DISORDERS OF TOOTH FORMATION Flashcards

1
Q

what 3 things can determine the shape/size of teeth

A
  • genetically determined
  • local or systemic factors
  • BOTH
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2
Q

what is hypodontia

A

failure of development/missing teeth - 8’s most common, then 5’s and upper 2’s

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3
Q

what is anodontia

A

this is the total lack of teeth (genetic disorder - no teeth present)

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4
Q

what are the treatment options for people with hypodontia/missing teeth

A
  • full and partial dentures
  • implants
    missing teeth and small teeth are often present together, composite is advised to mask conical of mis-shaped teeth
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5
Q

what is hyperdontia (supernumary)

A

this is when a patient has extra teeth
- patients with supernumerary primary teeth have 30-50% chance of being followed by supernumerary permanent teeth

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6
Q

where are extra teeth (hyperdontic) in patients mouths usually found typically?

A
  • ANTERIOR MAXILLA in the MIDLINE or immediately adjacent to midline referred to as MESIODENS
  • MOLAR regions are referred to as PARAMOLARS or DISTOMOLARS
  • 5:1 maxilla:mandible ratio!!!
  • usually idiopathic but may be associated with syndromes such as cleidocranial dysplasia
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7
Q

what is a mesiodens

A

Mesiodens is a supernumerary tooth present in the midline between the two central incisors

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8
Q

what is megadontia (3)

A
  • this is when the teeth are larger than normal
  • very rare
  • seen in cases of PITUITARY GIGANTISM where teeth are bigger than normal
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9
Q

what is microdontia(7)

A
  • this is when teeth are smaller than normal
  • MAXILLARY LATERAL INCISORS and MAXILLARY THIRD MOLARS mostly affected
  • maxillary lateral incisors - peg/conical shaped crowns
  • maxillary third molar - small but normal shape
  • identified radiographically (smaller in proportion to other teeth)
  • more common in FEMALES
  • OFTEN ASSOCIATED WITH VARIOUS TYPES OF ECTODERMAL DYSPLASIA AND DOWN SYNDROME!
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10
Q

what are the things we can consider in terms of root size within the dentition (4)

A
  • racial variation - SHORTER ROOTS seen in people of oriental/chinese background
  • african origin - LARGER ROOTS SEEN in these type of peopel
  • irradiation of the jaws, or chemotherapy, during root formation may lead to SMALLER roots
  • POSS CONSIDER ORTHO REFERRAL/TREATMENT
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11
Q

what is gemination (doubling)?(4)

A

‘DOUBLE TEETH’
- there will have been attempts at developmental separation of a SINGLE tooth germ to produce two SEPERATE teeth
- the cause is unknown
- anteriors/deciduous teeth are most commonly affected
- 1 canal and incisal notching present in these teeth

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12
Q

what is a concrescence

A
  • this is the joining of two teeth, one of which may be a supernumary, by cementum (root surface)
  • cause is thought to be from trauma or crowding as root surfaces may be in close proximity
  • MAXILLARY MOLARS most commonly affected
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13
Q

what is dilaceration(6)

A
  • this is the GROSS disruption of root formation
  • cause is thought to be trauma to TOOTH GERM during root development
  • WHEN THE REMAINDER OF THE TOOTH IS FORMED AT AN ANGLE
  • this may appear anywhere along the root surface
  • discovered radiographically
  • this can impede tooth eruption
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14
Q

what are the treatment options for tooth formation disorders

A

PRIMARY DENTITION - NO TREATMENT
PERMANENT DENTITION - dependant on:
- space available within arch
- morphology of pulp chambers and or root canals
- degree of attachment between the two parts of the tooth or teeth.

