Developmentalabnormalities    Islam Kassem        Level 7     ikassem@dr.com
• There are many developmental abnormalities  that can affect the teeth and facial skeleton. In  most cases, clinicians ne...
ikassem@dr.com
ikassem@dr.com
Classification of developmental              abnormalities1-Anomalies of the teeth2-Skeletal anomalies.                   ...
Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position.                ikassem@dr.com
Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position.                ikassem@dr.com
1-Abnormalities in number• Missing teeth• Additional teeth (hyperdontia)                    ikassem@dr.com
ikassem@dr.com
Missing teeth• Localized anodontia or hypodontia — usuallythird molars, upper lateral incisors or secondpremolars.• Anodon...
ikassem@dr.com
ectodermal dysplasia       ikassem@dr.com
Additional teeth (hyperdontia)• Localized hyperdontia — Supernumerary teeth— Supplemental teeth• Hyperdontia associated wi...
ikassem@dr.com
ikassem@dr.com
ikassem@dr.com
Cleidocranial dysplasia         ikassem@dr.com
Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position.                ikassem@dr.com
2-Abnormalities in structure• Genetic defects• Acquired defects                     ikassem@dr.com
Genetic defects• Amelogenesis imperfecta — Hypoplastic type— Hypocalcified type— Hypomature type• Dentinogenesis imperfect...
ikassem@dr.com
Shell tooth   ikassem@dr.com
Acquired defects• Turner teeth — enamel defects caused byinfection from overlying deciduous predecessor• Congenital syphil...
Turner tooth   ikassem@dr.com
Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position.                ikassem@dr.com
3-Abnormalities in size• Macrodontia — large teeth• Microdontia — small teeth, includingrudimentary teeth.                ...
Macrodontia   ikassem@dr.com
Microdontia   ikassem@dr.com
Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position.                ikassem@dr.com
4-Abnormalities in shape• Anomalies affecting -whole teeth• Anomalies affecting the crowns• Anomalies affecting roots andl...
Anomalies affecting -whole teeth• Fusion — two teeth joined together from thefusion of adjacent tooth germs• Gemination — ...
Fusionikassem@dr.com
Gemination   ikassem@dr.com
Concrecence   ikassem@dr.com
Dens in dente    ikassem@dr.com
Anomalies affecting the crowns• Extra cusps• Congenital syphilis— Hutchinson s incisors — crowns small,screwdriver or barr...
Congenital syphilis       ikassem@dr.com
Tapering pointed incisors —   ectodermal dysplasia.           ikassem@dr.com
Anomalies affecting roots and or pulp               canals• Number — additional roots, e.g. two-rootedincisors, three-root...
Bifid lower Premolar       ikassem@dr.com
3 root lower molar      ikassem@dr.com
Dilaceration — sharp bend in the root              direction                ikassem@dr.com
Taurodontism — short, stumpy roots and     longitudinally enlarged pulp chambers                  ikassem@dr.com
Pulp stones   ikassem@dr.com
Odontomes• Enameloma/enamel pearl• Cementoma (see fibro-cemento-osseousmesions in— Benign cementoblastoma (true cementoma)...
Enemeloma  ikassem@dr.com
Compound odontoma      ikassem@dr.com
Complex odontoma      ikassem@dr.com
Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position.                ikassem@dr.com
5-Abnormalities in position• Delayed eruption• Other positional anomalies                   ikassem@dr.com
Delayed eruption• Local causes— Loss of space— Abnormal crypt position — especially 8/8 and 3/3— Overcrowding— Additional ...
Other positional anomalies• Transposition two teeth occupying exchanged positions• Wandering teeth, movement of uneruptedt...
Submerged tooth infra occlusion             ikassem@dr.com
Transposition    ikassem@dr.com
Wandering 5   ikassem@dr.com
Skeletal anomalies• Abnormalities of the mandible and/or maxilla• Other rare developmental diseases andsyndromes.         ...
Abnormalities of the mandible or              maxilla• Micrognathia• Macrognathia (prognathism)• Other mandibular anomalie...
Micrognathia• True micrognathia — usually caused by bilateralhypoplasia of the jaw or agenesis of the condyles• Acquired m...
Micrognathia   ikassem@dr.com
Macrognathia (prognathism)• Genetic• Relative prognathism — mandibular/maxillarydisparity• Acquired, e.g. acromegaly owing...
Macrognathia    ikassem@dr.com
Other mandibular anomalies• Condylar hypoplasia• Condylar hyperplasia• Bifid condyle• Coronoid hyperplasia.               ...
Condylar hyperplasia       ikassem@dr.com
Cleft lip and palate• Cleft lip— Unilateral, with or without alveolar ridge— Bilateral, with or without alveolar ridge• Cl...
Alveolar cleft    ikassem@dr.com
Localized bone defects• Exostoses— Torus palatinus— Torus mandibularis• Idiopathic bone cavities (see Ch. 25)— Stafnes bon...
