Development & Eruption of the Primary & Permanent Dentitions Flashcards
1
Q
At what morphological stage does proliferation (cell division) occur?
A
bud stage
1
Q
At what morphological state does initiation (of tooth germ) occur?
A
dental lamina
2
Q
At what morphological stage does the beginning of histo-differentiation occur?
A
cap stage
3
Q
At what morphological stage does morpho-differenation and prominent histo-differentiation occur?
A
bell stage
4
Q
At what morphological stage does apposition (formation of dentin & enamel) occur?
A
early crown stage
5
Q
At what morphological stage does continued apposition of dentin and enamel including enamel maturation occur?
A
late crown stage
6
Q
At what morphological stage does formation of root dentin and cementum occur?
A
Early root stage
7
Q
Formation of dentin & enamel:
A
apposition
8
Q
Deficient development during INITIATION (dental lamina) results in:
A
Number anomalies
- adontia
- hypodontia
- oligodontia
9
Q
Excessive development during INITIATION (dental lamina) results in:
A
Number anomalies
- hyperdontia
10
Q
Deficient development during PROLIFERATION (bud, cap, early & advanced bell stage) results in:
A
Number & structure anomalies
- hypodontia
- oligodontia
11
Q
Excessive development during PROLIFERATION (bud, cap, early & advanced bell stage) results in:
A
Number & Structure anomalies
- hyperdontia
- odontoma
- epithelial rests
12
Q
Deficient development during HISTODIFFERENTIATION (cap, early & advanced bell stage) result in:
A
Enamel & Dentin structure anomalies
- Amelogenesis Imperfecta Type 1 (hypoplastic) & Type 4 (hypoplastic & hypomaturation)
- Dentinogenesis Imperfecta
13
Q
Deficient development during MORPHODIFFERENTIATION (bud, cap, early, & advanced bell stage) results in:
A
Size & shape anomalies
- microdontia
- peg laterals
- mulberry mulars
- Hutchinson’s 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
- Tauodontism
- Dens in dente
- Dens evaginates
- Dilaceration
- Germination
- Fusion
- Conrescence
15
Q
Deficient development during APPOSITION (deposition of enamel & dentin matrices) results in:
A
Enamel & Dentin & Cementum Apposition Anomalies
- Amelogenesis Imperfecta type 2 & 4
- Enamel hypoplasia
- Dentin dysplasia
- Regional Odontodysplasia
16
Q
Excessive development during APPOSITION (deposition of enamel & dentin matrices) results in:
A
Enamel & Dentin & Cementum Apposition anomalies
- Enamel pearls
- Hypercementosis
- Odontoma
17
Q
Deficient development during mineralization (mineralization of enamel & dentin matrices) results in:
A
Enamel & Dentin mineralization anomalies
- Amelogenesis IMperfecta type 2
- Enamel hypo-mineralization
- Flurosis
- Interglobular dentin
18
Q
Excessive development during mineralization (mineralization of enamel & dentin matrices) results in:
A
Enamel & Dentin mineralization anomalies
- Sclerotic dentin
19
Q
Deficient development during MATURATION (maturation of enamel & dentin matrices) results in:
A
Enamel and dentin maturation anomalies
- Amelogenesis Imperfecta Type 2 & 4
20
Q
Deficient development during ERUPTION (eruption of teeth) results in:
A
Eruption anomalies
- primary failure of eruption
- ectopic eruption
- ankylosis
21
Q
Excessive development during ERUPTION (eruption of teeth) results in:
A
Eruption anomalies
- natal/neonatal teeth
- acceleration eruption
22
Q
What anomalies may occur during the initiation phase? Give two examples
A
- Anomalies of NUMBER
- Supernumerary teeth
- Congenital tooth absence
23
Q
Hyperdontia =
A
supernumerary teeth
24
Incidence of supernumerary teeth =
0.3-3% and males 2:1 over females
25
Are supernumerary teeth more frequent in primary or permanent dentition?
