Dentition Variation

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Author:
emm64
ID:
114084
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Dentition Variation
Updated:
2011-11-02 19:51:43
Tags:
Morphology Variations Abnormal Dentition
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Morphology
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  1. ´╗┐Dental Anomaly Trends
    • more common in:
    • The permanent dentition than in the primary dentition
    • The maxilla than in the mandible
  2. Macrodontia
    • Can affect one or all teeth
    • Relative vs. generalized
  3. Microdontia
    • Common examples: peg lateral, small third molar
    • Localized (i.e. 1 tooth affected) is very common
    • Generalized is rare and usually associated with a disorder like Dwarfism or Down’s Syndrome
    • Strong genetic component
  4. Peg Lateral and treatment
  5. Over Retained Deciduous
  6. Supernumerary Teeth
    • Common examples:
    • Mesiodens
    • Maxillary 4th molars
  7. Hypodontia
    missing 6 or fewer teeth, excluding the 3rd molars
  8. Oligodontia
    missing >6 teeth, excluding the 3rd molars
  9. Anodontia
    missing all teeth
  10. Most common congenitally missing teeth
    • Within a specific tooth type, the most likely tooth to e missing is the most distal within that group
    • 3rd molars (maxillary > mandibular)
    • Maxillary lateral incisors
    • Mandibular 2nd premolars
  11. CoDiagnosis Supernumerary
    • Gardner’s Syndrome
    • Cleidocranial Dysplasia
  12. Co-Diagnosis Missing
    • Ectodermal Dysplasia
    • Down Syndrome (Trisomy 21)
    • Rubella Infection
    • Cleft Lip/Palate
  13. Gemination
    • Partial division of a single tooth germ
    • Crown is partially separated, but there is only one root
  14. Supernumerary Teeth Treatment
    Extract, as needed, for esthetics and/or function
  15. Missing Teeth Treatment
    Implants, fixed partial denture, removable dentures (partial or complete)
  16. Gemination/Fusion Treatment
    • Esthetic re-contouring with direct composite, veneers, or crowns
    • If doing a RCT, be aware of pulp canal anatomy
  17. Supernumerary Roots
    • Any tooth can have an extra root(s)
    • The anterior tooth most commonly affected is the mandibular canine:
    • 1 facial root
    • 1 lingual root
    • If performing a RCT or extraction, you need to know how many roots!
  18. Dens in Dente
    • “tooth within a tooth”
    • Deep enamel-lined pit that extends into the tooth
  19. Talon Cusp
    • An excess growth of cingulum in the shape of a talon (claw)
    • No Treatment typically needed, unless:
    • Sharp cusp irritates patient – Tx: enameloplasty
    • Be CAREFUL….cusp may have a pulp horn!
    • Defective grooves – Tx: sealant (or restoration if carious)
  20. Congenital Syphilis
    • Hutchinson’s (screw driver) Incisors
    • Mulberry molars
  21. Enamel Pearl
    • Round enamel growth on root of tooth
  22. Cervical Enamel Projection
    • Apical extension of enamel beyond the normal smooth CEJ margin
    • This can cause deep periodontal pocket formation
  23. Taurodont
    • A tooth with an elongated crown and apically placed furcation of the roots
    • Likely dut to delayed invagination of Hertwig's root sheeth
    • was commin in Neanderthal man (atavism)
  24. Dilaceration
    • Sharp bend in the tooth root
    • Usually caused by trauma during root development
  25. Excess Cementum
    • Hypercementosis
    • Excessive deposits of cementum on the root
    • Do we have to treat teeth with excess cementum?
  26. Biologic Staining (Intrinsic)
    • Caused by:
    • Pulp Necrosis (gray)
    • Acute Trauma (pink)
    • Root Fracture (pink)
    • Internal Root Resorption (pink or gray)
    • Color change is due to break down of blood cells within the pulp
  27. Disturbances in Color
    • Stains can come from inside or outside of the teeth!!
    • From Inside = Intrinsic Staining
    • From Outside = Extrinsic Staining

  28. Tetracycline Staining (Intrinsic)
    • Ingestion of tetracycline during pregnancy or early childhood, while the teeth are still developing
    • Is this reversible?
  29. Color can hint at a diagnosis: Congenital porphyria
    Pinkish-brown and glow scarlet under UV light
  30. Color can hint at a diagnosis: Cystic Fibrosis
    Yellowish-gray to dark brown
  31. Color can hint at a diagnosis: Erythroblastosis fatalis
    Blue-green primary teeth
  32. Color can hint at a diagnosis: Hyperbilirubinemia
    Yellow-green tint
  33. Color can hint at a diagnosis: Tetracycline therapy
    Yellow-brown and gray-black rings
  34. Fluorosis (Intrinsic)
    • You can have too much of a good thing!
    • Is this caused by excess topical fluoride or ingestion of excess fluoride?
    • Is this reversible?
  35. Extrinsic Staining
    • Caused by:
    • Diet
    • Smoking
    • Wine
    • Coffee/tea
    • Staining of plaque
  36. Enamel Hypoplasia
    • A defect in the tooth enamel that causes a decrease in the quantity or quality of the enamel (developmental defect)
    • Defect may:
    • Be a small pit or can affect the whole tooth
    • Affect one or all of the teeth

  37. Regressive Changes
    • Attrition: loss of tooth structure due to tooth to tooth contact
    • Abrasion: loss of tooth structure due to mechanical means
    • Erosion: loss of tooth structure due to chemical action
    • Attrition
    • Abrasion
    • Common sites:
    • Cervical thirds of teeth, especially on the buccal
    • Incisal edges
    • Once gum recession occurs, likelihood of abrasion increases
  38. Attrition
    • loss of tooth structure due to tooth to tooth contact
    • Wear typically benins on incisal edges or cusp tips
    • if mild-stays in enamel
    • if severe-wear extends into dentin
    • opposing teeth facets tend to match perfectly whin in occlusion or when jay is shifted to a habitual position

  39. Abrasion
    • loss of tooth structure due to mechanical means
    • Common sites:
    • Cervical thirds of teeth, especially on the buccal
    • Incisal Edges
    • Once Gum Recision Occurs, likelihood of abrasion increases

  40. Erosion
    • loss of tooth structure due to chemical action
    • Due to acid in:
    • Foods
    • Beverages
    • Stomach acid
    • In pregnant women who experience morning sickness and in bulimic patients, erosion is commonly seen at lingual surfaces of maxillary anteriors
  41. Abfraction
    loss of tooth structure from flexural forces???
  42. Fusion
    • Union of two separate tooth germs
    • Teeth share confluent dentin
    • most typically in anterior teeth
  43. Concresence
    Union of rootsof 2 or more teeth (confluent cementum)

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