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Dr. Paknahad
CLASSIFICATION
 (1) Size
 (2) Number
 (3) Shape/Form
 (4) Defects of Enamel and Dentin
Developmental
Disturbances
 Microdontia
 Macrodontia
Size
 Microdontia
 (1) Generalized
Microdontia
 (2) Localized
Microdontia
Size
 all teeth are smaller than
normal
 pituitary dawrfism
(1) Generalized
Microdontia
 affects most often maxillary
lateral incisior + 3rd
molar
 these 2 teeth are most often
congenitally missing
 peg late...
 Macrodontia
 (1) Generalized
Macrodontia
 (2) Localized
Macrodontia
Size
 all teeth are larger than
normal
 associated with
pituitary gigantism
(1) Generalized
Macrodontia
 Hemangioma, Hemifacial
hypertrophy
(2) Localized
Macrodontia
 (1) Size
 (2) Number
 (3) Shape/Form
 (4) Defects of Enamel and Dentin
Developmental
Disturbances
 Supernumerary teeth ( Hyperdontia,
Supplemental)
 many are impacted
 cleidocranial dysostosis,
gardner syndrome
Number
 most common
supernumerary tooth
 tooth situated between
maxillary central incisors
Mesiodens
 situated bucally or lingually
to one of the maxillary
molars
Paramolar
 molar located distal to molar
Distomolar/Distodens
 when all teeth are missing
 ectodermal dysplasia
Complete Anodontia
 lack of development of
one or more teeth
Permanent: m3pm2max
lateral mand central
 Primary: max incisors
Hypodontia
 lack of development of
six or more teeth
Oligodontia
POSITION
 Transposition
 (1) Size
 (2) Number
 (3) Shape/Form
 (4) Defects of Enamel and Dentin
Developmental
Disturbances
 joining of 2 developing
tooth germs
 resulting in a single
large tooth structure
Fusion
Fusion
 formation of 2 teeth from a
single enamel organ
 partial cleavage
Gemination(
Twinning)
 joined along the root surfaces
by cementum
more frequently in
posterior and maxillary regions
 may occur before or aft...
Taurodontism
 angulation or a sharp
bend or curve in root
or crown of a formed tooth
 trauma to a developing
tooth can cause root to ...
Dens
Evaginatus(Leon
g’s Premolar
)
 deep surface invagination
of crown or root that is lined
by enamel
 2 forms:
 coronal
 radicular
Dens Invaginatus
(De...
 Inverted tear drop
 droplets of ectopic enamel
 or so called enamel pearls
 may occasionally be found on
roots of teeth
 uncommon, minor
...
 occur most commonly in
bifurcation or trifurcation
of teeth
 maxillary molars are
commonly affected than
mandibular mol...
 D.D
Calculus/pulp stone
 (1) Size
 (2) Number and Eruption
 (3) Shape/Form
 (4) Defects of Enamel and Dentin
Developmental
Disturbances
 well-delineated additional
cusp
 located on the surface of
an anterior tooth
Talon’s Cusp
TURNER’S HYPOPLASIA
 Often Man. Pm
 ill defined radiolucency
 D.D: anomalies in radiation therapy
 characteristic of congenital
syphilis
 lateral incisors are peg-shaped
or screwdriver-shaped
 widely spaced
 notched ...
 dental condition usually
associated with congenital
syphilis
 characterized by multiple
rounded rudimentary enamel
cusp...
Amelogenesis
Imperfecta
group of conditions caused by
defects in the genes encoding
enamel matrix proteins
affects both ...
 inadequate formation of matrix
reduced enamel thickness
 abnormal contour
 absent interproximal
contact points
denti...
PICKET FENCE IN ANT.
 enamel is normal in form on
eruption but:
softer than normal
 tends to chip from
underlying
dentin
 snow-capped" teet...
 enamel matrix is formed in
normal quantity
 poorly calcified
 when newly erupted:
 enamel is normal in thickness
 no...
 with years of function:
 coronal enamel is removed
even less than dentin
abrasion to gingiva
 Radiographically:
 den...
affects both primary + permanent
dentition
have blue to gray
discoloration(a result of the obliteration the pulp
chamber...
Type I
occurs in families with
Osteogenesis Imperfecta
Type II
only have dentin abnormalities
and no bone disease
Dentin...
OSTEOGENESIS IMPERFECTA
 Progressive osteopenia
 Bone fractures
 Blue sclera
 Wormain bone
 Dentinogenesis imperfecta...
 Radiographically:
 bulbous crowns
 cervical constriction
 thin roots
 early obliteration of roots
canals + pulp cham...
 rare disturbance of dentin
formation
 normal enamel
 atypical dentin formation
 abnormal pulpal morphology
Dentin Dys...
 Classification:
 Type I (Radicular Type)
 Type II (Coronal Type)
Dentin Dysplasia
short roots(shallow w)
exfuliation with little trauma
 pulp obliteration before eruption
 periapical lesion with
no ev...
