Condition NatalTooth RigaFedeApathae

Classification AbnormalEruption AbnormalEruption

Definition&Etiology Anytoothpresentatbirth. Asmallulcerationontheundersurfaceofthetongue.Occurs duetocontactofenonatalornatalteethwiththetongue, typicallyduringsucking/feeding. Crooked,stagnated,oranglederuptionofteeth. Tissuetag;tissuelayingoverdentition

MostCommonlySeen

Comments Observedwithwhoopingcoughanddiphtheria,butnot explainedwhy.

EctopicEruption Operculum EruptionHematoma

AbnormalEruption AbnormalEruption AbnormalEruption

Maxillarycanines(palpableat910years) Fromtheretromollarpads,especiallyontopof wisdomteethorsecondmolars.

Canoftenleadtodamageandstagnation.

Ankylosis

AbnormalEruption

Ared,bloodfilledblisteroftheoralgingiva,oftencontaininga toothbud(ie.Astagnantbloodpoolaroundthedevelopmentof atooth). Whenteethbecomestuck.Causedbythefusionoftherootto Deciduousmolars thebone,withnoresoptionoccurings.

Couldbereferedtoas'bloodblisters'.

Toothcannotmove,andtheheightitstopsatisthe heightitachieves.Txforchildrenrequiresmonitoring andpossibleextractionofthetoothtopermit permenantdentitionerruption.Txforadultsmayalso involvesurgeryifconditionleadstocomplications. Comments

Condition Microdontia

Classification NaturallyOccuringVariation

Definition&Etiology

MostCommonlySeen

Teeththatareundersizedcomparedtotheircontralateraltooth PrimarilyseenasapeglateralSecondmostcommon Geneticallyinheritedinmostcases(familialtrait).It formiswithinthe3rdmolars. couldbesaidthatisolatedtypeisamerepresenceof oropposingtooth,oftenbilateral(ie.Atoothdoesnot"fill"its spaceinthedentalarch).Itcouldbeuniformtothearchesor anundersizedtoothinthedentition,whilegeneralized isolated. type(truetype)iswhenthejawisregularilysizedwith smallteeth.Truegeneralizedcasesoccuronlywith dwarfismandcancertreatmentduring morphodifferentiation. Coneshapedlateralincisor(conicalandpossiblytapered). Seeninmicrodontia Truegeneralizedcasesmayresultfrompituitary gigantismduringmorphodifferentiation. Conditionfoundin'ElephantMan'.

PegLaterals Macrodontia

NaturallyOccuringVariation NaturallyOccuringVariation

Teeththatareoversizedcomparedtotheircontralateraltoothor Incisorsandmadibular3rdmolars. opposingtooth. Theoccuranceofmacrodontiaononesideofthedentalarch, withtheothersideofthearchcontainingnormalteeth (unaffected). Overproductionofcementum(toomuchcementum).Associated Permenantmolars withtrauma,localorsytemicmetabolicdisturbancesand commonlywithchronicinflammationofpulp. Unusuallongpulpchamberthatmayextendintotherootareaof anormalsizedtooth. Asnamedescribes. Anextracusponananteriortooth. Mainlyfoundonmaxillarylaterals,followedby maxillarycentrals.Rarelyfoundonprimary dentition. Commonlyseenonthe3rdmolars.

Hemihypertrophy

NaturallyOccuringVariation

Hypercementoses

NaturallyOccuringVariation

Occursaftereruption.

Taurodontisum ExcessiveEnamel TalonCusps

NaturallyOccuringVariation NaturallyOccuringVariation NaturallyOccuringVariation

Alsoknownasbullorprisimteeth.Cancauseproblem forendodonics andtooth extractions.

AccessoryCusp EnamelPearls

NaturallyOccuringVariation NaturallyOccuringVariation

Extracuspsonatooth. Enameldepositsonareasenameldoesnotnaturallyoccur(ex. Onarootsurface).

