Developmental abnormalities


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Developmental abnormalities

  1. 1. Developmentalabnormalities Islam Kassem Level 7
  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
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  5. 5. Classification of developmental abnormalities1-Anomalies of the teeth2-Skeletal anomalies.
  6. 6. Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position.
  7. 7. Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position.
  8. 8. 1-Abnormalities in number• Missing teeth• Additional teeth (hyperdontia)
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  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.
  11. 11.
  12. 12. ectodermal dysplasia
  13. 13. Additional teeth (hyperdontia)• Localized hyperdontia — Supernumerary teeth— Supplemental teeth• Hyperdontia associated with specificsyndromes, e.g. cleidocranial dysplasia,Gardeners syndrome.
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  17. 17. Cleidocranial dysplasia
  18. 18. Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position.
  19. 19. 2-Abnormalities in structure• Genetic defects• Acquired defects
  20. 20. Genetic defects• Amelogenesis imperfecta — Hypoplastic type— Hypocalcified type— Hypomature type• Dentinogenesis imperfecta• Shell teeth• Regional odontodysplasia (ghost teeth)• Dentinal dysplasia (rootless teeth).
  21. 21.
  22. 22. Shell tooth
  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.
  24. 24. Turner tooth
  25. 25. Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position.
  26. 26. 3-Abnormalities in size• Macrodontia — large teeth• Microdontia — small teeth, includingrudimentary teeth.
  27. 27. Macrodontia
  28. 28. Microdontia
  29. 29. Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position.
  30. 30. 4-Abnormalities in shape• Anomalies affecting -whole teeth• Anomalies affecting the crowns• Anomalies affecting roots andlor pulp canals
  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.
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  33. 33. Gemination
  34. 34. Concrecence
  35. 35. Dens in dente
  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.
  37. 37. Congenital syphilis
  38. 38. Tapering pointed incisors — ectodermal dysplasia.
  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).
  40. 40. Bifid lower Premolar
  41. 41. 3 root lower molar
  42. 42. Dilaceration — sharp bend in the root direction
  43. 43. Taurodontism — short, stumpy roots and longitudinally enlarged pulp chambers
  44. 44. Pulp stones
  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.
  46. 46. Enemeloma
  47. 47. Compound odontoma
  48. 48. Complex odontoma
  49. 49. Anomalies of the teeth1-Number2-Structure3-Size4-Shape5-Position.
  50. 50. 5-Abnormalities in position• Delayed eruption• Other positional anomalies
  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.
  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
  53. 53. Submerged tooth infra occlusion
  54. 54. Transposition
  55. 55. Wandering 5
  56. 56. Skeletal anomalies• Abnormalities of the mandible and/or maxilla• Other rare developmental diseases andsyndromes.
  57. 57. Abnormalities of the mandible or maxilla• Micrognathia• Macrognathia (prognathism)• Other mandibular anomalies
  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.
  59. 59. Micrognathia
  60. 60. Macrognathia (prognathism)• Genetic• Relative prognathism — mandibular/maxillarydisparity• Acquired, e.g. acromegaly owing to excessivegrowth hormone from a pituitary tumour.
  61. 61. Macrognathia
  62. 62. Other mandibular anomalies• Condylar hypoplasia• Condylar hyperplasia• Bifid condyle• Coronoid hyperplasia.
  63. 63. Condylar hyperplasia
  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.
  65. 65. Alveolar cleft
  66. 66. Localized bone defects• Exostoses— Torus palatinus— Torus mandibularis• Idiopathic bone cavities (see Ch. 25)— Stafnes bone cavity.
  67. 67. Eagle’s syndrome
  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).
  69. 69. Curzons syndrome
  70. 70. Thank you• You can get it form•