ODONTOBLASTS and PREDENTIN was evident where the sclerotic dentin was formed.

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7
Q

What is a Mulberry Molar?

What is it often associated with?

A

MULBERRY MOLAR

  • dental condition usually associated with congenital SYPHILIS
  • characterized by multiple rounded RUDIMENTARY enamel CUSPS on the permanent FIRST molars.
  • This type of abnormality is characterized by DWARFED molars with cusps covered with globular enamel growths.
  • These teeth are FUNCTIONAL but can be cosmetically fixed with crowns, bridges, or implants.
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8
Q

What is Perimolysis?

🤮

A
  • a form of dental EROSION, characterized by dental tissue demineralization without bacterial involvement.
  • It can be of intrinsic or extrinsic origin.
  • Decalcification of the teeth from exposure to GASTRIC ACID in people with chronic VOMITING 🤮 .
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9
Q

Dentinogenesis 1 vs 2 (3)

Similarities?
Differences?

📻◼️

A

Type I and II have SIMILAR radiographic features:

  1. Total OBLITERATION of the pulp CHAMBER and root CANALS due to deposition of dentin
  2. BULBOUS crowns with apparent cervical constriction
  3. REDUCED root length with rounded apices
  4. AMBER translucence
  5. MULTIPLE PERIAPICAL radiolucency 📻◼️with Alveolar abscesses

SHEILDS TYPE 1:

  • Associated WITH Osteogenesis Imperfecta (OI).
  • Usually an autosomal dominant trait with VARIABLE expressivity but can be recessive if the associated osteogenesis imperfecta is of recessive type.
  • PRIMARY TEETH 🦷 more severely effected

SHEILDS TYPE 2:

  • Occurs ALONE; no OI
  • Effects both dentitions equally

SHEILDS TYPE III: BRANDYWINE isolate.

This type is rare with occurrences only in the secluded populations at MARYLAND, USA. its predominant characteristic is bell-shaped crowns, especially in the permanent dentition. Unlike Types I and II, it involves teeth with 🐚 SHELL-like appearance and multiple pulp exposures

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10
Q

Molar / Incisor Hypomineralization (MIH) is associated with what vitamin deficiency and common condition

A

Vitamin D - PRETERM BIRTH

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11
Q

Disorders featuring Multiple Supernumerary Teeth

🦷🦷🦷🦷🦷🦷🦷🦷🦷🦷🦷🦷

A

🦷🦷🦷🦷🦷🦷🦷🦷🦷🦷🦷🦷

Aperts 
Cleidocranial Dysplasia
Gardners 
Crouzons 
Downs
Sturge-Weber
Orofacialdigital 
CLP

🦷🦷🦷🦷🦷🦷🦷🦷🦷🦷🦷🦷

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12
Q

Most common Primary ANKYLOSED Tooth

A

Mandibular 2nd Molar

correlation exist between congenital missing Permanent Tooth (2nd PM) and ANKYLOSED Primary Tooth

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13
Q

Disorders with multiple congenital MISSING teeth.

🎃🎃🎃🎃🎃🎃🎃🎃🎃🎃🎃

A

🎃🎃🎃🎃🎃🎃🎃🎃🎃🎃🎃

Ectodermal Dysplasia
Crouzon*
Chondroectodermal Dysplasia (Ellis-Van Creveld)
Williams
Achondroplasia 
Incontinentia Pigmenti
Orofacialdigital*
Rieger
CLP*

🎃🎃🎃🎃🎃🎃🎃🎃🎃🎃🎃🎃

(*) - also can have Hyperdontia

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14
Q

MICRODONTIA

L23

A

Bell Stage / Morphodifferentiation

Genetics: Autosomal Dominent (localized)

Syndromes (Generalized)

Up to 8%

Max Laterals > 2nd PM > Third Molars

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15
Q

Syndromes associated with MICRODONTIA

A
Downs
Crouzons*
Ectodermal Dysplasia*
Chondroectodermal Dysplasia* (Ellis Van Crefeld)
Pituitary dwarfism
Hemifacial Microsomia

(*) associated with Hypodontia

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16
Q

Syndromes that cause MACRODONTIA

A

Localized:
Hemifacial Hyperplasia
(Accelerated eruption on affected side)

Generalized: (very rare)
Pituitary gigantism 
Pineal hyperplasia with Hyperinsulinism
XYY syndrome
Crouzon syndrome*
Otodental syndrome
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17
Q

Dens Evaginatus

Characteristics?
Syndromes?