CouldincludeTalonCusps,CuspofCarbabelli,orDens evaginatus. Notcommoninteethwithasingleroot.

Condition PulpPolyps

Classification CausesofAcquiredVariations

Definition&Etiology Soft,red,nonpainfulpolypsonthegingiva.Itisahyperplastic inflammatoryresponseofanopenpulpchambertochronic bacterialinfection. Severedecayofdeciduousteethofachild.Causedbyfeeding childbeveragesandfoodhighinfermentatablecarbohydrates. Carieswithinthepit&fissuresofatooth.Unroughingtheenamel willrevealsoftdentinaldecay.If>30%decaycouldeatthrough tothepulp. Abrokentooth,oftenduetoseverephysicaltrauma. Causeofdentitiondamage.

MostCommonlySeen

Comments

EarlyChildhoodCaries(ECC)

CausesofAcquiredVariations

Commonlyseenoncaseswhereextensivecariesare Txofapulppolypinmanycasescaninvolveeitherroot presentondeciduousteethand6yearmolars.Can canaltherapyorextractionofthetooth. affectpermenantdentition. Worthnotingthatfacialcariesneedssignificant attentionastheyarethelastsurfacesformingcaries.

Pit&FissureCaries

CausesofAcquiredVariations

FracturedTeeth Trauma Attrition

CausesofAcquiredVariations CausesofAcquiredVariations CausesofAcquiredVariations

Asymmetryintraumaishardtospeculateacausefor. Acceleratedbybruxism(grindingoftheteeth)ororal habbits. Commonlycausedbythirdpartyinstrumentssuchas toothbrushes,pipes,clamps,etc.

Abrasion

CausesofAcquiredVariations

Physiologicalconditioncausedbychronictoothfriction.Caused Commonlyseeninyoungchildrenortheelderly bynormalwearandtear.Leadstolossoftheocclusalorincisal population. toothstructure. Lossoftoothstructureduetoabnormalmechanicalwear.Itisa slowandchronicprocess.Commonlycausedbytoothbrush abrasionatthecervicalportionofthefacialaspect. Lossoftoothstructurecausedbychemicalaction(typicallya loweringofthepH). Excessivevomitingduetoexternalfactors.Causeserosionof teethduetotheacidity/lowpHofstomachcontents. Buccalandlingualsurfacesarecommonlyaffected.

Erosion ChronicRegurgiataion

CausesofAcquiredVariations CausesofAcquiredVariations

Patternoferrosionoftenindicatesthecausativeagent.

Condition Anodontia

Classification AnomaliesinNumbers

Definition&Etiology Thecompleteabsenceofteeth.Arareconditionthatisoftensex linked.

Patientssufferingfrombulimia,anorexia,pregnancy, Worthnotingthatmandibularteethareoftennot hiatalhernias,etc. errodedastheyareshieldedbythetongueduring regurgitation(tongueoftencoversmandibularsand alsodirectsstomachcontentstowardsmaxillaryteeth instead). MostCommonlySeen Comments Associatedwithectodermdefects,resultingin loss/defectsonotherstructuressuchashair,sebaceous glands,andsweatglands).Thetermpartialanodontia isincorrect. Commonlyoccursinthepermenantteeth,butalso Approx.5%ofthepopulationisaffectedwiththisasa withintheprimarydentition.Seeorderofoccurance hereditaryfactor.Txcommonlyinvolvesorthodontic forteethunderoligodontia (below). treatmentandinsomecasesusedof implants/bridges/etc. Mostcommonlyoccursinthepermanent3rd molars,permanentmaxillarylaterals,and permentantmandiubular2ndpremolars(more mostoccuringtoleast,respectively).Rarelyoccursin primarydentition,butcanoccurontheprimary mandibularcentralincisor.

Hypodontia

AnomaliesinNumbers

Congenitalabsenceofoneorafewteeth(3orlessteeth).

Oligodontia

AnomaliesinNumbers

Congenitalabsenceof4ormoreteeth.

