Developmental disorders

Jan Laco, M.D., Ph.D.

Developmental disorders
‡ 1. Teeth ‡ 2. Jaws ‡ 3. Clefts ‡ 4. Oral soft tissue

1. Developmental disorders - teeth
‡ 1a. Abnormalities of size and form ‡ 1b. Abnormalities of number ‡ 1c. Defects of structure ‡ 1d. Disorders of eruption

I.1a. M) ‡ macrodontia «teeth > normal ± absolute x relative ± generalized x single . 3. Abnormalities of size and form ‡ microdontia «teeth < normal ± permanent teeth ± absolute x relative ± generalized x single (upper 2.

twinning) ± incomplete division of tooth germ ± 2 separated crowns on single root ‡ fusion (synodontia) ‡ concrescence ± fusion after development of roots (injury) ± teeth united by cementum . Abnormalities of size and form ‡ gemination (schizodontia.1a.

bilateral. Abnormalities of size and form ‡ dilaceration ± angulation at crown-root junction (injury) ± difficult extraction ‡ talon cusp ± lingual or palatal aspect of permanent teeth ‡ dens invaginatus (dens in dente) ± invagination of enamel into pulp chamber ± upper 2. I. caries .1a.

1a. Abnormalities of size and form ‡ taurodontism (bull tooth) ± wide pulp chamber ± molars ‡ enamel pearl ± ameloblasts below amelocemental junction ± mm nodule. upper M .

Disorders of eruption .teeth ‡ 1a. Abnormalities of size and form ‡ 1b. Abnormalities of number ‡ 1c.1. Defects of structure ‡ 1d. Developmental disorders .

P: NO effect ± 2. Abnormalities of number ‡ Isolated hypodontia ± common ± hereditary ± 3. P + 2.1b. I ‡ Anodontia ± very rare . I ± 3. M + 2. I: false eruption of C to 1. M + 2.

M (90% patients) . Abnormalities of number ‡ Anhidrotic ectodermal dysplasia ± X-linked inheritance ± hypodontia + hypotrichosis + anhidrosis ± failure of development of alveolar process ‡ Down´ s syndrome ± no 3.1b.

Abnormalities of number ‡ Hyperdontia (additional teeth) ± common ± supernumerary: conical ‡ incisor + molar region + midline (mesiodens) ± supplemental: normal ‡ excessive growth of l. M ‡ Cleidocranial dysplasia ‡ Gardner´s syndrome .1b. dentalis ‡ 4.

Developmental disorders .teeth ‡ 1a.1. Defects of structure ‡ 1d. Abnormalities of number ‡ 1c. Disorders of eruption . Abnormalities of size and form ‡ 1b.

1c. predeccesor ± Turner tooth ± systemic diseases . Defects of structure ‡ deciduous teeth ± neonatal jaudice p yellow ± congenital porphyria p red ± Tetracycline ‡ permanent teeth ± periapical infection of d.

Gardner´s syndrome ‡ ‡ ‡ ‡ infective ± congenital syphilis metabolic ± childhood infections. rickets drugs ± tetracycline.1c. Defects of structure ± systemic diseases ‡ genetic ± amelogenesis imperfecta ± dentinogenesis imperfecta ± Ehlers-Danlos syndrome. cytotoxic chemotherapy fluorosis .

hard ± Hereditary enamel hypocalcification ‡ normal matrix poorly calcified ± soft. chalky .1c. Defects of structure ± systemic diseases ‡ Amelogenesis imperfecta ± all teeth + whole enamel x dentine normal ± Hereditary enamel hypoplasia ‡ defect of matrix formation ± pits. grooves.

Defects of structure ± systemic diseases ‡ Dentinogenesis imperfecta ± defect of collagen. Shell teeth . translucent enamel p chip away ± obliteration of pulp ± dentine .few tubules + abnormal matrix + incomplete calcification Dentinal dysplasia Regional odontodysplasia.1c. AD ± normal teeth shape ± brownish.

