Development & Eruption of the Primary & Permanent Dentitions Flashcards
(173 cards)
1
Q
At what morphological stage does initiation (of tooth germ) occur?
A
Dental lamina
2
Q
At what morphological stage does proliferation (cell division) occur?
A
Bud stage
3
Q
At what morphological stage does the beginning of histo-differentiation occur?
A
Cap stage
4
Q
At what morphological stage does morpho-differentiation & prominent histo-differentiation occur?
A
Bell stage
5
Q
At what morphological stage does apposition (formation of dentin & enamel) occur?
A
Early crown stage
6
Q
At what morphological stage does continued apposition of dentin & enamel including enamel maturation occur?
A
Late crown stage
7
Q
At what morphological stage does formation of root dentin & cementum occur?
A
Early root stage
8
Q
Formation of dentin & enamel:
A
apposition
9
Q
Deficient development during INITIATION (dental lamina) results in:
A
Number anomalies-
- adontia
- hypodontia
- oligodontia
10
Q
Excessive development during INITIATION (dental lamina) results in:
A
Number anomalies-
- hyperdontia
11
Q
Deficient development during PROLIFERATION (bud, cap, early & advanced bell stage) results in:
A
Number & structure anomalies-
- hypodontia
- oligodontia
12
Q
Excessive development during PROLIFERATION (bud, cap, early & advanced bell stage) results in:
A
Number & structure anomalies-
- hyperdontia
- odontoma
- epithelial rests
13
Q
Deficient development during HISTODIFFERENTIATION (cap, early & advanced bell stage) results in:
A
Enamel & dentin structure anomalies-
- Amelogenesis imperfecta type I (hypoplastic) & type IV (hypoplastic & hypomaturation)
- dentinogenesis imperfecta
14
Q
Deficient development during MORPHODIFFERENTIATION (bud, cap, early & advanced bell stage) results in:
A
Size & shape anomalies-
- microdontia
- peg lateral
- mulberry molars
- hutchisons incisors
- absence of cusp or root
14
Q
Excessive development during MORPHODIFFERENTIATION (bud, cap, early & advanced bell stage) results in:
A
Size & shape anomalies-
- macrodontia
- tuberculated cusps
- carabelli’s cusp
- taurodontism
- dens in dente
- dens evaginates
- dilaceration
- germination
- fusion
- concrescence
14
Q
Deficient development during APPOSITION (deposition of enamel & dentin matrices) results in:
A
Enamel & Dentin & cementum apposition anomalies-
- amelogenesis imperfecta type II & IV
- enamel hypoplasia
- dentin dysplasia
- regional odontodysplasia
15
Q
Excessive development during APPOSITION (deposition of enamel & dentin matrices) results in:
A
Enamel & dentin & cementum apposition anomalies-
- enamel pearls
- hypercementosis
- odontoma
16
Q
Deficient development during MINERALIZATION (mineralization of enamel & dentin matrices) results in:
A
Enamel & dentin mineralization anomalies-
- amelogenesis imperfecta type II
- enamel hypo-mineralization
- fluorosis
- interglobular dentin
17
Q
Excessive development during MINERALIZATION (mineralization of enamel & dentin matrices) results in:
A
Enamel & dentin mineralization anomalies-
- sclerotic dentin
18
Q
Deficient development during MATURATION (maturation of enamel & dentin matrices) results in:
A
Enamel & dentin maturation anomalies-
- amelogenesis imperfecta type II & IV
19
Q
Deficient development during ERUPTION (eruption of teeth) results in:
A
Eruption anomalies-
- primary failure of eruption
- ectopic eruption
- ankylosis
20
Q
Excessive development during ERUPTION (eruption of teeth) results in:
A
Eruption anomalies-
- natal/neonatal teeth
- accelerated eruption
21
Q
What anomalies occur during the initiation phase? Give two examples:
A
Anomalies of NUMBER
-Supernumerary teeth
-Congenital tooth absence
22
Q
Hyperdontia =
A
supernumerary teeth
23
Incidence of supernumerary teeth =
0.3-3%
Males 2:1 over females
24
Are supernumerary teeth more frequent in primary or permanent dentition?
