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Developmental anomalies of the teeth, specific and non specific disorders of hard dental tisuess 6 DM ... enamel defect that affects both dentitions, ... – PowerPoint PPT presentation

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Title: Prezentace%20aplikace%20PowerPoint


1
Developmental anomalies of the teeth, specific
and non specific disorders of hard dental
tisuess 6 DM
2
Developmental anomalies
  • tooth development is strict under genetic
    control
  • disturbances in tooth development result from
    gene mutation
  • tooth development may be disturbed at different
    stages of morphogenesis
  • definitive result depends on the timing and the
    type of insult

3
Developmental anomalies
  • Disturbances in tooth development
  • numerical variations (missing or supernumerary
    teeth)
  • variations in size of teeth
  • variations of shape of teeth
  • disturbances in eruption

4
Developmental anomalies
  • Numerical variations
  • 1.Hypodontia
  • number of teeth is decrease
  • the most commonly missing teeth are
  • the third molars, second premolars, maxillary
    lateral incisors
  • - oligodontia, anodontia, agenesis

5
Developmental anomalies
  • Numerical variations
  • 1.Hypodontia in deciduous dentiotion
  • - prevalence 0.1 0.7
  • central incisors
  • oligondontia and anodontia is rare, may be found
    in connection with ectodermal dysplasia

6
Developmental anomalies
  • Ectodermal dysplasia
  • describes a group of developmental, often
    inherit, disorders involving the ectodermally
    structures(hair,teeth, nails, skin and sweat
    glands)
  • presentationmultiple missing teeth, fine,
    sparse hair, dry skin, maxillary hypoplasia,
    eversion of the lips, pigmentation around the
    mounth and eyes. The teeth are conical, small,
    often with a large diastema.

7
Developmental anomalies
  • Numerical variations
  • 1.Hypodontia in permanent dentiotion
  • prevalence 6 10
  • usually affects 2 or more teeth in 50 of the
    cases
  • often occures symmetrical hypodontia
  • particular relation with the microdontia

8
Developmental anomalies
  • Solitary median maxillary central incisor
    syndrome
  • is very rare
  • midline symetrical maxillary central incisor
  • can be associated with cleft palate, choanal
    stenosis, umbilical hernia, hypoplasia of sella
    turcica, pituitary dysfunction, growth hormone
    deficiency

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10
Developmental anomalies
  • Numerical variations
  • 2. Hyperodontia
  • number of the teeth is increse
  • is quite rare as hypodontia
  • Frequency primary teeth 0,3 - 0,8
  • permanent teeth 1,0 3,5

11
Developmental anomalies
  • Numerical variations
  • 2. Hyperodontia
  • - shape is conical or normal
  • supernumerary teeth can erupt or cause anomalous
    eruption of neighbouring teeth
  • most frequent is mesiodens
  • part of syndrom cleidocranial dysplasia

12
Developmental anomalies
  • Cleidocranial dysplasia
  • short stature
  • aplasia or hypoplasia of clavicles
  • delayed ossification
  • delayed eruption of teeth
  • dentigerous cyst formation

13
Developmental anomalies
  • Dentes praelactales
  • frontal region in a newborns
  • no roots
  • Th extraction

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15
Developmental anomalies
  • Variations in tooth size
  • Macrodontia
  • teeth are larger than normal
  • true macrodontia involving the whole dentition
  • 2. Microdontia
  • one or more teeth are smaller than normal
  • most affect the maxillary third molars

16
  • General microdontia is a rare conditionoccuring
    in connection with congenital
  • Local microdontia involving single teeth,
    associated with hypodontia
  • 3. Rhizomicry
  • -lenght of the root is shorter than the height of
    the crown
  • connected with osteoporosis
  • predominantly affecting maxillary incisors and
    premolars

17
Developmental anomalies
  • Variations on tooth shape
  • Dens invaginatus
  • malformation due to an invagination of enamel
    epitelium resulting in a chanel or lumen
    surrounded by hard tissues within the tooth. The
    anomaly occurs most frequently in the palatal
    surface of max. lateral incisor.
  • 2. Conical peg-shaped tooth

18
Developmental anomalies
  • Variations on tooth shape
  • 3. Taurodontism
  • elongated root- stem with the furcation more
    apical than normally
  • 4. Double formation of teeth
  • a) concrescence- two normal appearing crowns are
    present and the fusion involves only the cementum

19
Developmental anomalies
Variations on tooth shape b) Fusion union in
dentin and/or enamel between two or more normal
teeth c) Gemination incomplete division of a
tooth germ or a union between normal and a
supernumerary tooth 5. Dnes evaginatus - is an
extra cusp, usually in the central groove or
ridge of a posterior teeth and in the cingulum of
the central or lateral incisor
20
Developmental anomalies
  • 6. Dens in dente
  • is a condition resulting from invagination of the
    inner enamel epithelium producing the appearance
    of a tooth within a tooth
  • 7. Dilaceration
  • - an abnormal bend of the rooth during its
    development and is thought to result from a
    traumatic episode

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23
Developmental anomalies
  • Variations in tooth eruption
  • tooth retention
  • tooth semiretention
  • anomalous position after eruption

24
Non specific disorders of hard dental tisuess
  • Hypoplasia
  • Hypomineralization
  • Hypoplasia
  • Ethiology- metabolic disorders, fever,
    endocrinic disease,trauma, inflammation
  • Cl. picture anomalous shape of dental crown,
    grooves and fissures, color-dark brown,
    yellowbrown.

