Dentition Variation

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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
    • Image Upload 1
  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
    • Image Upload 2
  4. Peg Lateral and treatment
    Image Upload 3
  5. Over Retained Deciduous
    Image Upload 4
  6. Supernumerary Teeth
    • Common examples:
    • Mesiodens
    • Maxillary 4th molars
    • Image Upload 5
  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
    • Image Upload 6
  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
    • Image Upload 7
  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!
    • Image Upload 8
  18. Dens in Dente
    • “tooth within a tooth”
    • Deep enamel-lined pit that extends into the tooth
    • Image Upload 9
    • Image Upload 10
  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)
    • Image Upload 11
    • Image Upload 12
  20. Congenital Syphilis
    • Hutchinson’s (screw driver) Incisors
    • Mulberry molars
    • Image Upload 13
  21. Enamel Pearl
    • Round enamel growth on root of tooth
    • Image Upload 14
  22. Cervical Enamel Projection
    • Apical extension of enamel beyond the normal smooth CEJ margin
    • This can cause deep periodontal pocket formation
    • Image Upload 15
  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)
    • Image Upload 16
  24. Dilaceration
    • Sharp bend in the tooth root
    • Usually caused by trauma during root development
    • Image Upload 17
  25. Excess Cementum
    • Hypercementosis
    • Excessive deposits of cementum on the root
    • Do we have to treat teeth with excess cementum?
    • Image Upload 18
  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

    Image Upload 19
  28. Tetracycline Staining (Intrinsic)
    • Ingestion of tetracycline during pregnancy or early childhood, while the teeth are still developing
    • Is this reversible?
    • Image Upload 20
  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?
    • Image Upload 21
  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

    Image Upload 22
  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

    Image Upload 23
  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

    Image Upload 24
  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
    • Image Upload 25
  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
    • Image Upload 26
  43. Concresence
    Union of rootsof 2 or more teeth (confluent cementum)

    Image Upload 27
Card Set
Dentition Variation
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