Non carious diseases of teeth

Question 1

Local factors of acquired disorders

Answer 1

trauma – dilacerated incisor/turner teeth
infection –turner teeth
radiotherapy
idiopathic – regional odontodysplasia/enamel opacities

Question 2

Systemic factors of acquired disorders

Answer 2

tetracycline disorders
serious systemic disease or malnutrition
fluorosis

Question 3

dilacerated incisor

Answer 3

trauma displaces the crown of the developing tooth
root development continues but at an angle
tooth fails to erupt often with retention of the deciduous predecessor

Question 4

turner teeth

Answer 4

arises due to local trauma/infeection
due to issues with primary predecessor
range of disorders from yellow-brown pigmentation of enamel to extensive pitting and irregularity of the crown

Question 5

regional odontodysplasia

Answer 5

ghost teth
local development eg vascular defect causing ischaemia, local infection

Question 6

enamel opacities

Answer 6

1 in 3 children
histologically hypomineralised

Question 7

tetracycline staining

Answer 7

tetracycline becomes incorporated in the teeth mineralising at the same time
teeth normal when erupt – gradually grey colour

Question 8

hereditary conditions

Answer 8

teeth only
- absent teeth/additional teeth
- connations
- dens-in-dente
- amelogenesis imperfecta and dentinogenesis imperfecta

affecting other tissues in addition to teeth
- osteogenesis imperfecta
- cleidocranial dysplasia
- anhidrotic ectodermal dysplasia
- down’s syndrome

Question 9

Connation

Answer 9

Union of 2 teeth during development involving enamel, dentine and pulp

Question 10

Concrescence

Answer 10

Union of teeth at roots by deposition of cementum
always affect roots

Question 11

Connations classified

Answer 11

fusion : union between 2 initially separate tooth germs
germination : the union by incomplete separation of 2 teeth developing from single tooth germ

Question 12

connation present in population

Answer 12

0.5-1% of population have deciduous tooth connation
0.1% of population have permanent tooth connation
inherited as an autosomal dominant trait

Question 13

clinical features of connation

Answer 13

enlarged crowns with apparent partial separation
cause crowding/delayed eruption of adjacent teeth

Question 14

concrescence

Answer 14

multiple teeth fused at root
molar teeth

Question 15

pathology concrescence

Answer 15

inflammatory/space-occupying lesion
union via cementum deposition

Question 16

treatment for both connations and concrescence

Answer 16

depends on aesthetic/function factors
endo and restorative procedures with permanent incisor connations
extractions for impacted and unerupted 3rd molars

Question 17

dens in dente

Answer 17

localised disturbance of tooth development
deep penetrating pit extending into the tooth from the crown
invaginated odontome

Question 18

general features of dens in dente

Answer 18

1-5% population
maxillary lateral incisors
bilateral

Question 19

clinical features dens in dente

Answer 19

tooth crown may be distorted
invagination arises in crown
base of pit will have a thin layer of enamel/dentine

Question 20

HPC dens in dente

Answer 20

incidental finding
morphological abnormality
periodontal pain

Question 21

radiolographical features of dens in dente

Answer 21

affected tooth may show intracoronal radiolucency
extend to involve root
associated with periapical radiolucency

Question 22

pathology of dens in dente

Answer 22

deeply penetrating pit lined by enamel
distortion of underlying dentine
enamel and dentine may be defective

Question 23

treatment of dens in dente

Answer 23

endodontic tx
extraction

Question 24

amelogenesis imperfecta

Answer 24

produce inherited congenital defects primarily of enamel formation with/without defects in tooth morphology and/or eruption

Question 25

clinical features amelogenesis imperfecta

Answer 25

hypoplastic - thin enamel. surface rough and discoloured. hypomature - abnormal thickness. opaque/discoloured hypocalcified - abnormal thickness of enamel

Question 26

radiological features of amelogenesis imperfecta

Answer 26

thin layer of enamel of normal radiodensity in hypoplastic AI reduced radiodensity of enamel in hypomature and hypocalcified AI may have been unerupted teeth or delayed eruption

Question 27

pathology of amelogenesis imperfecta

Answer 27

variety of morphological changes in enamel substructure as well as hardness and thickness

Question 28

dentinogenesis imperfecta

Answer 28

congenital defects in primarily in dentine formation, which may be associated with osteogenesis imperfecta

Question 29

dentinogenesis imperfecta general features

Answer 29

1 in 6k livebirths variety of inheritance patterns variety of molecular and biochemical defects affecting collagen

Question 30

dentinogenesis imperfecta HPC

Answer 30

present in childhood discolouration or rapid wear of teeth

Question 31

detinogenesis imperfecta clinical features

Answer 31

amber or blue bulbous crown easy fracturing of enamel with rapid attrition

Question 32

dentinogenesis imperfecta radiological features

Answer 32

teeth have short roots rapid obliteration of pulp chambers and canals after eruption

Question 33

dentinogenesis imperfecta pathology

Answer 33

enamel normal mantle dentine formation later formed dentine abnormal pulp cavity obliterated

Question 34

cleidocranial dysplasia

Answer 34

rare genetic condition that affects teeth and bones such as skull etc

Question 35

Cleidocranial dysplasia HPC

Answer 35

failure in eruption of permanent teeth

Question 36

Cleidocranial dysplasia clinical features

Answer 36

short stature prominence of frontal,parietal,occipital bones absent of clavicles delayed shedding of deciduous teeth

Question 37

cleidocranial dysplasia radiological features

Answer 37

absent clavicle broad skull

Question 38

cleidocranial dysplasia pathology

Answer 38

bone show trabeculation and thick collagen bundles teeth with thin roots with deficient or absent secondary cellular cementum

Question 39

treatment of cleidocranial dysplasia

Answer 39

combination of surgery and ortho surgery to remove deciduous teeth and expose permanent successors ortho to encourage eruption and align teeth

Question 40

Hypodidrotic ectodermal dysplasia

Answer 40

x-linked recessive condition characterised by a developmental failure of ectodermal structures, particularly skin/hair/sweat glands

Question 41

hypohidrotic ectodermal dysplasia general features

Answer 41

x linked recessive detected first in early childhood

Question 42

hypohidrotic ectodermal dysplasia clinical features

Answer 42

absent/malformed teeth cone shaped teeth few teeth

Question 43

down's syndrome

Answer 43

congenital condition characterised by intellectual disability, trisomy of chromosome 21

Question 44

general features of down's syndrome

Answer 44

characterised facies with prominent epicanthic folds, downwardly slanted palebral fissures, mid-facial hypoplasia short stature