permanent 5x more often
26
90-98% of supernumerary teeth are located in:
maxilla
27
The classification of supernumerary teeth may be:
normal or rudimentary (conical)
28
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
29
Hypodontia =
oligodontia
30
Incidence of hypodontia and anodontia in permanent teeth:
1/5-10% (excluding 3rds)
31
Incidence of hypodontia and anodontia in primary teeth:
less than 1%
32
Describe the frequency of hypodontia and anodontia starting with the most frequent tooth:
3rd molars (10-25%)
mandibular 2nd premolar (3.4%)
maxillary lateral incisors (2.2%)
maxillary 2nd premolar (0.85%)
33
T/F: There is no correlation between missing primary teeth and missing permanent teeth
false- significant correlation
34
T/F: Familial patterns may play a role in missing teeth
true
35
List some areas where problems may arise resulting hypodontia & andodontia:
1. failure of induction
2. abnormality of lamina
3. insufficient space
4. physical obstruction of lamina
36
Conditions associated with hypodontia:
1. ectodermal dysplaisa
2. crouzons
3. achondroplasia
4. chondroectodermal dysplasia (ellis-van creveld)
37
Describe the frequency of single tooth macrodontia:
rare
38
Microdontia is most frequently seen in:
lateral incisors, 2nd premolars, 3rd molars
39
Conditions associated with microdontia:
1. ectodermal dysplasia
2. chondroectodermal dysplasia
3. hemifacial microsomia
4. down syndrome
5. crouzon's
40
Conditions associated with macrodontia:
1. hemifacial hypertrophy
2. crouzons
3. otodental syndrome
41
What stage of tooth development might conjoined teeth occur in?
proliferation and morphodifferentiation
42
Gemination occurs more frequently in ____ dentition than ____ dentition
primary; permanent
43
If gemination occurs, the tooth will present as:
bifid crown with single root and pulp chamber
44
Anomaly caused by a single tooth germ that attempted to divide during its development resulting in a bifid crown:
gemination
45
Complete cleavage of single tooth bud resulting in supernumerary mirror image tooth:
twinnig
46
Describe the frequency of fusion/concresence :
incidince 0.5% more core common in primary teeth and higher frequency in asian population
47
How would you clinically diagnose gemination?
by counting crowns
48
Dentinal union of two embryologically developing teeth with two separate pulp chambers
fusion/ concrescence
49
How would you clinically diagnose fusion?
by counting normal number of teeth/crowns
50
Fusion after root formation is completed:
concrescence
51
Dens in dente (invaginatus) is an anomaly of:
morphodifferentation (size & shape)
52
Where do we typically see dens in dente (invaginatus) occur?
maxillary lateral incisors
53
What is the clinical significance of dens in dente?
caries relate
54
What is the etiology of dens in dente?
invagination of inner enamel epithelium
55
Dents evaginatus may also be called:
talon cusp
56
What is the significance of dents evaginatus (talon cusp)?
pulp tissue in cusp may complicate restorations
57
What is the incidence & etiology of dents evaginatus (talon cusp):
1.4%; caused by evagination of enamel epithelium focal hyperplasia of pulp mesenchyme
58
Failure of proper invagination of Hertwig's epithelial root sheath:
Taurodontism
59
Incidence of taurodontism:
0.54-5.6%; higher in patients with hypophosphatemic rickets
60
What syndromes are associated with taurodontism?
1. Klinefelter
2. Trichodento-osseous
3. Orofacialdigital
4. Ectodermal dysplasia
5. Amelogenesis imperfecta Type IV
6. Down syndrome
61
Usually due to trauma in primary dentition:
dilaceration
62
Dilaceration may be associated with what syndrome?
Lamella ichthyosis
63
Diagnose this image:
supernumerary teeth
64
Diagnose this image:
hypodontia
65
Diagnose this image:
gemination
66
Diagnose this image:
twinning tooth
67
Diagnose this image:
fusion
68
Diagnose this image:
Dens in dente
69
Diagnose this image:
Dents evaginatus (Talon cusp)
70
Diagnose this image:
taurodontism
71
Diagnose this image:
dilaceration
72
Amelogenesis imperfecta is an example of an anomaly of:
histodifferentation (structure)
73
Inherited defect with multiple patterns such as x-lined, autosomal dominant or recessive; Anomaly of histodifferentiation
amelogenesis imperfecta
74
What is the incidence of amelogenesis imperfecta?
variable from 1:14,000 to 1:4,000
75
How many types of amelogenesis imperfecta are present?
4 major types with 14 subgroups
76
Why is amelogenesis imperfecta distinguished from other enamel defects?
because of inheritance and no syndrome or systemic disease
77
Diagnose this image:
amelogenesis imperfecta
78
heritable defect of predentin matrix; normal mantle dentin:
dentinogenesis imperfecta
79
What is the incidence of dentinogenesis imperfecta?
1:8000
80
What type of dentinogenesis imperfecta occurs with osteogenesis imperfecta?
Shields Type I
81
What type of dentinogenesis imperfecta results in "opalescent dentin", occurs alone, both dentitions affected?