25
Non specific disorders of hard dental tisuess
Hypomineralization Ethiology- metabolic
disorders, fever, endocrinic disease,trauma,
inflammation Cl. picture normal shape of dental
crown, in hard dental tisuess are quality
changes. Color- white or brown smudges,
localization on labial surfaces of incisors
26
Specific disorders of hard dental tisuess
Dysplasia of hard dental tisuess 1.DENTIN
DYSPLASIA Ethiology ingestion of chemicals,
prematurity birthweight, severe malnutrition,
bilirubinemia Typ I radicular dentin dysplasia
or rootless tooth Typ II anomalous dysplasia of
dentin with frequent discoloration of primary
teeth, permanent teeth often appear normal
clinically but have thistle-tube formed pulp
chamber. Pulp stones may occure.
27
Specific disorders of hard dental tisuess
2. Fluoride induced defect
28
Specific disorders of hard dental tisuess
  • 3. Tetracycline defects
  • - TTC has a strong affinity to mineralized
    tisuess, primary to dentin and bones
  • dentin defects are persistent
  • discolored horizontal bands may appear gray,
    bluish
  • discolored enamel has some translucency left
  • this ATB shoud not be prescribed to children
    below the age of 8, pregnant women, lactating
    mothers

29
Specific disorders of hard dental tisuess
  • 4. Molar incisor hypomineralization
  • demarcated opacities in the perm. first molars,
    perm. incisors are often also involved
  • may affect one or all molars and one or more
    incisors
  • creamy white spot to yelowish brown discoloration
  • defect are porous

30
Specific disorders of hard dental tisuess
  • Subj. symptoms
  • shooting pain during brushing teeth or breathing
    cold air
  • Ethiology
  • - unknown, but suggestion are medical problem
    related to birth, respiratory diseases during
    first 3 years of life

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32
Specific disorders of hard dental tisuess
Amelogenesis imperfecta DefinitionAI represents
a roup of condition, genomic in origin, which
affect the structure and clinical appearance of
the enamel of all or nearly all teeth in a more
or less equal manner, and which may be associated
with morphologic or biochemical changes elsewhere
in the body.
33
Specific disorders of hard dental tisuess
  • - autosomal dominant, autosomal recessive
  • incidence 1 in 14 000
  • 4 major categories, 14 subtypes
  • General manifestation
  • normal intelligence, good general health
  • Craniofacial/dental manifestation
  • enamel defect that affects both dentitions,
    appearance is yellow- brown to orange depending
    on subtyp

34
Specific disorders of hard dental tisuess
Typ I- hypoplastic (occuring in the
histodifferation stage of tooth development,
insufficient quantity of enamel is formed)
TypII- hypomaturation (defect of in enamel
matrix apposition) Typ III- hypocalcified
(enamel is normal, but qualitatively the matrix
is poor calcified with a resultant fracturing of
the enamel surface. Hypocalcified enamel is soft
and fragile, especially at the incisal region,
and is easily fractured, exposing dentin.
35
Specific disorders of hard dental tisuess
Typ IV- hypomaturation, hypoplastic with
taurodontism (the enamel appears mottled with a
yellow-brown color and is pittedon the facial
surfaces. Molar teeth demonstrate taurodontism.
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37
Specific disorders of hard dental tisuess
  • Dentinogenesis imperfecta
  • Defect of predentin matrix that result amorphic,
    disorganized, and atubular circumpulpal dentin.
  • incidence 1 in 8000
  • 3 basic types
  • Shields type 1
  • Shields type 2
  • Shields type 3

38
Specific disorders of hard dental tisuess
  • Shields type 1
  • occurs with AI
  • inherit defect in collagen formation
  • osteoporotic brittle bones
  • bowing of the lips
  • blue sclera
  • bitemporal bossing
  • obliteration of pulp chamber,periapical
    radiolucencies, bulbous crowns, root fractures

39
Specific disorders of hard dental tisuess
  • Shields type 2
  • hereditary opalescent dentin
  • autosomal dominant
  • affect primary and permanent dentition
  • Shields type 3
  • is rare, bell-shaped crown,
  • it has occured exclusively in a triracial
    isolated group in Maryland

40
Specific disorders of hard dental tisuess
41
Specific disorders of hard dental tisuess
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