lecture 4 (part1) Disorders of Teeth Other Than Cariess (slide)

8/3/2019 lecture 4 (part1) Disorders of Teeth Other Than Cariess (slide)

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Disorders of teeth

other than caries


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Disorders of eruption and shedding

Natal and neonatal teeth:

Normal tooth germs in superficial locationssubsequently..prematurely erupt.

Enamel and dentine: normal Enamel may be hypoplastic

Absence of root formation (dentine,

cementum)Prognosis: lost spontaneously or need to be

extracted


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Retarded eruption

Endocrynopathies

Nutritional deficiencies

Chromosomal abnormalities: Downsyndrome

Traumatic displacement of tooth germs

Abnormally large crownsCleidocrainial dysplasia


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Premature loss

Causes:

Dental caries

Periodontal disease

hypophosphatasia


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Persistence of deciduous teeth

Failure of eruption of permanent teeth

Missing

Displaced

entire dentition: in cleidocrainial dysplasia


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Impaction of teeth

Unerupted or partially erupted beyond the time ofnormal full eruption

Third molars, mandibular premolars, maxillary canines Local Causes:

Abnormal position of tooth germ

Lack of space in the jaws

Supernumerary teeth, cysts, tumors

Complications:

Resorption of impacted teeth or adjacent erupted teeth

Development of odontogenic cysts and tumors


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Re impaction (infraocclusion)

Submerged teethDeciduous second molar is most commonly

affected.

Cause: not known: Roots get ankylosed to the bone

Followed by deficient development of thealveolar process

Adjacent teeth tilt over the submerged toothleading to reimpaction


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Non Bacterial Loss of ToothStructure

Attrition: Loss of tooth substance as a

result oftooth to tooth contact Physiologic or pathologic Physiologic:

Incisal edges of incisors Occlusal surfaces of molars Palatal cusps of maxillary

teeth

Buccal cusps of mandibularteeth Cup shaped surrounded by

enamel Transformation of contact

points to contact areas


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Attrition

Pathologic:

Abnormal occlusion

Bruxism

Abnormal tooth structure

Formation of reactionary dentin on pulpalsurface

Dentine: discolored and hypersensitive


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Abrasion

Pathologic wearing of teeth by friction of a foreignbody- independent of occlusion

Tooth brush abrasion:

Exposed root surface and cervical region of teeth Horizontal direction

Abrasive dentifrice

Clinically: wedge shaped with sharp angles

Polished dentine

May be accentuated in heavy load leading to abfraction


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abfractionAbrasion


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Abrasion

Pathologic wearing of teeth by friction of a foreignbody-independent of occlusion

Habitual abrasion: pipe smokersOccupational abrasion: hair grips holding


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Erosion

Loss of tooth substance by a chemical processother than bacterial action

Dietary erosion: acidic beverages

Labial surfaces of maxillary teeth and palatal ofposteriors

Clinically: shallow broad concavities


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Erosion

Occupational erosion: exposure to acidicatmospheres

Regurgitation ofstomach contents:

anorexia nervosa and bulimia nervosa

Gastro esophageal reflux

Reactionary dentine develops


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Resorption

Physiologic resorption: Role of osteoclast like cells In Primary teeth: Inherited or related to pressure from

successors

In permanent teeth: Superficial resorption of roots ofpermanent teethNot seen on radiographs

Pathological: resorption sufficient to be seenradiographically External Internal


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External Resorption

Causes:

1. Inflammation

2. Mechanical pressure

3. Idiopathic


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External ResorptionInflammatory Resorption

Pulp necrosis periapical inflammation

Apical portion of the roots

Luxation injuries and reimplantaion

Progressive resorption of the roots and replacement bybone

No ankylosis


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External Resorption Pressure/mechanical

resorption

Orthodontic treatment

Excessive force application

Occurs apically Reversed when cause is gone

Pressure associated with tumors


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External ResorptionIdiopathic resorption

Surrounding pulp leaving a narrow shell ofdentine

Pulp remains vital

Lacunae and channels

Resorbed tissue is replaced by granulationtissue

Ankylosis may result

Starts at cervical region


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Internal resorption

Pathologic resorption starts from pulpal surface

Associated with pulpitis

Idiopathic type also occur

Pink spot occurs when coronal dentin is involved


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External resorption of the crowns

Uncommon

Impacted teeth

Ankylosis may result


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lecture 4 (part1) Disorders of Teeth Other Than Cariess (slide)