Shields Type II
82
What type of dentinogenesis imperfecta is the most severe with several variants?
Shields Type III
83
Anomalies of apposition can occur in:
1. dentin
2. enamel
3. cementum
84
Dentin dysplasia (shields type I & II) Is an anomalies of:
Dentin Apposition
85
Regional odontodysplasia (Ghost teeth) is an anomaly of:
dentin apposition
86
The following conditions are associated with:
1. Vitamin-D resistant rickets
2. Hypoparathyroidism
3. Albrights syndrome
4. Ehlers-Danlos syndrome
5. Epidermolysis Bullosa
6. Osteogenesis imperfecta
Anomaly of dentin apposition
87
Ghost teeth=
regional odontodysplasia
88
Diagnose this image:
Dentinal dysplasia
89
Anomalies of enamel apposition can occur:
anytime tooth calcification is occuring
90
List the different ways anomalies of enamel apposition may be environmentally induced:
1. physiologic
2. developmental
3. ingestional
4. infectious
5. traumatic
6. iatrogenic
91
Hypercementosis & Hypophosphotasia are anomalies of:
cementum apposition
92
List the 4 types of hypophosphotasia:
1. Perinatal
2. Infantile
3. Childhood
4. Adult
93
Lack of serum phosphatase during apposition of cementum would result in:
Hypophosphotasia
94
Describe the inheritance pattern of hypophosphotasia:
autosomal recessive
95
Disease that results in little cementum being produced and early exfoliation of primary incisors with no resoprtion
Hypophosphotasia
96
Diagnose this image:
enamel hypoplasia
97
Diagnose this image:
Hypophosphotasia
98
Anomalies of mineralization can occur with both:
enamel & dentin
99
What is the prevalence of hypo mineralized first molars?
4-70%
100
Anomalies of mineralization (enamel & dentin) may be a possible problem with ____ after ___
ameloblast function; matrix completion
101
May be associated with febrile illness, antibiotics, nutritional deficiencies and preterm birth:
Anomalies of mineralization (enamel & dentin)
102
Tooth eruption is thought to occur because of 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 multifactoria
103
The initiation and calcification of primary teeth occurs _____, very early
in utero
104
Tooth: Maxillary central incisor
Initial calcification:
Crown completion:
Root completion:
Tooth: Maxillary central incisor
Initial calcification: 14 weeks IU
Crown completion: 1.5 months
Root completion: 1.5 years
105
Tooth: Maxillary lateral incisor
Initial calcification:
Crown completion:
Root completion:
Tooth: Maxillary lateral incisor
Initial calcification: 16 week IU
Crown completion: 2.5 months
Root completion: 2 years
106
Tooth: Maxillary canine
Initial calcification:
Crown completion:
Root completion:
Tooth: Maxillary canine
Initial calcification: 17 weeks IU
Crown completion: 9 months
Root completion: 3.25 years
107
Tooth: Maxillary first molar
Initial calcification:
Crown completion:
Root completion:
Tooth: Maxillary first molar
Initial calcification: 15.5 weeks IU
Crown completion: 6 months
Root completion: 2.5 years
108
Tooth: Maxillary second molar
Initial calcification:
Crown completion:
Root completion:
Tooth: Maxillary second molar
Initial calcification: 19 weeks IU
Crown completion: 11 months
Root completion: 3 years
109
Tooth: mandibular central incisors
Initial calcification:
Crown completion:
Root completion:
Tooth: mandibular central incisors
Initial calcification: 14 weeks IU
Crown completion: 1.5 months
Root completion: 1.5 years
110
Tooth: mandibular lateral incisors
Initial calcification:
Crown completion:
Root completion:
Tooth: mandibular lateral incisors
Initial calcification: 16 weeks IU
Crown completion: 3 months
Root completion: 1.5 years
111
Tooth: mandibular canine
Initial calcification:
Crown completion:
Root completion:
Tooth: mandibular canine
Initial calcification: 17 weeks IU
Crown completion: 9 months
Root completion: 3.25 years
112
Tooth: mandibular first molar
Initial calcification:
Crown completion:
Root completion:
Tooth: mandibular first molar
Initial calcification: 15.5 weeks IU
Crown completion: 5.5 months
Root completion: 2.5 years
113
Tooth: mandibular second molar
Initial calcification:
Crown completion:
Root completion:
Tooth: mandibular second molar
Initial calcification: 18 weeks IU
Crown completion: 10 months
Root completion: 3 years
114
Tooth formation begins at:
7 weeks in utero
115
Mineralization begins at the:
4th month of fetal development
116
Describe the eruption pattern of primary teeth:
symmetrical
117
_____ primary teeth erupt first
mandibular
118
T/F: Timing of eruption is more important than sequence
False- sequence is more important than timing
119
Favorable eruption sequence for primary teeth:
ABDCE
120
Favorable eruption sequence for maxillary permenant teeth:
61245378
121
Favorable eruption sequence for mandibular permanent teeth:
61234578
122
What is the likely age of the child seen with these teeth?