Defects of structure ± systemic diseases ‡ Ehlers . supernumerary teeth .1c.Danlos syndrome (floppy joints) ± collagen disorder ± hypermobile joints + loose skin ± small teeth + short roots + pulp stones ‡ Gardner´s syndrome ± multiple osteomas (jaws) + skin tumors + colonic polyps p malignant change ± impacted teeth.

pallidum ± permanent teeth ‡ upper 1.Hutchinson ± later fetal infection ± dental follicle infection by T.1c. I (Hutchinson´s incisors) ± barrel-shaped fissure on incisal edge ‡ 1. M (Moon´s molar) ± pitted occlusal surface . Defects of structure ± systemic diseases ‡ Congenital syphilis .

Defects of structure ± systemic diseases ‡ Tetracycline (TTC) ± calcifying tissues ± yellow fluorescence (UV light) ± during teeth development ± fetus x infancy ± dentine ± bright yellow p brown p grey ± permanent ± NOT TTC under 12 years .1c.

Defects of structure ± systemic diseases ‡ Fluorosis (mottled enamel) ± o fluoride in drinking water ± paper-white patches p brown ± permanent teeth ± hydroxyapatite p calcium fluoroapatite ± matrix normal .1c.

Developmental disorders . Abnormalities of number ‡ 1c.1. Abnormalities of size and form ‡ 1b.teeth ‡ 1a. Disorders of eruption . Defects of structure ‡ 1d.

rickets .1d. Disorders of eruption ‡ deciduous teeth: 6th month ± 2nd year ± at birth: natal teeth ± 1st month: neonatal teeth (lower 1. I) ‡ permanent teeth: 6th year ± 25th year ± loss of space. predecessor ± cretenism. retention of a dec.

Clefts ‡ 4.Developmental disorders ‡ 1. Jaws ‡ 3. Oral soft tissue . Teeth ‡ 2.

Developmental disorders .jaws ‡ ‡ ‡ ‡ ‡ ‡ micrognathia x macrognathia hereditary prognathism craniofacial anomalies cherubism Gardner´s syndrome osteogenesis imperfecta .2.

Teeth ‡ 2.Developmental disorders ‡ 1. Jaws ‡ 3. Oral soft tissue . Clefts ‡ 4.

o males.genetic component (40%) cleft lip . inc. inc. Developmental disorders .3.clefts ‡ ‡ ‡ ‡ ‡ ‡ NOT clefts   non-fusion !!! ? ethiology . 1/2000 lip : lip + palate : palate «22% : 58% : 20% + Down´s syndrome . 1/1000 cleft palate .o females.

staphyloschisis .uranoschisis uvula cleft . Developmental disorders .clefts ‡ cleft lip ± cheiloschisis ± lateral: unilateral (left side) x bilateral ± medial ‡ ‡ ‡ ‡ cleft alveolar ridge ± gnathoschisis hard palate cleft ± palatoschisis soft palate cleft .3.

Developmental disorders .clefts ‡ complications ± malformation or absence of teeth in defect ± + other congenital defects ± feeding disorder ± breathing disorder ± speech defect ± cosmetic defect .3.

Clefts ‡ 4.Developmental disorders ‡ 1. Jaws ‡ 3. Teeth ‡ 2. Oral soft tissue .

Developmental disorders ± oral soft tissues ‡ 4a. oral mucosa ‡ 4b. tongue . gingiva and periodontium ‡ 4c.4.

soft. buccal location . Developmental disorders ± oral mucosa ‡ white sponge nevus ± AD inheritance ± white.4a. thickened area of oral mucosa ± Mi: acantosis + hyperkeratosis + intracellular oedema ‡ Fordyce´s granules ± heterotopic sebaceous glands ± 80% adults ± soft. papules ± symetrical. creamy spots.

preceding of teeth eruption ± Mi: collagen bundles ± gingivectomy after puberty ‡ Ehlers-Danlos syndrome .4b. Developmental disorders ± gingiva and periodontium ‡ hereditary gingival fibromatosis ± AD inheritance ± grossly enlarged gingivae .

Developmental disorders ± tongue ‡ macroglossia ± ± ± ± muscle hypertrophy congenital haemangioma or lymphangioma Down´s syndrome lingual thyroid ‡ inc. foramen caecum ‡ cleft tongue ‡ ankyloglossia . 10% ‡ nodule.4c.

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