Permanent 5x more often
25
90-98% of supernumerary teeth are located in the:
maxilla
26
The classification of supernumerary teeth may be:
normal or rudimentary (conical)
27
List the syndromes associated with supernumerary teeth:
1. apert
2. cleidocranial dysplasia
3. gardner syndrome
4. crouzon's disease
5. down syndrome
6. hallerman-strief
28
Hypodontia =
oligodontia
29
Incidence of hypodontia & anodontia in permanent teeth:
1.5-10% (excluding thirds)
30
Incidence of hypodontia & anodontia in primary teeth:
Less than 1%
31
Describe the frequency of hypodontia & anodontia starting with the most frequently missing teeth:
3rd molars: 10-25%
mandibular 2nd premolar: 3.4%
maxillary lateral incisors: 2.2%
maxillary second premolar: 0.85%
32
T/F: There is no correlation between missing primary & missing permanent teeth
False- significant correlation
33
T/F: Familial patterns may play a role in missing teeth
true
34
List some areas where problems may arise, resulting in hypodontia & anodontia:
1. failure of induction
2. abnormality of lamina
3. insufficient space
4. physical obstruction of lamina
35
Condition associated with hypodontia:
1. Ectodermal dysplasia
2. Crouzon's
3. Achondroplasia
4. Chondroectodermal dysplasia (Ellis-Van Creveld)
36
Describe the frequency of single tooth macrodontia:
rare
37
Microdontia is most frequently seen in:
lateral incisors, 2nd premolars, 3rd molars
38
Conditions associated with microdontia:
1. ectodermal dysplasia
2. chondroectrodermal dysplasia
3. hemifacial microsomia
4. down syndrome
5. crouzon's
39
Conditions associated with macrodontia:
1. hemifacial hypertrophy
2. crouzon's
3. otodental syndrome
40
What stage of tooth development might conjoined teeth occur in?
proliferation & morphodifferentiation
41
Gemination occurs more frequently in ____ dentition than ____ dentition
primary; permanent
42
If gemination occurs, the tooth will present as:
bifid crown with single root and single pulp chamber
43
Anomaly caused by a single tooth germ that attempted to divide during its development resulting in a bifid crown:
Gemination
44
Complete cleavage of single tooth bud resulting in supernumerary mirror image tooth:
Twinning
45
Describe the frequency of fusion/concresence:
incidence 0.5% more common in primary teeth and higher frequency in asian population
46
How would you clinically diagnose gemination:
By counting crowns
47
Dentinal union of two embryologically developing teeth with two separate pulp chambers:
Fusion/concresence
48
How would you clinically diagnose fusion?
By counting normal number of teeth/crowns
49
Fusion after root formation is complete:
Concresence
50
Dens in dente (Invaginatus) is an anomaly of:
morphodifferentation (size & shape)
51
Where do we typically see dens in dente (invaginatus) occur?
Maxillary lateral incisors
52
What is the clinical significance of dens in dente?
caries related
53
What is the etiology of dens in dente?
Invagination of inner enamel epithelium
54
Dens evaginatus may also be called:
talon cusp
55
What is the significance of Dents evaginatus (talon cusp)?
Pulp tissue in cusp may complicate restorations
56
What is the incidence & etiology of dents evaginatus (talon cusp)?
1.4%; caused by evagination of enamel epithelium focal hyperplasia of pulp mesenchyme
57
Failure of proper invagination of Hertwig's epithelial root sheath:
Taurodontism
58
Incidence of taurodontism:
0.54-5.6%; higher in patients with hypophosphatemic rickets
59
What syndromes are associated with taurodontism?
1. Klinefelter
2. Trichodento-osseus
3. Orofacialdigital
4. Ectodermal dysplasia
5. amelogenesis imperfecta type IV
6. Down syndrome
60
Usually due to trauma I primary dentition:
dilaceration
61
Dilaceration may be associated with what syndrome?
Lamellar ichthyosis
62
Diagnose this image:
Supernumerary teeth
63
Diagnose this image:
Hypodontia
64
Diagnose this image:
Gemination
65
Diagnose this image:
Twinning
66
Diagnose this image:
Fusion
67
Diagnose this image:
Dens in dente
68
Diagnose this image:
Dents evaginatus (talon cusp)
69
Diagnose this image:
Taurodontism
70
Diagnose this image:
Dilaceration
71
Amelogenesis imperfecta is an example of an anomaly of:
Histodifferentiation (structure)
72
inherited defect with multiple patterns such as X-linked, autosomal dominant, or recessive; anomaly of hxisodifferentiation:
Amelogenesis imperfecta
73
What is the incidence of amelogenesis imperfecta?
Variable from 1;14,000 to 1;4,000
74
How many types of amelogenesis imperfect are present?
4 major types with 14 subgroups
75
Why is amelogenesis imperfecta distinguished from other enamel defects?
because of inheritance & no syndrome or systemic disease
76
Diagnose this image:
amelogenesis imperfecta
77
Heritable defect of predentin matrix; normal mantle dentin:
Dentinogenesis imperfecta
78
What is the incidence of dentinogenesis imperfecta?
1:8,000
79
What type of dentinogenesis imperfecta occurs with osteogenesis?
Shields type I
80
What type of dentinogenesis imperfecta results in "opalescent dentin" & occurs alone, both dentitions affected:
Shields type II
81
What type of dentinogenesis imperfecta is the most severe with several variants?