6 months
123
What is the likely age of the child seen with these teeth?
12 months
124
What is the likely age of the child seen with these teeth?
16 months
125
What is the likely age of the child seen with these teeth?
18 months
126
What is the likely age of the child seen with these teeth?
22 months
127
What is the likely age of the child seen with these teeth?
26 months
128
The following conditions are all considered:
1. gingival cysts of newborn
2. Bohn's nodules
3. Dental lamina cysts
4. Epsteins pearls
anomalies of eruption
129
Inclusion cysts may also be called:
Epstein's pearls
130
Where are inclusion cysts (Epstein's pearls) located?
palatal midline
131
Was is the treatment for inclusion cytsts (epsteins pearls)?
Self-limiting without intervention
132
Diagnose the following image:
Inclusion cyst (Epstein's pearls)
133
Most likely ectopic mucous glands that occur on the buccal and lingual aspect of the alveolus:
Bohn's nodules
134
What treatment is indicated for Bohn's Nodules?
No tx indicated
135
Diagnose the following image:
Bohn's Nodules
136
Remnants of the dental lamina occurring on the crest of the alveolus:
Dental lamina cysts
137
Diagnose the following image:
Dental lamina cysts
138
Teeth present at birth:
natal teeth
139
Teeth present within the first 30 days of life:
neonatal teeth
140
Most natal and neonatal teeth are:
actual primary teeth
141
Natal/ neonatal teeth may be associated with:
syndrome
142
What treatment is indicated for natal/neonatal teeth?
possible extraction if aspiration risk or malformed
143
Diagnose the following image:
natal/neonatal teeth (dependent on time of development)
144
Traumatic ulceration from feeding:
Riga Fede disease
145
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
146
For permanent dentition, typically root formation is completed:
2-3 years after eruption
147
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
148
- bluish swelling
- asymptomatic
- treatment 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
149
Diagnose the following image:
eruption hematoma
150
Delayed exfoliation of primary teeth can be due to:
1. lack of permeant successor
2. ankylosis
151
Delayed exfoliation of primary teeth commonly occurs with:
primary 1st and 2nd molars
152
How should you evaluate for an ankylosed or submerged tooth?
evaluate marginal ridges in mouth and on radiograph
153
For ankylosed tooth it is important to make that:
successor tooth is present
154
Occurs when a tooth erupts outside the typical path of eruption
Ectopic eruption
155
Diagnose the following image:
ectopic eruption
156
Ectopic eruption commonly occurs in:
maxillary permanent first molars
157
Systemic conditions causing delayed eruption of permanent teeth:
1. cleidocranodysplasia
2. hypothyroidism
3. hypopituitarism
158
Systemic conditions causing premature exfoliation of primary teeth:
1. Hypophosphotasia
2. Langerhans histocytosis
3. Hyperthryoidism
159
With time, the frenum attachment will typically migrate:
apically
160
- somewhat controversial among practicioners
- may be performed by other professionals including ENT, plastic surgeons, and pediatricians
- surgical intervention may be needed if impacting neutron and feeding and/or speech
Frenectomy
161
Non-nutritive sucking habits spontaneously develop between:
2-4 years of age or earlier
162
Non-nutritive sucking habits may cause:
protrusion of maxillary incisors
163
When considering non-nutritive sucking habits, evaluates:
frequency, intensity, and duration of habit
164
Most non-nutritive sucking habits are:
self-limiting
165
Most common types of non-nutritive sucking habits:
1. digit sucking
2. pacifier sucking
166
non-nutritive sucking habit usually ceases at:
4-6 years of age
167
The success of intervention of non-nutritive sucking habits is dependent on:
readiness of child
168
Comparison of primary and permanent incisors and cuspids: (3)
1. primary crown is wider M-D
2. primary crown width at cervical 1/3 is greater
3. root-to-crown ratio is greater
169
Describe the primary molar roots:
long, slender, flaring
170
Describe the occlusal table of primary teeth:
narrow
171
Describe the cervical ridges on primary teeth:
pronounced
