Oral radiology ,white & pharoah, Dental anomaly, Chapter 19

1. Dr. Paknahad

2. CLASSIFICATION

4.  (1) Size
 (2) Number
 (3) Shape/Form
 (4) Defects of Enamel and Dentin
Developmental
Disturbances

5.  Microdontia
 Macrodontia
Size

6.  Microdontia
 (1) Generalized
Microdontia
 (2) Localized
Microdontia
Size

7.  all teeth are smaller than
normal
 pituitary dawrfism
(1) Generalized
Microdontia

8.  affects most often maxillary
lateral incisior + 3rd
molar
 these 2 teeth are most often
congenitally missing
 peg lateral
(2) Localized
Microdontia

9.  Macrodontia
 (1) Generalized
Macrodontia
 (2) Localized
Macrodontia
Size

10.  all teeth are larger than
normal
 associated with
pituitary gigantism
(1) Generalized
Macrodontia

11.  Hemangioma, Hemifacial
hypertrophy
(2) Localized
Macrodontia

12.  (1) Size
 (2) Number
 (3) Shape/Form
 (4) Defects of Enamel and Dentin
Developmental
Disturbances

13.  Supernumerary teeth ( Hyperdontia,
Supplemental)
 many are impacted
 cleidocranial dysostosis,
gardner syndrome
Number

14.  most common
supernumerary tooth
 tooth situated between
maxillary central incisors
Mesiodens

15.  situated bucally or lingually
to one of the maxillary
molars
Paramolar

16.  molar located distal to molar
Distomolar/Distodens

17.  when all teeth are missing
 ectodermal dysplasia
Complete Anodontia

18.  lack of development of
one or more teeth
Permanent: m3pm2max
lateral mand central
 Primary: max incisors
Hypodontia

19.  lack of development of
six or more teeth
Oligodontia

20. POSITION
 Transposition

21.  (1) Size
 (2) Number
 (3) Shape/Form
 (4) Defects of Enamel and Dentin
Developmental
Disturbances

22.  joining of 2 developing
tooth germs
 resulting in a single
large tooth structure
Fusion

23. Fusion

24.  formation of 2 teeth from a
single enamel organ
 partial cleavage
Gemination(
Twinning)

25.  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

26. Taurodontism

27.  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 tooth
Bull’s eye
Dilaceration

28. Dens
Evaginatus(Leon
g’s Premolar
)

29.  deep surface invagination
of crown or root that is lined
by enamel
 2 forms:
 coronal
 radicular
Dens Invaginatus
(Dens in Dente)

30.  Inverted tear drop

31.  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

32.  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

33.  D.D
Calculus/pulp stone

34.  (1) Size
 (2) Number and Eruption
 (3) Shape/Form
 (4) Defects of Enamel and Dentin
Developmental
Disturbances

35.  well-delineated additional
cusp
 located on the surface of
an anterior tooth
Talon’s Cusp

36. TURNER’S HYPOPLASIA
 Often Man. Pm
 ill defined radiolucency
 D.D: anomalies in radiation therapy

37.  characteristic of congenital
syphilis
 lateral incisors are peg-shaped
or screwdriver-shaped
 widely spaced
 notched at the end
Hutchinson’s Incisor

38.  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

39. 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

40.  inadequate formation of matrix
reduced enamel thickness
 abnormal contour
 absent interproximal
contact points
dentin + pulp chambers
appear normal
Hypoplastic
Amelogenesis Imperfecta

41. PICKET FENCE IN ANT.

42.  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

43.  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

44.  with years of function:
 coronal enamel is removed
even less than dentin
abrasion to gingiva
 Radiographically:
 density of enamel is less than
dentin
Hypocalcified
Amelogenesis Imperfecta

45. 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

46. Type I
occurs in families with
Osteogenesis Imperfecta
Type II
only have dentin abnormalities
and no bone disease
Dentinogenesis Imperfecta

47. OSTEOGENESIS IMPERFECTA
 Progressive osteopenia
 Bone fractures
 Blue sclera
 Wormain bone
 Dentinogenesis imperfecta
 Cl III
 Impaction of m1, m2

48.  Radiographically:
 bulbous crowns
 cervical constriction
 thin roots
 early obliteration of roots
canals + pulp chambers
 periapical lesion with
no evidence of Caries
Dentinogenesis Imperfecta

49.  rare disturbance of dentin
formation
 normal enamel
 atypical dentin formation
 abnormal pulpal morphology
Dentin Dysplasia

50.  Classification:
 Type I (Radicular Type)
 Type II (Coronal Type)
Dentin Dysplasia

51. short roots(shallow w)
exfuliation with little trauma
 pulp obliteration before eruption
 periapical lesion with
no evidence of Caries

Type I (Radicular Type)

52.  II (coronal)
Primary: like DI
Permanent: normal clinically
thistle tube pulp in inc. pm.

53.  coronal pulps are usually large
(thistle tube appearance)
 filled with globules of abnormal
dentin
Type II (Coronal Type)

54. DIFFERENTIAL DIAGNOSIS
 Thistle tube in one-root tooth ?
 Tooth with out roots?
 Rarefying osteitis with no caries?
 Bulbus crown with cervical constriction?

55. 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

56.  Radiographically:
 marked reduction in
radiodensity
 teeth assume a “ghost”
appearance
 both enamel + dentin appear
very thin
 pulp chamber is exceedingly
large
Delayed eruption
Susceptible to caries
DD: D.I.
Regional
Odontodysplasia

58. ATTRITION
 Physiologic wearing
 First functional cusps
 Flat facets
 Reduced pulp chambers and canals

59. ABRASION
 Brushing pm>can>inc
 Dental floss deeper in dis.

60. EROSION
 Chemical with out bacteria
 Edge smoother than abrasion

61. INTERNAL RESORBTION
Causes: Acute trauma/direct and
indirect pulp cap/pulpotomy/enamel
invagination
 Pink mottle
D.D:
 Bacc/ling caries
 External root resorbtion

63. EXTERNAL ROOT RESORBTION
 Tooth root
 Unerupted tooth crown
Cause:
 Reimplantation, local inflammation, too much
mechanical forces
Features:
 AP Blunting
 Normal supporting structures

65. HYPERCEMENTOSIS
Cause:
Super eruption
Too much occ forces
Inflammation
Paget/gigantism and acromegaly