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Oral Diseases > Theme 4 - Dental Abnormalities > Flashcards

Theme 4 - Dental Abnormalities Flashcards

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1
Q

What do we look at in the development of the ‘ideal’ dentition?

A
  • Number
  • Form
  • Structure
  • Eruption (position/delay)
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2
Q

List the abnormalities of number of teeth

A
  • Anodontia
  • Hypodontia
  • Hyperdontia
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3
Q

Define anodontia

A

Rare absence of all teeth

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4
Q

Define hypodontia

A

Absence of teeth less than 6

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5
Q

Define hyperdontia

A

Supernumerary or supplementary teeth

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6
Q

How do supernumerary teeth differ from supplementary teeth?

A
  • Supernumerary teeth are of abnormal form, supplementary teeth are normal copies of present dentition
  • Supernumerary more common in Females, supplementary teeth more common in males
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7
Q

Which teeth commonly have supplementary teeth?

A

Upper 2’s > Lower 5’s > Upper 5’s

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8
Q

List the syndromes associated with Hypodontia

A
  • Hypohidrotic ectodermal dysplasia
  • Cleft lip and palate
  • Down syndrome
  • Crouzon syndrome
  • Ellis-van Creveld syndrome
  • Orofacial digital syndrome
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9
Q

List the syndromes associated with Hyperdontia

A
  • Cleidocranial dysplasia
  • Cleft lip and palate
  • Orofacial digital syndrome
  • Gardner syndrome
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10
Q

Define hypohidrotic ectodermal dysplasia

A
  • Genetic skin disorder
  • X-linked recessive (rare in females)
  • Mutation in ectodysplasin A (ED1) gene
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11
Q

What are the general features of hypohidrotic ectodermal dysplasia?

A
  • Smooth dry skin with sparse hair
  • Partial/total absence of sweat glands
  • Nail abnormalities
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12
Q

What are the dental abnormalities of hypohidrotic ectodermal dysplasia?

A
  • Anodontia/Hypodontia
  • Delayed eruption
  • Deformed teeth
  • Conical crowns
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13
Q

Define cleidocranial dysplasia

A
  • Bone and teeth disorder
  • Autosomal dominant
  • Mutation in CBFA1/RUNX2 gene
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14
Q

What are the general features of cleidocranial dysplasia?

A
  • Absent/Hypoplastic clavicles
  • Fontanelles and sutures persist
  • Helmet-like skull
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15
Q

What are the dental abnormalities of cleidocranial dysplasia?

A
  • Hypoplastic maxilla
  • High, narrow palate
  • Retained deciduous teeth
  • Supernumerary teeth
  • Delayed/failure eruption
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16
Q

What conditions are associated with abnormalities of tooth form - size?

A
  • Microdontia

- Macrodontia

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17
Q

What syndromes are associated with size abnormalities?

A
  • Ehlers Danlos syndrome
  • Downs syndrome
  • Congenital heart disease
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18
Q

Define Ehlers Danlos syndrome

A

Inherited defect of collagen causing joint and skin issues

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19
Q

What are the dental abnormalities of Ehlers danlos?

A
  • Microdontia
  • Short roots
  • Pulp stones
  • Fragile mucosa
  • Juvenile periodontitis
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20
Q

What are the classifications of the abnormal shape/form of teeth?

A

Mesiodens, paramolar, distomolar, peg-shaped lateral

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21
Q

If a tooth is a mesiodens -what is it?

A
  • Supernumerary

- Positioned midline of central incisors

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22
Q

If a tooth is a paramolar - what is it?

A
  • Supernumerary

- Positioned buccal/palatal to maxillary molars

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23
Q

If a tooth is a distomolar - what is it?