 II (coronal)
Primary: like DI
Permanent: normal clinically
thistle tube pulp in inc. pm.
 coronal pulps are usually large
(thistle tube appearance)
 filled with globules of abnormal
dentin
Type II (Coronal Typ...
DIFFERENTIAL DIAGNOSIS
 Thistle tube in one-root tooth ?
 Tooth with out roots?
 Rarefying osteitis with no caries?
...
Odontogenesis Imperfecta
 Ghost Teeth
etiology is unknown(Developmental)
one or several teeth in a
localized area are ...
 Radiographically:
 marked reduction in
radiodensity
 teeth assume a “ghost”
appearance
 both enamel + dentin appear
v...
ATTRITION
 Physiologic wearing
 First functional cusps
 Flat facets
 Reduced pulp chambers and canals
ABRASION
 Brushing pm>can>inc
 Dental floss deeper in dis.
EROSION
 Chemical with out bacteria
 Edge smoother than abrasion
INTERNAL RESORBTION
Causes: Acute trauma/direct and
indirect pulp cap/pulpotomy/enamel
invagination
 Pink mottle
D.D:
 B...
EXTERNAL ROOT RESORBTION
 Tooth root
 Unerupted tooth crown
Cause:
 Reimplantation, local inflammation, too much
mechan...
HYPERCEMENTOSIS
Cause:
Super eruption
Too much occ forces
Inflammation
Paget/gigantism and acromegaly
Dental anomaly
Dental anomaly
Dental anomaly
Dental anomaly
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Dental anomaly

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Oral radiology ,white & pharoah, Dental anomaly, Chapter 19

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Dental anomaly

  1. 1. Dr. Paknahad
  2. 2. CLASSIFICATION
  3. 3.  (1) Size  (2) Number  (3) Shape/Form  (4) Defects of Enamel and Dentin Developmental Disturbances
  4. 4.  Microdontia  Macrodontia Size
  5. 5.  Microdontia  (1) Generalized Microdontia  (2) Localized Microdontia Size
  6. 6.  all teeth are smaller than normal  pituitary dawrfism (1) Generalized Microdontia
  7. 7.  affects most often maxillary lateral incisior + 3rd molar  these 2 teeth are most often congenitally missing  peg lateral (2) Localized Microdontia
  8. 8.  Macrodontia  (1) Generalized Macrodontia  (2) Localized Macrodontia Size
  9. 9.  all teeth are larger than normal  associated with pituitary gigantism (1) Generalized Macrodontia
  10. 10.  Hemangioma, Hemifacial hypertrophy (2) Localized Macrodontia
  11. 11.  (1) Size  (2) Number  (3) Shape/Form  (4) Defects of Enamel and Dentin Developmental Disturbances
  12. 12.  Supernumerary teeth ( Hyperdontia, Supplemental)  many are impacted  cleidocranial dysostosis, gardner syndrome Number
  13. 13.  most common supernumerary tooth  tooth situated between maxillary central incisors Mesiodens
  14. 14.  situated bucally or lingually to one of the maxillary molars Paramolar
  15. 15.  molar located distal to molar Distomolar/Distodens
  16. 16.  when all teeth are missing  ectodermal dysplasia Complete Anodontia
  17. 17.  lack of development of one or more teeth Permanent: m3pm2max lateral mand central  Primary: max incisors Hypodontia
  18. 18.  lack of development of six or more teeth Oligodontia
  19. 19. POSITION  Transposition
  20. 20.  (1) Size  (2) Number  (3) Shape/Form  (4) Defects of Enamel and Dentin Developmental Disturbances
  21. 21.  joining of 2 developing tooth germs  resulting in a single large tooth structure Fusion
  22. 22. Fusion
  23. 23.  formation of 2 teeth from a single enamel organ  partial cleavage Gemination( Twinning)
  24. 24.  joined along the root surfaces by cementum more frequently in posterior and maxillary regions  may occur before or after the teeth have erupted extraction of one may result in extraction of the other Concrescence
  25. 25. Taurodontism
  26. 26.  angulation or a sharp bend or curve in root or crown of a formed tooth  trauma to a developing tooth can cause root to form at an angle to normal axis of tooth Bull’s eye Dilaceration
  27. 27. Dens Evaginatus(Leon g’s Premolar )
  28. 28.  deep surface invagination of crown or root that is lined by enamel  2 forms:  coronal  radicular Dens Invaginatus (Dens in Dente)
  29. 29.  Inverted tear drop
  30. 30.  droplets of ectopic enamel  or so called enamel pearls  may occasionally be found on roots of teeth  uncommon, minor abnormalities, which are formed on normal teeth Enamel Pearls
  31. 31.  occur most commonly in bifurcation or trifurcation of teeth  maxillary molars are commonly affected than mandibular molars  may have a core of dentin containing pulp horn may cause stagnation at gingival margin but, if they contain pulp, this will be exposed when pearl is removed Enamel Pearls
  32. 32.  D.D Calculus/pulp stone
  33. 33.  (1) Size  (2) Number and Eruption  (3) Shape/Form  (4) Defects of Enamel and Dentin Developmental Disturbances
  34. 34.  well-delineated additional cusp  located on the surface of an anterior tooth Talon’s Cusp
  35. 35. TURNER’S HYPOPLASIA  Often Man. Pm  ill defined radiolucency  D.D: anomalies in radiation therapy
  36. 36.  characteristic of congenital syphilis  lateral incisors are peg-shaped or screwdriver-shaped  widely spaced  notched at the end Hutchinson’s Incisor
  37. 37.  dental condition usually associated with congenital syphilis  characterized by multiple rounded rudimentary enamel cusps on permanent 1st molars dwarfed molars with cusps covered with globular enamel growths  giving the appearance of a mulberry Mulberry Molar
  38. 38. Amelogenesis Imperfecta group of conditions caused by defects in the genes encoding enamel matrix proteins affects both dentition  deciduous  permanent  classified based on pattern of inheritance:  hypoplasia  hypomaturation  hypocalcified
  39. 39.  inadequate formation of matrix reduced enamel thickness  abnormal contour  absent interproximal contact points dentin + pulp chambers appear normal Hypoplastic Amelogenesis Imperfecta
  40. 40. PICKET FENCE IN ANT.