Eagle’s syndrome     ikassem@dr.com
Other rare developmental diseases            and syndromes• Cleidocranial dysplasia • Gorlins syndrome (nevoid basal cellc...
Curzons syndrome      ikassem@dr.com
Thank you• You can get it form• http://www.slideshare.net/islamkassem                        ikassem@dr.com
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Developmental abnormalities

  1. 1. Developmentalabnormalities Islam Kassem Level 7 ikassem@dr.com
  2. 2. • There are many developmental abnormalities that can affect the teeth and facial skeleton. In most cases, clinicians need little more than to be able to recognize these abnormalities ikassem@dr.com
  3. 3. ikassem@dr.com
  4. 4. ikassem@dr.com
  5. 5. Classification of developmental abnormalities1-Anomalies of the teeth2-Skeletal anomalies. ikassem@dr.com
  6. 6. Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position. ikassem@dr.com
  7. 7. Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position. ikassem@dr.com
  8. 8. 1-Abnormalities in number• Missing teeth• Additional teeth (hyperdontia) ikassem@dr.com
  9. 9. ikassem@dr.com
  10. 10. Missing teeth• Localized anodontia or hypodontia — usuallythird molars, upper lateral incisors or secondpremolars.• Anodontia or hypodontia associated withsystemic disease — e.g. Downs syndrome,ectodermal dysplasia. ikassem@dr.com
  11. 11. ikassem@dr.com
  12. 12. ectodermal dysplasia ikassem@dr.com
  13. 13. Additional teeth (hyperdontia)• Localized hyperdontia — Supernumerary teeth— Supplemental teeth• Hyperdontia associated with specificsyndromes, e.g. cleidocranial dysplasia,Gardeners syndrome. ikassem@dr.com
  14. 14. ikassem@dr.com
  15. 15. ikassem@dr.com
  16. 16. ikassem@dr.com
  17. 17. Cleidocranial dysplasia ikassem@dr.com
  18. 18. Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position. ikassem@dr.com
  19. 19. 2-Abnormalities in structure• Genetic defects• Acquired defects ikassem@dr.com
  20. 20. Genetic defects• Amelogenesis imperfecta — Hypoplastic type— Hypocalcified type— Hypomature type• Dentinogenesis imperfecta• Shell teeth• Regional odontodysplasia (ghost teeth)• Dentinal dysplasia (rootless teeth). ikassem@dr.com
  21. 21. ikassem@dr.com
  22. 22. Shell tooth ikassem@dr.com
  23. 23. Acquired defects• Turner teeth — enamel defects caused byinfection from overlying deciduous predecessor• Congenital syphilis — enamel hypoplastic andaltered in shape (see below)• Severe childhood fevers, e.g. measles — linearenamel defectsFluorosis — discolouration or pitting of theenamel• Discolouration — e.g. tetracycline staining. ikassem@dr.com
  24. 24. Turner tooth ikassem@dr.com
  25. 25. Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position. ikassem@dr.com
  26. 26. 3-Abnormalities in size• Macrodontia — large teeth• Microdontia — small teeth, includingrudimentary teeth. ikassem@dr.com
  27. 27. Macrodontia ikassem@dr.com
  28. 28. Microdontia ikassem@dr.com
  29. 29. Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position. ikassem@dr.com
  30. 30. 4-Abnormalities in shape• Anomalies affecting -whole teeth• Anomalies affecting the crowns• Anomalies affecting roots andlor pulp canals ikassem@dr.com
  31. 31. Anomalies affecting -whole teeth• Fusion — two teeth joined together from thefusion of adjacent tooth germs• Gemination — two teeth joined together butarising from a single tooth germ• Concrescence — two teeth joined together bycementum• Dens-in-dente (invaginated odontome) — infolding of the outer surface of a tooth into theinterior usually in the cingulum pit region ofmaxillary lateral incisors. ikassem@dr.com
  32. 32. Fusionikassem@dr.com
  33. 33. Gemination ikassem@dr.com
  34. 34. Concrecence ikassem@dr.com
  35. 35. Dens in dente ikassem@dr.com
  36. 36. Anomalies affecting the crowns• Extra cusps• Congenital syphilis— Hutchinson s incisors — crowns small,screwdriver or barrel-shaped, and oftennotched— Moons/mulberry molars — dome-shaped ormodular• Tapering pointed incisors — ectodermaldysplasia. ikassem@dr.com
  37. 37. Congenital syphilis ikassem@dr.com
  38. 38. Tapering pointed incisors — ectodermal dysplasia. ikassem@dr.com
  39. 39. Anomalies affecting roots and or pulp canals• Number — additional roots, e.g. two-rootedincisors, three-rooted premolars or four-rootedmolars• Morphology, including:— Bifid roots— Excessively curved roots— Dilaceration — sharp bend in the rootdirection— Taurodontism — short, stumpy roots andlongitudinally enlarged pulp chambersPulp stones — localized or associated withspecific syndromes, e.g. Ehlers-Danlos (floppyjoint syndrome). ikassem@dr.com
