developmental anomalies of the teeth, specific and non – specific disorders of hard dental tisuess...
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Developmental anomalies of the teeth, specific and non –
specific disorders of hard dental tisuess
6 DM
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Developmental anomalies
- tooth development is strict under genetic control
- disturbances in tooth development result from gene mutation
- tooth development may be disturbed at different stages of morphogenesis
- definitive result depends on the timing and the type of insult
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Developmental anomalies
Disturbances in tooth development:
numerical variations (missing or supernumerary teeth)
variations in size of teeth
variations of shape of teeth
disturbances in eruption
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Developmental anomalies
Numerical variations
1.Hypodontia
- number of teeth is decrease
- the most commonly missing teeth are:
the third molars, second premolars, maxillary lateral incisors
- oligodontia, anodontia, agenesis
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Developmental anomalies
Numerical variations
1.Hypodontia in deciduous dentiotion:
- prevalence 0.1 – 0.7%
- central incisors
- oligondontia and anodontia is rare, may be found in connection with ectodermal dysplasia
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Developmental anomalies
Ectodermal dysplasia:
- describes a group of developmental, often inherit, disorders involving the ectodermally structures(hair,teeth, nails, skin and sweat glands)
- presentation:multiple missing teeth, fine, sparse hair, dry skin, maxillary hypoplasia, eversion of the lips, pigmentation around the mounth and eyes. The teeth are conical, small, often with a large diastema.
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Developmental anomalies
Numerical variations
1.Hypodontia in permanent dentiotion:
- prevalence 6 – 10%
- usually affects 2 or more teeth in 50% of the cases
- often occures symmetrical hypodontia
- particular relation with the microdontia
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Developmental anomalies
Solitary median maxillary central incisor syndrome
- is very rare
- midline symetrical maxillary central incisor
- can be associated with cleft palate, choanal stenosis, umbilical hernia, hypoplasia of sella turcica, pituitary dysfunction, growth hormone deficiency
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Developmental anomalies
Numerical variations
2. Hyperodontia
- number of the teeth is increse
- is quite rare as hypodontia
Frequency: primary teeth 0,3 - 0,8%
permanent teeth 1,0 – 3,5%
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Developmental anomalies
Numerical variations
2. Hyperodontia
- shape is conical or normal
- supernumerary teeth can erupt or cause anomalous eruption of neighbouring teeth
- most frequent is mesiodens
- part of syndrom cleidocranial dysplasia
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Developmental anomalies
Cleidocranial dysplasia:
- short stature
- aplasia or hypoplasia of clavicles
- delayed ossification
- delayed eruption of teeth
- dentigerous cyst formation
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Developmental anomalies
a) Dentes praelactales
- frontal region in a newborns
- no roots
Th: extraction
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Developmental anomalies
Variations in tooth size:
1. Macrodontia
- teeth are larger than normal
- true macrodontia involving the whole dentition
2. Microdontia
- one or more teeth are smaller than normal
- most affect the maxillary third molars
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General microdontia: is a rare conditionoccuring in connection with congenital
Local microdontia: involving single teeth, associated with hypodontia
3. Rhizomicry
-lenght of the root is shorter than the height of the crown
-connected with osteoporosis
- predominantly affecting maxillary incisors and premolars
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Developmental anomalies
Variations on tooth shape
1. Dens invaginatus
- malformation due to an invagination of enamel epitelium resulting in a chanel or lumen surrounded by hard tissues within the tooth. The anomaly occurs most frequently in the palatal surface of max. lateral incisor.
2. Conical peg-shaped tooth
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Developmental anomalies
Variations on tooth shape
3. Taurodontism
- elongated root- stem with the furcation more apical than normally
4. Double formation of teeth
a) concrescence- two normal appearing crowns are present and the fusion involves only the cementum
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Developmental anomalies
Variations on tooth shape
b) Fusion – union in dentin and/or enamel between two or more normal teeth
c) Gemination – incomplete division of a tooth germ or a union between normal and a supernumerary tooth
5. Dnes evaginatus
- is an extra cusp, usually in the central groove or ridge of a posterior teeth and in the cingulum of the central or lateral incisor
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Developmental anomalies
6. Dens in dente
- is a condition resulting from invagination of the inner enamel epithelium producing the appearance of a tooth within a tooth
7. Dilaceration
- an abnormal bend of the rooth during its development and is thought to result from a traumatic episode
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Developmental anomalies
Variations in tooth eruption
a) tooth retention
b) tooth semiretention
c) anomalous position after eruption
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Non – specific disorders of hard dental tisuess
1) Hypoplasia
2) Hypomineralization
Hypoplasia:
Ethiology:- metabolic disorders, fever, endocrinic disease,trauma, inflammation
Cl. picture: anomalous shape of dental crown, grooves and fissures, color-dark brown, yellowbrown.
