CONGENITAL AND DEVELOPMENTAL DEFECTS OF TEETH.pptx

Classification and explanation of congenital and developmental abnormalities of teeth.

1. DEVELOPMENTAL DEFECTS OF TEETH PRENISHA.F.P PG STUDENT

2. CONTENTS: Introduction Classification

3. CLASSIFICATION: Size Shape Number Structure Disturbance in eruption Microdontia Macrodontia Gemination , Fusion . Concrescence. Dilaceration . Talon cusp. Dens-in-dente. Dens e vaginatus Taurodontism . Missing teeth supernumerary Amelogenesis imperfecta . D entinogenisis imperfecta . Dentin dysplasia Transposition Premature /Delayed eruption

4. MICRODONTIA True generalized Relative generalized Localized

5. MACRODONTIA True generalized Relative generalized Localized

6. SUPERNUMERARY TEETH Arise from extra-teeth buds. Rare in deciduous teeth. May resemble the tooth anatomically or not.

7. Mesiodens Paramolars

8. ANODONTIA ETIOLOGY Hereditary Radiation

9. TRANSPOSITION Permanent canine and 1st premolar. Second premolar (between 6 & 7). Central & lateral incisors.

10. GEMINATION A single tooth bud divides by an invagination Partial division T ooth with a single root and a crown that is divided totally or partially. Complete division complete separation with formation of 2 teeth with crowns and roots

11. CLINICAL IMPLICATIONS: Poor esthetics due to a partially divided tooth. Hypoplastic enamel and increased caries susceptibility Malocclusion and periodontal problems.

12. FUSION Union of two normally separated teeth. Types 1- Fusion occurs early before calcification: The tooth formed is one single large tooth. 2- Fusion occurs late after calcification: There may be union in the roots only with two separate or single root canal

13. CONCRESCENCE It is a form of fusion but by cementum only. Etiology Trauma and crowding of teeth with resorption of interdental bone so that teeth are united with deposition of cementum . It may occur before or after development of teeth (true & acquired).

14. TAURODONTISM Bull-like teeth. Describes the increase in length of the crown on the expense of root with elongated pulp chamber so, it shows increase distance between the CEJ and root furcation.

15. Radiographic features 1.Tooth rectangular in shape. 2. Large elongated pulp chamber. 3. Lack of usual constriction at cervical area. 4. Furcation is few mms away from the apex (short root)

16. DILACERATION This term refers to an angle or sharp bend either in the crown or root. Etiology : Developmental or could be due to trauma Trauma of deciduous teeth may cause dilaceration of the permanents. Site : Any where in the root and may be in the crown. More in maxillary anterior teeth.

17. Clear angulation Buccal or lingual dilaceration Distal dilaceration

18. DENS IN DENTE: It is due to enfolding of the enamel organ to the interior during development and before calcification. Etiology : 1- Focal growth stimulation or focal growth retardation in certain areas. 2- External trauma. Site : Most common in crowns, but may be in the roots due to folding of epithelial root sheath of Hertwig . It Appears as a palatal pit.

19. TYPES: Clinical significance : The palatal pit is difficult to clean. very thin enamel separate the defect from the pulp chamber. There is a risk of caries and pulp necrosis.

20. DENS EVAGINATUS: Clinical significance : The palatal pit is difficult to clean. very thin enamel separate the defect from the pulp chamber. There is a risk of caries and pulp necrosis .

21. Radiographically : extension of pulp covered by Enamel & Dentin. Significance: occlusal interference. prevention of complete eruption of the opposing tooth. wearing with subsequently pulp exposure.