  40. 40. Bifid lower Premolar ikassem@dr.com
  41. 41. 3 root lower molar ikassem@dr.com
  42. 42. Dilaceration — sharp bend in the root direction ikassem@dr.com
  43. 43. Taurodontism — short, stumpy roots and longitudinally enlarged pulp chambers ikassem@dr.com
  44. 44. Pulp stones ikassem@dr.com
  45. 45. Odontomes• Enameloma/enamel pearl• Cementoma (see fibro-cemento-osseousmesions in— Benign cementoblastoma (true cementoma)— Periapical cemento-osseous dysplasia— Focal cemento-osseous dysplasia— Florid cemento-osseous dysplasia(gigantiform cementoma)• Composite— Compound odontome — made up of one or more smalltooth-like denticles— Complex odontome — complex mass of disorganized dentaltissue. ikassem@dr.com
  46. 46. Enemeloma ikassem@dr.com
  47. 47. Compound odontoma ikassem@dr.com
  48. 48. Complex odontoma ikassem@dr.com
  49. 49. Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position. ikassem@dr.com
  50. 50. 5-Abnormalities in position• Delayed eruption• Other positional anomalies ikassem@dr.com
  51. 51. Delayed eruption• Local causes— Loss of space— Abnormal crypt position — especially 8/8 and 3/3— Overcrowding— Additional teeth— Retention of deciduous predecessor— Dentigerous and eruption cysts• Systemic causes— Metabolic diseases, e.g. cretinism and rickets— Developmental disturbances, e.g. cleidocranial dysplasia— Hereditary conditions, e.g. gingival fibromatosis andcherubism. ikassem@dr.com
  52. 52. Other positional anomalies• Transposition two teeth occupying exchanged positions• Wandering teeth, movement of uneruptedteeth for no apparent reason (distal drift)• Submersion, second deciduous molars apparently descend into thejaws. Since these teeth do not in fact submerge, but rather remain intheir original position while the adjacent Other positional anomalies• Transposition, two teeth occupying exchanged positions• Wandering teeth, movement of unerupted teeth for no apparentreason (distal drift)• Submersion, second deciduous molars apparently descend into thejaws. Since these teeth do not in fact submerge, but rather remainin their original position while the adjacent ikassem@dr.com
  53. 53. Submerged tooth infra occlusion ikassem@dr.com
  54. 54. Transposition ikassem@dr.com
  55. 55. Wandering 5 ikassem@dr.com
  56. 56. Skeletal anomalies• Abnormalities of the mandible and/or maxilla• Other rare developmental diseases andsyndromes. ikassem@dr.com
  57. 57. Abnormalities of the mandible or maxilla• Micrognathia• Macrognathia (prognathism)• Other mandibular anomalies ikassem@dr.com
  58. 58. Micrognathia• True micrognathia — usually caused by bilateralhypoplasia of the jaw or agenesis of the condyles• Acquired micrognathia — usually caused by unilateralearly ankylosis of the temporomandibular joint. ikassem@dr.com
  59. 59. Micrognathia ikassem@dr.com
  60. 60. Macrognathia (prognathism)• Genetic• Relative prognathism — mandibular/maxillarydisparity• Acquired, e.g. acromegaly owing to excessivegrowth hormone from a pituitary tumour. ikassem@dr.com
  61. 61. Macrognathia ikassem@dr.com
  62. 62. Other mandibular anomalies• Condylar hypoplasia• Condylar hyperplasia• Bifid condyle• Coronoid hyperplasia. ikassem@dr.com
  63. 63. Condylar hyperplasia ikassem@dr.com
  64. 64. Cleft lip and palate• Cleft lip— Unilateral, with or without alveolar ridge— Bilateral, with or without alveolar ridge• Cleft palate— Bifid uvula— Soft palate only— Soft and hard palate• Clefts of lip and palate (combined defects)— Unilateral (left or right)— Cleft palate with bilateral cleft lip. ikassem@dr.com
  65. 65. Alveolar cleft ikassem@dr.com
  66. 66. Localized bone defects• Exostoses— Torus palatinus— Torus mandibularis• Idiopathic bone cavities (see Ch. 25)— Stafnes bone cavity. ikassem@dr.com
  67. 67. Eagle’s syndrome ikassem@dr.com
  68. 68. Other rare developmental diseases and syndromes• Cleidocranial dysplasia • Gorlins syndrome (nevoid basal cellcarcinoma syndrome)• Eagle syndrome• Crouzon syndrome (craniofacial dysostosis)• Apert syndrome• Mandibular facial dysostosis (Treacher Collinssyndrome). ikassem@dr.com
  69. 69. Curzons syndrome ikassem@dr.com
  70. 70. Thank you• You can get it form• http://www.slideshare.net/islamkassem ikassem@dr.com
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