Hyperdontia

AnomaliesinNumbers

Presenceyofsupernumeracyteeth,thatistosay,extrateeththat Frequnetlyaffectsthepermenantdentition.Inrarer Aka.Supernumeracyteeth.Commonlyoccursas mediodems.Teethmaybeeruptedorimpacted.Tx wouldnotbepresentinthenormaldentition. casesaffectstheprimarydentition.Itis8times morepresentinthemaxillaryarch. commonlyincludesoralsurgeryforremovalof supernumeracyteeth,andsometimesorthodontic workduetocommoncrowdingcausedbyextrateeth. Amalformed,peglikestructurethatoccursbetweenthe maxillarycentralincisors. Oftenoccursincasesofhyperdontia.

Mesiodems

AnomaliesinNumbers

EctodermalDysplasia

AnomaliesinNumbers

Agroupofconditionsinwhichthereisabnormaldevelopmentof theskin,hair,nails,teeth,orsweatglands. Definition&Etiology MostCommonlySeen

Thesearethestructurestypicallydevelopedlastin development. Comments Aka.Toothwithinatooth.Canclincallyappearasa deepcreviceoraccentuatedlingualpit.Txtypically includesendodonicintervention.

Condition DensinDente

Classification AnomaliesinShape

Dilaceration

AnomaliesinShape

Flexion

AnomaliesinShape

Maxillarilylaterals. Enamelanddentinofacrowninvaginateorfoldonitselfinan apicaldirectiontowardsthepulpchamberonthelingualaspect ofthetooth.Oftenbilateral. Developmentdisturbancesintheshapeoftheteeth,often Oftenseeninsupernumeracyteeth(hyperdontia) angulationorasharpcurveintherootorcrownofthetooth(not andinteethwithaccessoryroots. linear).Causedbytraumaand/orpressuretothedeveloping tooth. Distortionofonlytherootstructure.Likedilaceration,thisisalso causedbypressureand/ortraumatothetoothbutoccurslaterin development,causingsharpbends. Anincompletelydivided(bifid)crown,withtheaffectedtooth Oftenseenintheprimarymandibularincisorsand stillhavingasinglerootandacommonpulpcavity.Canappear permenantmaxillaryincisors. 'fused'. Affectsprimarymorethanpermenantdentition, Unionoftwoadjacentteeth,whereintworootsandtwopulp cavitiesarepresent.Teethappear'fused'.Thoughttobecaused withtheanteriorteethmostcommonlyaffected. bypressureorforce. Twoormoreteethjoinedthroughthecementumonly.Causedby Commonlyseeninthepermenantmolars,especially excessivecementumdeposition. themaxillarymolars. Asignofcongenitalsyphilis,teetharesmallerandmorewidely spacedthannormal,withnotchesontheirbitingsurfaces. Rootswhichareabnormallyshort(whilecrownsremainnormal size). Extracuspsonthesurfaceofatooth. Extrarootsonatooth.Canleadtodilaceration. Theabsenceofanormallypresentcusponatooth. Commonlyseenonanteriorteeth,especially maxillarycentrals. Commonlyseenonthe3rdmolars. Commonlyseenonthe3rdmolars,butcanalso occuronotherteeth. Oftenseenforthelingualcuspofthemandibular firstmolar,thedistolingualcuspofthemaxillary molars,andthedistalcuspofthemandibular1st molars.

Notcommonlyrecognizedasadentalterm.Itisworth notingthatflexioncancausetraumato underlining/adjacentdevelopingteeth. Donotconfusewithfusion(onevs.tworoot/chamber).

Gernination

AnomaliesinShape

Fusion

AnomaliesinShape

Donotconfusewithfusion(twovs.once root/chamber). Ifonetoothofthetwo(ormore)needstobeextracted, surgicalseperationoftheteethmayberequired. Onanteriors,incisaledgeappearsnotched,whileon posteriorteeth,occlusalsurfaceappearsgnarled,with poorlydevelopedcusps. Thoughttobehereditary.Shortrootsmayleadto shortenedclinicallifeforaffectedteeth. CouldincludeTalonCusps,CuspofCarbabelli,orDens evaginatus.

