Dental Anomalies II new.pdf

7/26/2019 Dental Anomalies II new.pdf

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Anomalies of Structure Enamel

Dentin

Cementum


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Enamel Tooth structure abnormalities result from disruption

during the histodifferentiation, apposition, andmineralization stages of tooth development.

Enamel defects manifested as:

Hypoplasia

Hypocalcification

Can be:Heritable defects

Environmental defects


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Hypoplasia: disturbance of matrix deposition,characterized by irregular enamel in thickness ordeficient in structure.

Hypocalcification: disturbance in mineralization,characterized by normal enamel in thickness but partof it is poorly mineralized


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Amelogenesis Imperfecta Distinct patterns of inheritance.

Defective enamel, so on radiograph the pulpal outline

appears normal and root morphology. Hypoplastic vs hypomaturation vs hypocalcified


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Hypoplastic AmelogenesisImperfecta

Occurs in histodifferentiation

stage of tooth developmentThin Enamel resulting in highsensitivity to thermal stimuli

Lack of contact points between

teethRough smooth or randomlypitted enamel


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Hypomaturation AmelogenesisImperfecta

Defect in enamel matrix

apposition normal enamel thickness

a low value of radiodensity andmineral content

porous surface that becomesstained


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HypocalcificationAmelogenesis Imperfecta

Defect in the calcification

stage of enamel formation Qualitatively the matrix is

poorly calcified with aresultant fracturing of the

enamel surface exposingdentin surface especially atincisal edge


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Environmental Enamel HypoplasiaSystemic causes

Nutritional deficiencies (Vit. A ,C, D, Ca+ PO4)

Severe Infections, Fever ( Rubella , Syphilis ..)Asthma

Neurologic defects as cerebral palsy

Radiation

Flouride

Syndromes ??


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Localized Enamel Hypoplasia Local infection,

Local trauma,

Iatrogenic surgery as occurs in cleft palate closure Primary tooth overretention.


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Turner hypoplasia Turner hypoplasia is a

classic example ofhypoplastic defects inpermanent teethresulting from localinfection or trauma tothe primary precursor


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Pre-operativePost-operative


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Full mouth rehabilitation of

Amelogenesis Imperfecta


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DentinDentinogenesis Imperfecta

defect during the histodifferentiation stage of toothdevelopment

defect of predentin matrix results in amorphic,disorganized, and atubular circumpulpal dentin(which is high in organic content and containsinterglobular calcification)

The mantle dentin is normal.


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Dentinogenesis Imperfecta Shields type 1 occurs with osteogenesis imperfecta.

Defect in collagen formation

Blue sclera, brittle bones, bowing of limbs Periapical radiolucencies

Bulbous crowns

Obliteration of pulp chambers

Root fractures


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Dentinogenesis Imperfecta Shields type 2, (hereditary opalescent dentin)

Periapical radiolucencies

Bulbous crowns Obliteration of pulp chambers

Root fractures


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Dentinogenesis imperfecta (Hereditary opalescent dentine)


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Dentinogenesis Imperfecta Shields type 3

a predominance of bell-shaped crowns

involves teeth with a shell-like appearance andmultiple pulp exposures.

It has occurred exclusively in a triracial isolated groupin Maryland known as the Brandywine population


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Dentin Dysplasia Inherited dentin disorders resulting in characteristic

features involving the circumpulpal dentin and rootmorphology.


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Dentin DysplasiaShields type 1 (Radicular Dentin

Dysplasia, rootless teeth)

Normal crown morphology with

an amber translucency). The roots tend to be short and

sharply constricted.

Multiple periapical

radiolucencies and absent pulpchambers.


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Dentin DysplasiaShields type 2

Involves amber-colored primary teeth closelyresembling dentinogenesis imperfecta

Permanent teeth appear normal, but radiographicallythey demonstrate thistle-tube-shaped pulp chamberswith multiple pulp stones

no periapical radiolucencies are visible


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Regional Odontodysplasia Localized arrest in tooth development thought to

result from a regional vascular developmentalanomaly.

Affected teeth have thin layers of poorly calcifiedenamel and dentin with large, diffusely calcified pulpchambers and shortened, poorly defined roots


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Regional Odontodysplasia Ghost teeth radiographic appearance with shortened

roots and shell-like crowns


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Cementum Epidermolysis bullosa dystrophica, an inherited

vesicular and bullous disease of the skin and mucousmembranes,

involves formation of fibrous, poorly calcified acellularcementum and overproduction of cellular cementum.


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Hypophosphatasia

Failure of bone to mineralize properly, which isassociated with low serum alkaline phosphatase levels.

Osteoporosis

bone fragility

premature loss of primary incisors

Failure of cementum formation


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REFERENCES:

Pediatric Dentistry : Infancy through AdolescencePinkhamCh. 4 (Anomalies of Developing Dentition)

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Dental Anomalies II new.pdf