A
  • Supernumerary

- Positioned distal to 3rd molars

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24
Q

Describe double teeth

A
  • Form abnormality of two single teeth becoming one

- Two causes: fusion and germination

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25
How does double teeth form?
- Fusion -> union between dentine and/or enamel of 2+ separate teeth - Germination -> partial development of 2 teeth from single tooth bud due to incomplete division
26
Describe concrescence
- Form abnormality | - Roots of 2+ teeth unite by cementum alone after crown formation
27
Describe taurodontism
- Form abnormality - Pulp chamber height is greater than normal with no cervical constriction - Root canals are smaller and so are the roots - Present in permanent molars - Associated with Kilinefelter syndrome (XXY)
28
Describe dilaceration
- Form abnormality - Crown of tooth displaced from normal alignment with root - Present in permanent upper incisors
29
List disorders with abnormalities of tooth structure affecting enamel
- Amelogenesis imperfecta - Chronological hypoplasias - Congenital syphilis - Fluorosis
30
State the different causes of enamel abnormalities
- Local causes -> trauma/infection, idiopathic enamel opacity - Genetic -> amelogenesis imperfecta - Systemic -> infections, chronic diseases, nutritional deficiencies, chemotherapy, excess fluoride
31
Describe congenital syphilis
- Rare disease affecting structure of tooth - Infection of tooth germ by T.pallidum - Creates -> hutinsons incisors (screw-driver shaped with notch), mulberry molars (nodular cusps), moons molars (dome shaped crowns)
32
Describe fluorosis
- Excess fluoride causing structural abnormalities in dentition - Causes hypoplastic/hypomineralised enamel - Severity depends on dosage, duration and timing - Usually affects permanent dentition - Shows -> white flecks, patches, stations, discolourations on teeth
33
Why is permanent dentition affected and not primary in fluorosis?
Excess fluoride at the time permanent teeth are developing will affect the enamel structure - primary teeth are no longer developing
34
Describe amelogenesis imperfecta
- Hereditary enamel defect - AD or X-linked - Causes either Hypoplasia or Hypomineralisation/Hypomaturation of enamel
35
How do we determine whether a patient has hypoplastic or hypomineralised/hypomaturation AI?
- Hypoplastic AI -> hard enamel (defective matrix) with varied thickness, generalised thinning of enamel with grooving and pitting, smaller crowns with abnormal cusp morphology - Hypomineralised AI -> soft enamel (defective mineralisation) with normal thickness, normal morphology when erupt, soft/chalky enamel that chips easily to expose dentine (severe attrition)
36
State AI classification (1988)
- Type I Hypoplastic - Type II Hypomaturation - Type III Hypocalcified - Type IV Hypomaturation-Hypoplastic with taurontism
37
How is AI inherited?
- AD - AR - X-linked - Isolated trait
38
What components of enamel are affected in AI?
- Amelogenin - Ameloblastin and Enamelin - Tuftelin
39
What do we base AI classification off of?
- Mode of inheritance - Gene defect - Biochemical consequences - Clinical features
40
What are the causes of dentine abnormalities?
- Local -> trauma/infection - Hereditary -> Dentinogenesis imperfecta, dentinal dysplasia - Environmental -> Rickets, hypophosphatasia, juvenile hypoparathyroidism
41
How do we classify DI?
- Type I DI in osteogenesis imperfecta - Type II in teeth only (shell teeth) - Type III Brandywine isolate
42
How do we classify dentinal dysplasia?
- Type I Radicular dentine dysplasia (rootless teeth) | - Type II Coronal dentine dysplasia
43
Describe Type I DI - Osteogenesis Imperfecta
- Rare hereditary disease causing a defect in Type I collagen
44
What are the clinical features of osteogenesis imperfecta?
- Slender bones (mechanically weak) - Deformity/Fractures/Deafness - Lax ligaments, thin translucent skin, blue sclera - Dentinogenesis imperfecta
45
Describe Type II DI
- Hypomineralised dentine of hereditary defect equal in males and females
46
What are the clinical features of Type II DI?
- Discoloured teeth (brown/grey tint) - Bulbous crowns - Rapid attrition
47
What are the radiological features of Type II DI?
- Thin, short, blunt roots | - Pulp chamber becomes obliterated
48
What are the histopathological features of Type II DI?
- Thin layer of normal mantle dentine - Circumpulpal dentine has reduced number of tubules (sometimes tubular) that are abnormally wide - Cellular and vascular inclusions - Straight ameldodentinal junction
49
Define dentinal dysplasia
Abnormal dentine formation with additional abnormal pulp chamber morphology
50
Describe Type I Radicular Dentine Dysplasia (Rootless teeth)
- Normal crowns - Short roots - Obliterated pulp - Roots composed of dysplastic dentine - Disorganised dentinal tubules - Calcified globules of abnormal dentine
51
Describe Type II Coronal dentinal dysplasia
- Deciduous teeth look like DI - Normal permanent teeth - Obliterated pulp - Pulp stones - Thistle shaped pulp
52
One environmental cause of dentinal defects is Rickets. Describe Rickets.
- Failure of calcification due to lack of Vitamin D | - Body has a deficiency or resistance to Vitamin D action
53
What are some reasons as to why the body has a deficiency or resistance to Vitamin D action?
- Diet - Absorption (GIT) - Lack of UV light - Renal disease (Vit D resistant rickets) - Drugs (Phenytoin)
54
What are the clinical/dental features of Rickets?
- Short statute - Bow legs - Bone deformity and fractures - Delayed eruption - Enamel hypoplasia - Dentine abnormalities
55
Describe regional odontodysplasia (Ghost teeth)
- Idiopathic condition affecting primary and permanent dentition causing defective enamel and dentine - Unilateral and anterior maxilla commonly affected
56
Describe the clinical features of regional odontodysplasia (ghost teeth)
- Hypoplastic teeth - Abnormal form (look very small and pointed) - Delayed eruption
57
What are the enamel and dentine effects in ghost teeth?
- Enamel -> irregular mineralisation - Dentine -> thin, wide pulp chamber, open apices, wide predestine zone and interlobular dentine, increased pulp stones, calcification of follicle
58
What are three abnormalities of cementum?
- Hypercementosis - Ankylosis - Hypocementosis
59
What can cause hypercementosis/Ankylosis?
- Idiopathic - Infections - Overcrowding - Functionless/uneruption - Paget's disease
60
Describe a condition that is associated with hypocementosis
- Cleidocranial dysplasia - Hypophosphatasia causing hypocementosis - Defective mineralisation causing skeletal and dental defects - Can cause premature tooth loss of deciduous teeth
61
What problems can cause premature eruption?
- Hypoplastic enamel - Rootless teeth - Mobile (risk to airway) - Interfere with feeding
62
What problems can cause localised delayed eruption?
- Primary teeth retention - Hyperdontia - Abnormal crypt position - Reduced space - Dentigerous/eruption cyst
63
What problems can cause generalised delayed eruption?
- Hypothyroidism (cretinism) - Rickets - Cleidocranial dysplasia - Down syndrome

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