Dental anomaly

Dr. Paknahad

CLASSIFICATION

(1) Size

(2) Number

(3) Shape/Form

(4) Defects of Enamel and Dentin

Developmental Disturbances

Microdontia

Macrodontia

Size

Microdontia

(1) Generalized Microdontia

(2) Localized Microdontia

Size

all teeth are smaller than normal

pituitary dawrfism

(1) Generalized Microdontia

affects most often maxillary lateral incisior + 3rd molar

these 2 teeth are most often congenitally missing

peg lateral

(2) Localized Microdontia

Macrodontia

(1) Generalized Macrodontia

(2) Localized Macrodontia

Size

all teeth are larger than normal

associated with pituitary gigantism

(1) Generalized Macrodontia

Hemangioma, Hemifacial hypertrophy

(2) Localized Macrodontia

(1) Size

(2) Number

(3) Shape/Form

(4) Defects of Enamel and Dentin

Developmental Disturbances

Supernumerary teeth

( Hyperdontia, Supplemental)

many are impacted

cleidocranial dysostosis, gardner syndrome

Number

most common supernumerary tooth

tooth situated between maxillary central incisors

Mesiodens

situated bucally or lingually to one of the maxillary molars

Paramolar

molar located distal to molar

Distomolar/Distodens

when all teeth are missing

ectodermal dysplasia

Complete Anodontia

lack of development of one or more teethPermanent: m3pm2max lateral mand central

Primary: max incisors

Hypodontia

lack of development of six or more teeth

Oligodontia

POSITION

Transposition

(1) Size

(2) Number

(3) Shape/Form

(4) Defects of Enamel and Dentin

Developmental Disturbances

joining of 2 developing tooth germs

resulting in a single large tooth structure

Fusion

Fusion

formation of 2 teeth from a single enamel organ

partial cleavage

Gemination(Twinning)

joined along the root surfaces

by cementum

more frequently in

posterior and maxillary regions

may occur before or after the

teeth have erupted

extraction of one may result in

extraction of the other

Concrescence

Taurodontism

angulation or a sharp

bend or curve in root

or crown of a formed tooth

trauma to a developing

tooth can cause root to form

at an angle to normal

axis of toothBull’s eye

Dilaceration

Dens Evaginatus(Leong’s Premolar

)

deep surface invagination of crown or root that is lined by enamel

2 forms:

coronal radicular

Dens Invaginatus (Dens in Dente)

Inverted tear drop

droplets of ectopic enamel

or so called enamel pearls

may occasionally be found on roots of teeth

uncommon, minor abnormalities, which are formed on normal teeth

Enamel Pearls

occur most commonly in

bifurcation or trifurcation

of teeth maxillary molars are

commonly affected than

mandibular molars may have a core of dentin

containing pulp horn may cause stagnation at

gingival margin but, if they

contain pulp, this will

be exposed when pearl is

removed

Enamel Pearls

D.D

Calculus/pulp stone

(1) Size

(2) Number and Eruption

(3) Shape/Form

(4) Defects of Enamel and Dentin

Developmental Disturbances

well-delineated additional cusp

located on the surface of an anterior tooth

Talon’s Cusp

TURNER’S HYPOPLASIA

Often Man. Pm ill defined radiolucency

D.D: anomalies in radiation therapy

characteristic of congenital syphilis

lateral incisors are peg-shaped or screwdriver-shaped

widely spaced

notched at the end

Hutchinson’s Incisor

dental condition usually

associated with congenital

syphilis

characterized by multiple

rounded rudimentary enamel

cusps on permanent 1st molars

dwarfed molars with cusps

covered with globular enamel

growths

giving the appearance of a

mulberry

Mulberry Molar

Amelogenesis Imperfecta

group of conditions caused by

defects in the genes encoding

enamel matrix proteins

affects both dentition

deciduous permanent

classified based on pattern of

inheritance:

hypoplasia hypomaturation hypocalcified

inadequate formation of matrix

reduced enamel thickness

abnormal contour absent interproximal

contact points

dentin + pulp chambers

appear normal

Hypoplastic Amelogenesis Imperfecta

PICKET FENCE IN ANT.

enamel is normal in form on

eruption but:

softer than normal tends to chip from

underlying

dentin snow-capped" teeth

Radiographically:

affected enamel exhibits

radiodensity similar to

dentin

Hypomaturation Amelogenesis Imperfecta

enamel matrix is formed in normal quantity

poorly calcified

when newly erupted:

enamel is normal in thickness normal form but weak opaque or chalky in appearance

Hypocalcified Amelogenesis Imperfecta

with years of function:

coronal enamel is removedeven less than dentin

abrasion to gingiva

Radiographically:

density of enamel is less than dentin

Hypocalcified Amelogenesis Imperfecta

affects both primary + permanent

dentition

have blue to gray

discoloration(a result of the obliteration the pulp chamber, which normally gives a pinkish coloration to the dentin)

Dentinogenesis Imperfecta

Type Ioccurs in families with

Osteogenesis Imperfecta

Type IIonly have dentin abnormalities

and no bone disease

Dentinogenesis Imperfecta

OSTEOGENESIS IMPERFECTA

Progressive osteopenia Bone fractures Blue sclera Wormain bone Dentinogenesis imperfecta Cl III Impaction of m1, m2

Radiographically:

bulbous crowns cervical constriction thin roots early obliteration of roots canals + pulp chambers

periapical lesion with no evidence of Caries

Dentinogenesis Imperfecta

rare disturbance of dentin formation

normal enamel

atypical dentin formation

abnormal pulpal morphology

Dentin Dysplasia

Classification:

Type I (Radicular Type)

Type II (Coronal Type)

Dentin Dysplasia

short roots(shallow w)

exfuliation with little trauma

pulp obliteration before eruption

periapical lesion with no evidence of Caries

Type I (Radicular Type)

II (coronal)Primary: like DIPermanent: normal clinically thistle tube pulp in inc. pm.

coronal pulps are usually large (thistle tube appearance)

filled with globules of abnormal dentin

Type II (Coronal Type)

DIFFERENTIAL DIAGNOSIS

Thistle tube in one-root tooth ?

Tooth with out roots?

Rarefying osteitis with no caries?

Bulbus crown with cervical constriction?

Odontogenesis Imperfecta Ghost Teeth

etiology is unknown(Developmental) one or several teeth in a

localized area are affected

maxillary teeth are involved

more frequently than

mandibular area

teeth affected may exhibit

a delay or total failure in

eruption

Regional Odontodysplasia

Radiographically:

marked reduction in

radiodensity teeth assume a “ghost”

appearance both enamel + dentin appear

very thin pulp chamber is exceedingly

largeDelayed eruption

Susceptible to caries

DD: D.I.

Regional Odontodysplasia

ATTRITION Physiologic wearing First functional cusps

Flat facets Reduced pulp chambers and canals

ABRASION

Brushing pm>can>inc

Dental floss deeper in dis.

EROSION

Chemical with out bacteria Edge smoother than abrasion

INTERNAL RESORBTION

Causes: Acute trauma/direct and indirect pulp cap/pulpotomy/enamel invagination

Pink mottleD.D: Bacc/ling caries External root resorbtion

EXTERNAL ROOT RESORBTION

Tooth root Unerupted tooth crownCause: Reimplantation, local inflammation, too much

mechanical forcesFeatures:

AP Blunting Normal supporting structures

HYPERCEMENTOSISCause:Super eruption

Too much occ forces

Inflammation

Paget/gigantism and acromegaly