Shields type III
82
Anomalies of apposition can occur in:
1. dentin
2. enamel
3. cementum
83
Dentin dysplasia (shields type I & II) is an anomaly of:
dentin apposition
84
Regional odontodyspluasia "ghost teeth" is a anomaly of:
dentin apposition
85
The following conditions are associated with:
1. vitamin D resistant rickets
2. hypoparathyroidism
3. Albright's syndrome
4. Ehlers-Danlos syndrome
5. epidermolysis bullosa
6. osteogenesis imperfecta
Anomaly of dentin apposition
86
Ghost teeth =
regional odontodysplasia
87
Diagnose this image:
Dentinal dysplasia
88
Anomalies of enamel apposition can occur anytime:
tooth calcification is occurring
89
List the different ways anomalies of enamel apposition may be environmentally induced:
1. physiologic
2. developmental
3. ingestional
4. infectious
5. traumatic
6. iatrogenic
90
Hypercementosis & hypophosphatasia are anomalies of:
cementum apposition
91
List the four types of hypophosphatasia:
1. perinatal
2. infantile
3. childhood
4. adult
92
Lack of serum alkaline phosphatase during apposition of cementum would result in:
Hypophosphotasia
93
Describe the inheritance pattern of hypophosphotasia:
autosomal recessive
94
Disease that results in little cementum being produced & early exfoliation of primary incisors with no resorption:
hypophosphotasia
95
Diagnose this image:
Enamel hypoplasia
96
Diagnose this image:
Hypophosphotasia
97
Anomalies of mineralization can occur with both:
enamel & dentin
98
What is the prevalence of hypo mineralized first molars?
4-70%
99
Anomalies of mineralization (enamel & dentin) may be a possible problem with ____ after _____
ameloblast function; matrix completion
100
May be associated with febrile illness, antibiotics, nutritional deficiencies & preterm birth:
Anomalies of mineralization (enamel & dentin)
101
Tooth eruption is thought to occur because the interaction of:
1. root growth
2. hydrostatic pressure
3. bone remodeling
4. periodontal ligament traction (dental follicle essential)
5. connective tissue proliferation at the pulp apex
6. likely multifactorial
102
initiation & calcification of primary teeth occurs _____ very early
in utero
103
Tooth: maxillary central incisor
Initial calcification:
Crown completion:
Root completion:
Tooth: maxillary central incisor
Initial calcification: 14 weeks IU
Crown completion: 1.5 mo
Root completion:1.5 yrs
104
Tooth: maxillary lateral incisor
Initial calcification:
Crown completion:
Root completion:
Tooth: maxillary lateral incisor
Initial calcification: 16 weeks IU
Crown completion: 2.5 mo
Root completion:2 yrs
105
Tooth: maxillary canine
Initial calcification:
Crown completion:
Root completion:
Tooth: maxillary canine
Initial calcification: 17 weeks IU
Crown completion: 9 mo
Root completion: 3.25 yrs
106
Tooth: maxillary 1st molar
Initial calcification:
Crown completion:
Root completion:
Tooth: maxillary 1st molar
Initial calcification: 15.5 weeks IU
Crown completion: 6 mo
Root completion: 2.5 yrs
107
Tooth: maxillary 2nd molar
Initial calcification:
Crown completion:
Root completion:
Tooth: maxillary 2nd molar
Initial calcification: 19 weeks IU
Crown completion: 11 mo
Root completion: 3 yr
108
Tooth: mandibular central incisor
Initial calcification:
Crown completion:
Root completion:
Tooth: mandibular central incisor
Initial calcification: 14 weeks IU
Crown completion: 2.5 mo
Root completion: 1.5 yr
109
Tooth: mandibular lateral incisor
Initial calcification:
Crown completion:
Root completion:
Tooth: mandibular lateral incisor
Initial calcification: 16 weeks IU
Crown completion: 3 mo
Root completion: 1.5 yrs
110
Tooth: mandibular canines
Initial calcification:
Crown completion:
Root completion:
Tooth: mandibular canines
Initial calcification: 17 weeks IU
Crown completion: 9 mo
Root completion: 3.25 yrs
111
Tooth: mandibular 1st molar
Initial calcification:
Crown completion:
Root completion:
Tooth: mandibular 1st molar
Initial calcification: 15.5 weeks IU
Crown completion: 5.5 mo
Root completion: 2.5 yrs
112
Tooth: mandibular 2nd molar
Initial calcification:
Crown completion:
Root completion:
Tooth: mandibular 2nd molar
Initial calcification: 18 weeks IU
Crown completion: 10 mo
Root completion: 3 yrs
113
Tooth formation begins at:
7 weeks in utero
114
Mineralization begins at the:
4th month of fetal development
115
Describe the eruption pattern of primary teeth:
symmetrical
116
_____ primary teeth erupt first
mandibular
117
T/F: Timing of eruption is more important than sequence
False- sequence is more important than timing
118
Favorable eruption sequence for primary teeth:
ABDCE
119
Favorable eruption sequence for maxillary permanent teeth:
61245378
120
Favorable eruption sequence for mandibular permanent teeth:
61234578
121
What is the likely age of the child seen with these teeth:
6 months
122
What is the likely age of the child seen with these teeth:
12 months
123
What is the likely age of the child seen with these teeth:
16 months
124
What is the likely age of the child seen with these teeth:
18 months
125
What is the likely age of the child seen with these teeth:
22 months
126
What is the likely age of the child seen with these teeth:
26 months
127
The following conditions are all considered:
1. gingival cyst of newborn
2. Bohn's nodules
3. Dental lamina cysts
4. Epstein's pearls
Anomalies of eruption with primary dentition
128
Inclusion cysts may also be called:
Epstein's pearls
129
Where are inclusion cysts (Epstein's pearls) located?
