Dental anomalies

Dental anomalies:

D r.suffiyan saleem M.Phil - oral pathology University of health sciences,Lahore PAKISTAN Dental anomalies

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Definition Dental anomalies are craniofacial abnormalities of form, function, or position of the teeth, bones, and tissues of the jaw and mouth.

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Classification of dental anomalies

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I. ALTERATIONS IN NUMBER OF TEETH Anodontia Supernumerary teeth Mesiodens

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ANODONTIA congenital absence of teeth because of failure of development of tooth germs Total anodontia is rare Partial anodontia ( hypodontia ) is more common

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SUPERNUMERARY TEETH Supernumerary teeth are additional number of teeth, over and above the usual number for the dentition Mostly seen in Gardner's syndrome, cleidocranial dysostosis syndrom Cleft(palate (or cleft lip)

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MESIODENS Mesiodens is a supernumerary tooth that occurs in the anterior maxilla Mostly between maxillary central incisors. one of the major cause of diastema .

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II. ALTERATIONS IN SIZE OF TEETH Macrodontia Microdontia

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Macrodontia megadontia teeth that are larger than normal hemifacial hypertrophy can cause crowding in primary n permanent dentition

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MICRODONTIA teeth that are smaller than normal Most common maxillary lateral incisors or maxillary third molars occur in a condition known as pituitary dwarfism. Can cause spacing in primary n permanent dentition

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III. ALTERATIONS IN SHAPE OF TEETH Fusion ( Synodontia ) Gemination Concrescence Dens in dente ( dens invaginatus ) Dens evaginatus Talon cusp Taurodontism Dilaceration Hypercementosis Enamel Pearl Attrition Abrasion Erosion

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FUSION ( Synodontia ) union of two or more adjacent tooth germs must involve the dentin cause is unknown, Clinically, a fusion results in one less tooth in the dental arch The involvement of a supernumerary tooth makes it difficult to differentiate fusion from gemination .

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GEMINATION incomplete attempt of a tooth germ to divide into two. Tooth has two crowns or a large crown partially separated Single (common) root and root canal Etiology of this condition is unknown one more tooth in the dental arch

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CONCRESCENCE fusion occurring after root formation has been completed, teeth united by their cementum . Mostly association with the maxillary second and third molars difficulty in tooth extraction

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DENS IN DENTE (Dens invaginatus , Dilated composite odontome ) invagination of the calcified layers of a tooth into the body of the tooth Also called tooth within a tooth Can cause development and spread of dental caries maxillary lateral incisor is the most frequently affected tooth

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DENS EVAGINATUS tubercle or cusp located in the center of the occlusal surface affect predominantly premolar and molar teeth tubercle wears off relatively quickly causing early exposure of the accessory pulp horn that extends into the tubercle

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TALON CUSP accessory cusp located on the lingual surface of maxillary or mandibular teeth pattern resembling an eagle's talon . maxillary central or lateral incisor are often involved

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TAURODONTISM crowns of normal size and shape but have large rectangular bodies pulp chamber is dramatically increased in its apico-occlusal heights apically displaced furcations short roots and pulp canals involves molar tooth seen in association with amelogenesis imperfecta . not recognizable clinically but on a radiograph,

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DILACERATION Abnormal bend in the root of a tooth exact cause is not known result of trauma to a developing tooth difficulties during extraction or root canal therapy.

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HYPERCEMENTOSIS excessive build-up of cementum around tooth evident on a radiograph affects vital teeth exect cause not known mostly seen in periapical inflammation, tooth repair and teeth that are not in occlusion

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ENAMEL PEARL ( Enameloma ) ectopic mass of enamel usually found at the furcation area of roots molars are more frequently affected (maxillary > mandibular ) mistaken for calculus pearl appears as a well-defined round radiopacity .

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ATTRITION, ABRASION, EROSION surfaces physiologic wear of different teeth

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Attrition is an age-related process conditions such as dentinogenesis imperfecta and amelogenesis imperfecta may result in increased attrition process slowly enough to allow for pulpal recession. radiographic appearance is smooth wearing of the incisal and occlusal surfaces

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Abrasion loss of tooth structure from mechanical wear, that is, from friction of a foreign body on a tooth surface. common cause is vigorous toothbrushing or use of abrasive dentifrice. Process slowly enough to allow for pulpal recession.

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Erosion loss of tooth structure that results from a chemical action not involving a bacterial process involves all surfaces of teeth contact with acidic foods and beverages Regurgitation of gastric contents ,beverages and citric juices produces generalized erosion of teeth not seen on radiographs

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Submerged teeth Impacted teeth Transposed teeth Ankylosed teeth V. ABNORMALITIES IN POSITION OF TEETH

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SUBMERGED TEETH retained deciduous tooth (usually a molar) with its occlusal surface at a lower level than the adjoining permanent teeth tooth is usually ankylosed

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IMPACTED TEETH tooth which is prevented from erupting due to crowding or from some physical barrier or abnormal eruption path very rare for the incisors and first molars to be impacted third molar is the most commonly impacted tooth impacted tooth has the potential to develop a cyst ( dentigerous cyst) or a neoplasm ( ameloblastoma ).

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TRANSPOSED TEETH two teeth that have exchanged their positions in the dental arch. canine is most often involved, its position interchanged with the first premolar Second premolars are infrequently found between the first and second molars does not occur in primary dentitions

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ANKYLOSED TEETH fusion of the cementum to the surrounding bone There is no PDL present extremely difficult to extract

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Amelogenesis Imperfecta Dentinogenesis Imperfecta Dentinal Dysplasia Odontodysplasia VI. DEFECTS OF ENAMEL AND/OR DENTIN

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AMELOGENESIS IMPERFECTA disturbance in the ectodermal layers of developing teeth hereditary abnormality affect either the primary or the permanent dentition. soft enamel starts to fracture. Dark brown color enamel has the same radiopacity as the dentin, and the two cannot be differentiated on a radiograph

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DENTINOGENESIS IMPERFECTA a hereditary abnormality in the formation of dentin teeth varies from gray to brownish violet to yellowish brown color crown fractures easily because of abnormal DEJ pulp chambers and root canals may be partially or completely obliterated Radiographically , the teeth exhibit thin, short roots

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DENTINAL DYSPLASIA Dentinal dysplasia is a hereditary abnormality subdivided into type I or radicular type; (also known as rootless teeth) affects primarily the root portion On a radiograph, short conical roots periapical lesions without any obvious cause Premature tooth loss may occur because of short roots type II or coronal type. (also known as coronal dysplasia) affects primarily the pulp chambers frequently contain pulp stones

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Environmental causes Tetracycline Fluorosis Coffee , tea, and red wine Scurvy ( vit.c def )

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THANX ALOT