22. TALON’S CUSP: It is projecting from the cingulum of upper or lower anterior teeth. Clinical Picture Surrounded by 2 grooves. Blends to the surface of the tooth. Significance * May Interfere with occlusion. * Caries susceptibility

23. ENAMEL PEARL: Is a small globule of enamel1-3 mm in diameter that occurs on the roots of molars (furcation area). Differential diagnosis: 1. Isolated piece of calculus 2. Pulp stone

24. AMELOGENESIS IMPERFECTA: Developmental anomaly that affects enamel formation. Marked changes in e namel in either part or all the teeth in both dentitions. Dentin and roots are usually normal. Causes delayed eruption of the affected teeth. Increases tendency for impaction

25. TYPES E. Hypoplastic type in matrix formation. E. Hypocalcification in mineralization. E. Hypomaturation . Hypomaturation Hypocalcifid type. (mottled E).

26. Hypomaturation type (generalized white opacities with brownish discolorations on upper central incisors ) ( b) Hypomaturation type (generalized yellowish opacities). ( c) Hypomaturation type, mixed dentition. Chipping of enamel. (e) Hypoplastic type (rough, pitted). ( f) Hypoplastic type (rough, vertical grooves). ( g) Hypoplastic type (rough, thin enamel)

27. DENTINOGENESIS IMPERFECTA Hereditary opalescent dentin It is a developmental anomaly affecting dentin in both sexes and both dentitions

28. Types of Dentinogenesis imperfecta Type I - DI with OI. Type II - DI without OI. Type I: More in deciduous teeth > permanent Type II: Equal in both .

29. General clinical picture (DI ) opalescent dentin Tooth Color : Teeth vary in color from brownish, yellowish brown or to even violet with unusual translucency . Enamel: May be lost due to abnormal DEJ, so dentin undergo discoloration and rapid attrition.

30. RADIOGRAPHIC PICTURE: Bulbous teeth with variable degrees of attrition. In the early stage of development, the pulp appears more wide then quickly shows calcification. Partial or total obliteration of pulp due to deposition of dentin in both deciduous and permanent teeth. Short blunted roots. Occasionally associated with multiple periapical R L. without actual pulp exposure but not as frequent as in Dentin dysplasia

31. Dentin Dysplasia (Rootless teeth) Very rare, characterized by normal enamel, defective dentin, abnormal pulp morphology. Very short conical roots with obliteration of pulp. Associated with periapical radiolucency.

32. Type I (Radicular) Roots are either short or of abnormal shape ( specules ). Obliteration of pulp before eruption . Associated with periapical radiolucencies . Teeth of normal color Teeth malalignment Tooth exfoliation

33. Type II (Coronal ) Crowns as in DI Obliteration of pulp after eruption Pulp chambers may become flame-like shaped. Anterior teeth and premolars may develop thistle-tube shaped pulp chamber.

34. Regional Odontodysplasia ( Ghost teeth) It is a relatively rare disorder of unknown etiology affecting both enamel & dentin of both dentitions. Enamel and Dentin are both hypoplastic and hypocalcified . Results in arresting development of the involved teeth. One or several teeth in a localized area are affected.

35. Clinically: It affects maxillary anterior teeth more than mandibular. Central > lateral > canine. Teeth have irregular shape with defective mineralization. Teeth show delayed eruption. Increase incidence of caries, pulp infection and tooth fracture.

36. Radiographically : Thin Enamel & Dentin with large pulp. Sometimes Enamel is very hypo-dense so that it may not be evident on radiographs.

37. Turner’s Hypoplasia Usually involve single tooth. Permanent > deciduous. Ranges from mild discoloration or pitting of E, to severe defects and abnormal anatomy. Due to infection or trauma to deciduous .

38. Congenital Syphilis Affects permanent dentition more than deciduous. Deciduous teeth are usually normal as abortion would occur if treponeamal spirochetes get access through the placenta to the fetus.

39. CLINICAL PICTURE: Anterior teeth : Hutchinson’s teeth. #1 >#2 >#6 Screw driver with rounding of the mesial and distal incisal angles. Notching of the incisal edge. Molars: Mulberry molars or Moon's molars Narrow crown with globular shaped cusps

40. CONCLUSION