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Non – specific disorders of hard dental tisuess
Hypomineralization:
Ethiology:- metabolic disorders, fever, endocrinic disease,trauma, inflammation
Cl. picture: normal shape of dental crown, in hard dental tisuess are quality changes. Color- white or brown smudges, localization on labial surfaces of incisors
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Specific disorders of hard dental tisuess
Dysplasia of hard dental tisuess
1.DENTIN DYSPLASIA
Ethiology: ingestion of chemicals, prematurity birthweight, severe malnutrition, bilirubinemia
Typ I: radicular dentin dysplasia or rootless tooth
Typ II: anomalous dysplasia of dentin with frequent discoloration of primary teeth, permanent teeth often appear normal clinically but have thistle-tube formed pulp chamber. Pulp stones may occure.
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Specific disorders of hard dental tisuess
2. Fluoride induced defect
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Specific disorders of hard dental tisuess
3. Tetracycline defects
- TTC has a strong affinity to mineralized tisuess, primary to dentin and bones
- dentin defects are persistent
- discolored horizontal bands may appear gray, bluish
- discolored enamel has some translucency left
- this ATB shoud not be prescribed to children below the age of 8, pregnant women, lactating mothers
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Specific disorders of hard dental tisuess
4. Molar – incisor hypomineralization
- demarcated opacities in the perm. first molars, perm. incisors are often also involved
- may affect one or all molars and one or more incisors
- creamy white spot to yelowish brown discoloration
- defect are porous
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Specific disorders of hard dental tisuess
Subj. symptoms:
- shooting pain during brushing teeth or breathing cold air
Ethiology:
- unknown, but suggestion are: medical problem related to birth, respiratory diseases during first 3 years of life
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Specific disorders of hard dental tisuess
Amelogenesis imperfecta
Definition:AI represents a roup of condition, genomic in origin, which affect the structure and clinical appearance of the enamel of all or nearly all teeth in a more or less equal manner, and which may be associated with morphologic or biochemical changes elsewhere in the body.
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Specific disorders of hard dental tisuess
- autosomal dominant, autosomal recessive
- incidence 1 in 14 000
- 4 major categories, 14 subtypes
General manifestation:
- normal intelligence, good general health
Craniofacial/dental manifestation:
- enamel defect that affects both dentitions, appearance is yellow- brown to orange depending on subtyp
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Specific disorders of hard dental tisuess
Typ I:- hypoplastic (occuring in the histodifferation stage of tooth development, insufficient quantity of enamel is formed)
TypII:- hypomaturation (defect of in enamel matrix apposition)
Typ III:- hypocalcified (enamel is normal, but qualitatively the matrix is poor calcified with a resultant fracturing of the enamel surface. Hypocalcified enamel is soft and fragile, especially at the incisal region, and is easily fractured, exposing dentin.
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Specific disorders of hard dental tisuess
Typ IV:- hypomaturation, hypoplastic with taurodontism (the enamel appears mottled with a yellow-brown color and is pittedon the facial surfaces. Molar teeth demonstrate taurodontism.
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Specific disorders of hard dental tisuess
Dentinogenesis imperfecta
Defect of predentin matrix that result amorphic, disorganized, and atubular circumpulpal dentin.
- incidence 1 in 8000
- 3 basic types
Shields type 1
Shields type 2
Shields type 3
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Specific disorders of hard dental tisuess
Shields type 1
- occurs with AI
- inherit defect in collagen formation
- osteoporotic brittle bones
- bowing of the lips
- blue sclera
- bitemporal bossing
- obliteration of pulp chamber,periapical radiolucencies, bulbous crowns, root fractures
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Specific disorders of hard dental tisuess
Shields type 2
- hereditary opalescent dentin
- autosomal dominant
- affect primary and permanent dentition
Shields type 3
- is rare, bell-shaped crown,
- it has occured exclusively in a triracial isolated group in Maryland
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Specific disorders of hard dental tisuess
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Specific disorders of hard dental tisuess