Concresence

AnomaliesinShape

Hutchinson'sTeeth

AnomaliesinShape

DwarfedRoots AccessoryCusps(Tubercles) AccessoryRoots MissingCusps

AnomaliesinShape AnomaliesinShape AnomaliesinShape AnomaliesinShape

EnamelPearls Condition EnamelDysplasia

AnomaliesinShape Classification AnomaliesinStructure

Enameldepositsonareasenameldoesnotnaturallyoccur(ex. Onarootsurface). Definition&Etiology Abnormalenamelformation,characterizedbybands,ridges,or pittedareasofdicoloredenamel.Thoughttobehereditary, causedsystemically(drugs,infection,nutirition)orlocally (trauma,periapicalinfections). Anenameldefectthatcausessoft,undercalcifiedenamel. Appearsopaque,softandchalky.Canbecausedbydefective maturationofameloblasts. Enamelhypoplasia/underdevelopedenamelofapermenant tooth.Typicallycausedbyinjuryofadevelopingtoothbud throughtraumaoraperiapicalinfectionaroundadecidious tooth.

Notcommoninteethwithasingleroot. MostCommonlySeen Comments

Hypocalcification

AnomaliesinStructure

Canoccuronbothprimaryandpermenant dentitions.

Turner'sTooth

AnomaliesinStructure

Surfacescanwearrapidlyandaremoresusceptableto caries.Affectedteeth(white,chalkybands)canindicate atwhatpointindevelopmenthypocalcification occurred. Aside:Usuallyonlyaffectsonetooth.

DentalFluorosis

AnomaliesinStructure

AmeleogenesisImperfecta

AnomaliesinStructure

Causedbyexcessivefluorideintakeduringenamelcalcification (manytimesgreaterthan1ppm/levelsfoundinwatersupply). Usuallyinvolvesallteeth.Canleadtodiscolourationoftheteeth. Chalkyisamildcase,andmoderatecasesleadtobrown spots/bands. Completetopartialabsenceofenamelthatdoesnotmature. Crownsappearastrongshadeofwhite,yellowbrown,pitted,or grooved.Thisconditionishereditary.

Causedbyflourideionincorperationratherthan hydroxylion,causingformationoffluorapatiterather thanhydroxyapetite.Fluorapatiteislesssolublein acidicenviornment,preventingdentalcaries. Ararecondition.Withnoenamel,thedentinisaquick targetforattrition,abrassion,orboth.Alsosuspectable torampantcariesandsensitivity.

DentinalDysplasia

AnomaliesinStructure

DentinogenesisImperfecta

AnomaliesinStructure

Abnormaldentinformation.Thoughttobehereditary,caused systemically(drugs,infection,nutirition)orlocally(trauma, periapicalinfections). Lackofdentinogenesis.Causescrownoftoothtoappearbluish Affectsallorsomeoftheteeth,beitpermenantor Patientissubjecttogreaterchanceofattrition. brownincolour(opalescence).Enamelisnormalbutbreaksapart primarydentition. easily.Pulpchambercanbecomebrittleduetoobliteration, leadingthestructuretobemorebrittleduetolackofnutrition. Theenameltendstoseperatefromthedentin.Conditionis hereditary. Stainingoftheteethcausedbytheuseoftheantibioticdrug tetracyclineduringprimaryorpermenanttoothdevelopment. Seenasadarkgrayshadeinareasexposedduringdevelopment (discolouredbyexposuretoUVlight). Definition&Etiology MostCommonlySeen Tetracyclinecanbeusedlongorshorttermon individualswhenrequired,buttheissueiswhenthisis donebeforetheageof8.

TetracyclineStaining

AnomaliesinStructure

Condition

Classification

Comments