A

MORPHODIFFERENTIATION

“TALON” cusp / extra cusp

Contains Enamel/Dentin/PULP
(Cannot just shave down)

Most prevalent on MAX INCISORS

Evagination of Enamel Epithelium;
Focal Hyperplasia of Pulp Mesenchyme

Syndromes:
Lobodontia “wolf-like” teeth
Rubenstein-Taybi

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18
Q

Dens in Dente

Dens Invaginatus

A

Caused by invagination of IEE

IEE which produces Ameloblasts which produces Enamal, which forms a hole and then tunnel into the tooth*

Caries can progress quickly through the tunnel

Most common in PERMANENT MAX LAT

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19
Q

Taurodontism

Associated with?

A

Vertically elongated pulp chamber and short roots

Associated with:

AMELOGENESIS Type IV

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20
Q

Dilaceration

A

Abnormal bend in root

Usually due to TRAUMA in Primary Tooth

INTRUSION pushes primary root into developing tooth.

21
Q

Turners Hypoplasia

A

Periapical infection or trauma to primary tooth causes inflammatory response that messes up Ameloblasts of the developing permanent tooth.

22
Q

Congenital Syphilis creates what two Tooth Anomalies?

A

Hutchinson’s Incisors (hypoplastic notch)

Mulberry Molars (globular enamel)

23
Q

Enamel Hypoplasia

What stage?

A

Failure in APPOSITION phase

Tissue is UNDERDEVELOPED

LESS than normal number of cells

Enamel is laid down from the DEJ ➡️ Outward direction, possible to determine how early or late trauma/infection was by level of hypoplasia present

24
Q

Enamel Hypocalcification

What Stage?

A

Failure in MATURATION stage

Abnormal mineralization resulting in WHITE SPOTS.

25
Q

Amelogenesis Imperfecta

🔔

General Facts

A

BELL 🔔 Stage / Histodifferentiation

(When we are seeing differentiation of IEE into Ameloblasts)

YELLOW-BROWNISH in color
(which makes senses with a thinner enamel)

Autosomal Dominant, Recessive, or X-Linked

INTRINSIC alteration to Enamel

ALL TEETH, Primary and Permanent are affected

THIN TO NO ENAMEL, but dentin and pulps are fine.

26
Q

Dentinogenesis Imperfecta

👁🔵

🔔

A

BELL 🔔 Stage / Histodifferentiation

(Mess up of Dental Papilla turning into Odontoblasts which secrete the Dentin)

Autosomal Dominant

INTRINSIC alteration of DENTIN
-amorphic and atubular

ALL TEETH, Primary and Permanent are affected

  1. SHORT ROOTS
  2. OBLITERATED ROOT CANALS
  3. BELL-SHAPED CROWNS
  4. BULBOUS CROWNS in XRAYS due to constricted DEJ

Blue Sclera 👁 🔵

27
Q

Dentin Dysplasia

A

Autosomal Dominant

INTRINSIC alteration of DENTIN

ALL TEETH: Primary and Permanent are affected

2 types:

TYPE 1 - Short Roots

  • mobility
  • premature exfoliation

TYPE 2 - Chevron / Bow tie Pulps ^

  • more coronal
  • obliterated pulp canals

NOT good teeth for Restoration

28
Q

Regional Odontodysplasia

💁🏽‍♀️

A

“Ghost Teeth”

Affects: Ameloblasts, Odontoblasts, and Cementoblasts (AOC)💁🏽‍♀️

Disorganized growth of ALL the tissues

ONE QUADRANT of teeth exhibit:

  • Large Pulps
  • Open Apices
  • Short Roots

ALL TEETH (QUADRANT): Primary and Permanent affected

TX: Extract affected teeth

29
Q

Enamel Pearl

A

Only on MOLARS

Chunk of Enamel blocking attachment of SHARPEY’S Fibers
(Terminal ends of connective tissue fibers, mostly type 1 collagen that connects PDL to Cementum)

Patient will automatically have a PERIODONTAL POCKET

Will NOT come off with scaling

30
Q

Pre-Eruptive Resorption

What is it?
What does it contain?
Where is it most prevalent?