  41. 41.  enamel is normal in form on eruption but: softer than normal  tends to chip from underlying dentin  snow-capped" teeth  Radiographically:  affected enamel exhibits radiodensity similar to dentin Hypomaturation Amelogenesis Imperfecta
  42. 42.  enamel matrix is formed in normal quantity  poorly calcified  when newly erupted:  enamel is normal in thickness  normal form  but weak  opaque or chalky in appearance Hypocalcified Amelogenesis Imperfecta
  43. 43.  with years of function:  coronal enamel is removed even less than dentin abrasion to gingiva  Radiographically:  density of enamel is less than dentin Hypocalcified Amelogenesis Imperfecta
  44. 44. affects both primary + permanent dentition have blue to gray discoloration(a result of the obliteration the pulp chamber, which normally gives a pinkish coloration to the dentin) Dentinogenesis Imperfecta
  45. 45. Type I occurs in families with Osteogenesis Imperfecta Type II only have dentin abnormalities and no bone disease Dentinogenesis Imperfecta
  46. 46. OSTEOGENESIS IMPERFECTA  Progressive osteopenia  Bone fractures  Blue sclera  Wormain bone  Dentinogenesis imperfecta  Cl III  Impaction of m1, m2
  47. 47.  Radiographically:  bulbous crowns  cervical constriction  thin roots  early obliteration of roots canals + pulp chambers  periapical lesion with no evidence of Caries Dentinogenesis Imperfecta
  48. 48.  rare disturbance of dentin formation  normal enamel  atypical dentin formation  abnormal pulpal morphology Dentin Dysplasia
  49. 49.  Classification:  Type I (Radicular Type)  Type II (Coronal Type) Dentin Dysplasia
  50. 50. short roots(shallow w) exfuliation with little trauma  pulp obliteration before eruption  periapical lesion with no evidence of Caries  Type I (Radicular Type)
  51. 51.  II (coronal) Primary: like DI Permanent: normal clinically thistle tube pulp in inc. pm.
  52. 52.  coronal pulps are usually large (thistle tube appearance)  filled with globules of abnormal dentin Type II (Coronal Type)
  53. 53. DIFFERENTIAL DIAGNOSIS  Thistle tube in one-root tooth ?  Tooth with out roots?  Rarefying osteitis with no caries?  Bulbus crown with cervical constriction?
  54. 54. Odontogenesis Imperfecta  Ghost Teeth etiology is unknown(Developmental) one or several teeth in a localized area are affected  maxillary teeth are involved more frequently than mandibular area teeth affected may exhibit a delay or total failure in eruption Regional Odontodysplasia
  55. 55.  Radiographically:  marked reduction in radiodensity  teeth assume a “ghost” appearance  both enamel + dentin appear very thin  pulp chamber is exceedingly large Delayed eruption Susceptible to caries DD: D.I. Regional Odontodysplasia
  56. 56. ATTRITION  Physiologic wearing  First functional cusps  Flat facets  Reduced pulp chambers and canals
  57. 57. ABRASION  Brushing pm>can>inc  Dental floss deeper in dis.
  58. 58. EROSION  Chemical with out bacteria  Edge smoother than abrasion
  59. 59. INTERNAL RESORBTION Causes: Acute trauma/direct and indirect pulp cap/pulpotomy/enamel invagination  Pink mottle D.D:  Bacc/ling caries  External root resorbtion
  60. 60. EXTERNAL ROOT RESORBTION  Tooth root  Unerupted tooth crown Cause:  Reimplantation, local inflammation, too much mechanical forces Features:  AP Blunting  Normal supporting structures
  61. 61. HYPERCEMENTOSIS Cause: Super eruption Too much occ forces Inflammation Paget/gigantism and acromegaly

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