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15
Q

what do we mean by an invaginated tooth (5)

A
  • this is the infolding on the palatal surface of the crown of the tooth and lined with enamel, sometimes extending into the root
  • appear as a normally shaped/malformed crown that exhibits a deep pit or crevice in area of cingululm
  • radiographically - a tooth like structure appears within the involved tooth
  • pear shaped mass of enamel is seen in dentine surrounding a radiolucent area
  • hence, ‘dens in dente’ - TOOTH WITHIN A TOOTH
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16
Q

what is the treatment for an invaginated tooth

A
  • fissure seal SOON after eruption
  • vitality test/radiograph
  • endodontic treatment if pulp involvement - invagination can sometimes involve the pulp
17
Q

what is an evaginated tooth

A
  • a small tubercule on the occlusal surface of the premolar in the CENTRAL part of the fissure pattern
  • more common in CHINESE patients
  • typically FRACTURED off or worn down by normal wear
18
Q

what is the treatment for evaginated teeth

A
  • radiographic evaluation to determine any pulpal involvement (pulp horns evagination)
  • restricted and repeated grinding of the tubercule followed by a fissure sealant.
  • removal of tubercule and limited pulpotomy may be required
19
Q

what is dens evaginatus

A

TALON CUSP- a horn like projection OF THE CINGULUM of the maxillary incisor teeth which may reach and contact the incisal edge of the tooth

20
Q

what is the treatment for dens evaginatus

A
  • fissue seal margins
  • possible pulpotomy
  • no treatment if no interference with occlusion
21
Q

What is taurodontism

A
  • BULL LIKE teeth
  • molar teeth where the pulp chambers of the teeth are enlarged vertically at the roots!
22
Q

what is amelogenesis imperfecta

A
  • it is the incomplete or defective formation of enamel, resulting in the alteration of tooth form or colour
  • enamel hypoplasia results from a disturbance of or damage to the ameloblasts during enamel matrix formation
  • ameloblasts are one of the most sensitive cell groups in the body
  • may be genetic/inherited
23
Q

how many types of amelogenesis imperfecta are there

A

12 types at least but clinically only 2 CLASSIFICATIONS are NEEDED :

HYPOPLASIA - deficient enamel matrix resulting in thinner enamel, grooved/pitted, glossy, hard/translucent

HYPOMINERALISATION - defect in mineralisation of the enamel, normal thickness but very soft, discoloured - yellow/brown, opaque/chalky, prone to caries/enamel is weak, enamel chips easily, poorly formed.

24
Q

what is the management of amelogenesis imperfecta(5)

A
  • simple restorative measures ie preformed crowns on 6’s asap!
  • sensitive handling of pt
  • aesthetics
  • sensitive to thermal and mechanical stimuli
  • poor OH and staining - keep on top of this
25
Q

what is dentinogenesis imperfecta(5)

A
  • inherited disorder of dentine, which could be associated with a collagen disorder
  • primary and permanent teeth are affected
  • teeth are opalescent with a greyish or brownish colour
  • enamel unaffected structurally, but flakes off due to poor adhesion to the dentine
  • pulpal exposure likely in deciduous dentition
26
Q

what is the infection we can get within disorders of tooth formation

A

CONGENITAL SYPHILIS

27
Q

what is congenital syphilis (4)

A
  • it is caused by spirochete treponema pallidum, found in the dental follicle
  • transmitted via the placenta (birth)
  • may be associated with blindness, deafness or paralysis
  • rare in most parts of the world
28
Q

what are the 3 anomalies of congenital syphilis ( what 3 unusual things/forms can we get from the infection)

A
  1. hutchinson’s incisors
  2. mulberry molars
  3. moons molars
29
Q

what are the features of hutchinsons incisors

A
  • affects upper central incisors
  • ‘notch’ on incisal edges
  • mesio-distal (both sides) narrowing of incisal portion of the crown
  • may lead to an anterior OPEN bite
30
Q

what are the features of mulberry molars(4)

A
  • affects PERMANENT first molars
  • occlusal surface is rough and pitted
  • compressed nodules instead of cusps
  • similar in appearence to that of a raspberry/mulberry
31
Q

what are the features of moons molars

A
  • affects PERMANENT first molars
  • round or dome shaped