Dental Anomalies
Introduction
Anomalies deviation of normal condition
Most dental anomalies will present in
childhood
Diagnosis and management contribute
important areas of paediatric dentistry
Etiology: growth and development disturbance
Disturbance of Growth & Development
Genetic 78%
Environment 22%
-Prenatal
-Postnatal
Growth and Development
Initiation (bud stage)
Embryo 5 weeks
Oral epithelium dental
lamina
Proliferation (cap stage)
Mesenchim cell proliferation, thicken,
vascularated dental papillae
Dental papillae pulp+dentine
Thicken of mesenchime cell
cementum, periodontal membrane,
alveolar bone
Histodifferentiation (bell stage)
Cellular differentiation
Inner enamel epithelium
ameloblast enamel
Outer enamel epithelium
odomtoblast dentine
Morphodifferentiation
Differentiation of size and shape
Dentinoenamel junction
Lead to matrix depotition
Apotition
Matrix depotition
Consideration in the Management
Informing and supporting child and parent
Establishing a diagnosis
Genetic counselling
Interdisciplinary formulation of definitive treatment plan
Elimination of pain
Restoration of aesthetics
Provision of adequate function
Maintenance of occlusal vertical dimension
Use of intermediate restoration in childhood and adolescence
Planning for definitive treatment at an optimal age
Dental anomalies at different stages
of dental development
Dental lamina formation stage
Hypodontia/oligodontia/anodontia
Supernumerary teeth
Double teeth, geminated, or fused teeth
Odontomes
Odontogenic tumour
Odontogenic keratocyst
Histodifferentiation
Regional odontodysplasia
Morphodifferentiation
Macrodontia
Microdontia
Invaginated odontome
Evaginated odontome
Carabelli trait
Talon cusp
Huchinsons incisors and mulberry molars
Taurodontism
Matrix deposition
Dentine : dentinogenesis imperfecta, dentinal
dysplasia
Enamel : amelogenesis imperfecta
Enamel hypoplasia
Enamel opacities
fluorosis
Eruption and root development
Premature eruption
Natal and neontal teeth
Delayed eruption
Ectopic eruption
Eruption cyst
Transposition of teeth
Impaction
Arrested root development
Failure of eruption in amelogenesis imperfecta
Failure eruption in cleidocranial dysplasia
Hypodontia
Hypodontia; progressive
degrees of missing teeth
Oligodontia: >6 missing
teeth
Anodontia: compolete
absence of teeth.
Related to genetic
syndromes
Supernumerary teeth
Arising as a result of budding of dental lamina
Frequency in primary teeth 0,3-0,8%
Permanent teeth 1,0-3,5%
98% in maxilla 75% of which are
mesiodens
Macrodontia
Any tooth or teeth larger
than normal
Largely because of an
isolated disturbace of
development
Etiology unknown
Microdontia
One or more teeth that are smaller than normal
for the tooth type
Maxillary lateral incisors
Primary dentition <0,5%
Permanent dentition 2%
More common in females
Double tooth
Formed by fusion
Fusion: joining of two
teeth
Gemination: budding of
a second tooth from a
single tooth germ.
Usually one root canal
is present
Talon cusp
Horn-like projection of
the cingulum of the
maxillary incisor teeth
Primary dentition
almost unknown
Permanent dentition 12%
Tooth discoloration
Opacitization
Result from a defect in the quality of the enamel
Hypomineralization result in a change in the
porosity of the enamel
Fluorosis
Manifest as hypomineralization of the enamel
Enamel Hypoplasia
Defect in quantity
Caused by failure of
apposition and protein
matrix formation
Alteration in the
mineralization of the
matrix
Amelogenesis Imperfecta
Applied to inherited defects of the enamel
Primary and permanent teeth
Frequency estimated 1:14000 in the USA
Diagnosis based on a combination of the mode
of inheritence and clinical and radiographic
appearance
Dentinogenesis Imperfecta
Inherited disorder of dentine
May be associated with osteogenesis
imperfecta
Thank
You