Palatal midline
130
What is the treatment for inclusion cysts (Epstein's pearls?
Self-limiting without intervention
131
Diagnose the following image:
Inclusion cysts
132
Most likely ectopic mucous glands, occurring on buccal & lingual aspect of alveolus:
Bohn's nodules
133
What treatment is indicated for Bohn's nodules?
No Tx indicated
134
Diagnose the following image:
Bohn's nodules
135
Remnants of the dental lamina occurring on the crest of the alveolus:
Dental lamina cysts
136
Diagnose the following image:
Dental lamina cyst
137
Teeth present at birth:
natal teeth
138
Teeth present within the first 30 days of life:
neonatal teeth
139
Most natal/neonatal teeth are:
actual primary teeth
140
natal/neonatal teeth may be associate with:
syndrome
141
What treatment is indicated for natal/neonatal teeth?
Possible extraction if aspiration risk or malformed
142
Diagnose the following image:
Natal/neonatal teeth
143
Traumatic ulceration from feeding:
Riga Fede disease
144
Conditions associated with teething:
1. normal process
2. increased drooling
3. desire to bite or chew
4. mild discomfort
5. no direct link to high fever, diarrhea, facial rash or sleep problems
145
For permanent dentition, typically root formation is completed:
2-3 years after eruption of the tooth
146
List some possible eruption disturbances associated with permanent teeth:
1. eruption hematoma
2. retained primary teeth
3. ectopic eruption
4. early or late loss of primary teeth
147
-bluish swelling
-asymptomatic
-treatment is indicated when eating is impaired or pain is present
-can be associated with primary or permanent teeth
-radiograph should be taken to verify tooth position
Eruption hematoma
148
Diagnose the following image:
eruption hematoma
149
Delayed exfoliation of primary teeth can be related to:
1. lack of permanent successor
2. ankylosis
150
Delayed exfoliation of primary teeth commonly occurs with:
primary first and second molars
151
How should you evaluate for an ankylosed or submerged tooth?
Evaluate marginal ridges in mouth & on the radiograph
152
For an ankylosed tooth it is important to make sure:
successor tooth is present
153
Occurs when a tooth erupts outside the typical path of eruption:
ectopic eruption
154
Diagnose the following image:
ectopic eruption
155
Ectopic eruption commonly occurs in:
maxillary permanent first molars
156
Systemic conditions causing delayed eruption of permanent teeth:
1. cleidocranial dysplasia
2. hypothyroidism
3. hypopituitarism
157
Systemic conditions causing premature exfoliation of primary teeth:
1. hypophosphotasia
2. langerhans histiocytosis
3. hyperthyroidism
158
With time, the frenum attachment will typically migrate:
apically
159
Somewhat controversial among practitioners; may be performed by other professionals including ENT, plastic surgeons & pediatricians
Surgical intervention may be needed if impacting nutrition and feeding and/or speech:
Frenectomy
160
Non-nutritive sucking habits spontaneously develop:
between 2-4 age or earlier
161
Non-nutritive sucking habits may cause:
protrusion of maxillary incisors
162
When considering non-nutritive sucking habits, evaluate:
frequency, intensity & duration of habit
163
Most non-nutritive sucking habits are:
self-limiting
164
Most common types of non-nutritive sucking habits:
1. digit sucking
2. pacifier sucking
165
Non-nutritive sucking habit usually ceases at:
4-6 years of age
166
The success of intervention of non-nutritive sucking habits is dependent on:
readiness of child
167
Comparison of primary & permanent incisors & cuspids : (3)
1. primary crowns are wider M-D
2. primary crown width at cervical third is greater
3. root:crown ratio is greater
168
Describe the primary molar roots:
long, slender & flaring
169
Describe the occlusal table of primary teeth:
narrow
170
Describe the cervical ridges on primary teeth:
pronounced
171