A

Defect located in the dentin of an unerupted tooth, just beneath the dentin-enamel junction, with a prevalence of 0.5-2% of the teeth. The depth of the lesion is variable and may also reach the pulp.

Contains soft tissue and inflammatory cells

4% for the permanent mandibular first molar,
2% for the mandibular first premolar
1% for the permanent maxillary first molar, maxillary first premolar, and mandibular second molar.

31
Q

What is the percentage range of a congenital missing tooth?

A

1.5-10%

32
Q

Taurodontism is commonly found in what Syndrome?

A

KLIENFELTERS

33
Q

Natal teeth

Etiology?

A

The presence of teeth at birth or within a month post-delivery.

Superficial position of the tooth germ.

34
Q

Natal and Neonatal teeth are associated with what Syndromes

A
ELLIS VAN CREVOLD (chondroectodermal dysplasia)
PACHYONYCHIA CONGENITAL 
HALLERMAN-STRIEF
RUBENSTIEN-TAYBI
PIERRE-ROBIN
CLEFT LIP / PALATE
PFEIFFER
ECTODERMAL DYSPLASIA
35
Q

Decoronation of a tooth

What is it?
Purpose?

A

ROOT - PRESERVE - WIDTH - INTRUSION

Surgical method for treating ankylosed incisors in children and adolescents.
The crown and root filling are removed, leaving the ROOT IN SITU to be resorbed and covered with a mucoperiosteal flap. Leaving the root in its alveolus to be replaced by bone.

Early loss of a permanent tooth leads to loss of alveolar bone, especially in buccopalatal width. Decoronation PRESERVES not only the WIDTH of the ridge but also the vertical height.

36
Q

Syndromes associated with HYPERDONTIA

A

APERT - CLEIDOCRANIAL - GARDNER - CROUZON

37
Q

Hyperdontia is often associated with?

A

DELAYED ERUTION

38
Q

Most common congenital missing teeth?

3/⬇️2/L/⬆️2

A

THIRD MOLAR - 20%

MAND 2ND PREMOLAR - 3.4%

MAX LATERAL - 2.2%

MAX 2ND PREMOLAR - .85%

Lamina issues

39
Q

T/F?

Missing Third Molars is associated with missing Lateral Incisors

A

TRUE

40
Q

What conditions are often associated with HYPODONTIA?

SSS

A

ECTODERMAL ORGANS

SALIVA GLANDS - SKIN - SWEAT GLANDS

Hyposalivation

41
Q

Difference between CLEIDOCRANIAL Dysplasia and CHONDROECTODERMAL Dysplasia?

A

CLEIDOCRANIAL
+++++ Supernumerary teeth
🧠 delayed

CHONDROECTODERMAL (EVC)
- - - - Hypodontia
🚫🧠delayed

42
Q

Which Dentinogenesis Imperfecta type is associated with Osteogenesis Imperfecta?

A

Shields Type 1

43
Q

What is the difference between Dentinogenesis Imperfecta and Dentin Dysplasia?

A

DI

  • Histodifferation
  • 3 subtypes (1,2,Brandywine)
  • 1 in 6,000 to 1 in 8,000

DD

  • Apposition
  • 2 subtypes
  • 1 in 100,000
  • The features of DD-II resemble DGI-II in the primary dentition. The permanent dentition, however, is either unaffected or radiographically has thistle tube-shaped deformity of the pulp chamber and pulp stone
44
Q

What dental anomaly’s would be present with someone who had Vit D Rickets?

A

Hypomineralized Dentin

Enlarged pulp and pulp horns

45
Q

Which Amelogenesis is associated with Hypocalcification, and enamel lost right after eruption?

A

AMELOGENESIS III - MINERALIZATION

46
Q

How would a tooth that is HYPOMATURED look?

What AI’s are these?

A

MOTTLED BROWN-YELLOW SNOWCAPPED
POUROUS - CHIPS AWAY

AI - 2
AI - 4

47
Q

What nutrient deficiencies can cause Enamel Hypoplasia?

A

VIT A C D - Calcium - Phosphate - Fluoride

48
Q

T/F

Enamel Hypoplasia is a marker for celiac disease.

A

TRUE

49
Q

Tetracyclines can stain teeth how quickly

What age is it ok to begin to prescribe?

A

Staining can result in 3 days administration

Should NOT prescribe from 5th month in utero to 8 years old