Chapter 5:

Developmental Disorders

Vi Hoang, Paola Martinez, Melany Esquivel, Shalma Balderas

 Embryonic Development of the Face
● The mandibular arch forms the lower part of
3rd week the cheeks, the mandible, and part of the
● of embryonic life, of the ectoderm forms the tongue.
primitive oral cavity (which is called stomodeum).
● Lateral nasal processes forms the side of the
Just above it is a process called the frontal
process. Just below it is a structure called the first nose
branchial arch. All of the face and most of the ● Median nasal process forms the center and tip
structures of the oral cavity develop from either of the nose.
the frontal process or the first branchial arch. ● Later, the median nasal process grows
● Then the first branchial divides into Maxillary downward between the maxillary processes to
process and mandibular process. form the globular process forming into the
4th week
philtrum(upper lip)
● As the development continues two pits
open(called olfactory pits) marking the opening of
the nose that develop on the surface of the frontal
process.
● The frontal process divides into 3 parts: (1)The
median nasal process, (2) the right lateral nasal
process, (3) left lateral process.
Oral and Nasal Cavities
● The area of the palate called the
premaxilla develops from the globular
process
● Lateral palatine processes form from the
maxillary process
● ˜The lateral palatine processes fuse with
the premaxilla, creating a Y-shaped
pattern
● ˜The body of the tongue develops from
the first branchial arch
● ˜The base of the tongue forms from the
second and third branchial arches
Development of the oral cavity by week

Question

● The ectoderm forms

the primitive oral cavity
which is called ….

-stomodeum
Do eruption cysts need
treatment?
Development of Cyst
 Calcifying Odontogenic Cyst
- Composed of odontogenic
epithelium that contains “ghost”
cells.

- The cystic variant of a ghost cell

lesion accounts for the majority
of cases and is called a calcifying
odontogenic cyst.

- Solid variant is called a

dentinogenic ghost cell tumor.

- Affects all ages. Most commonly What ages are affected by the
seen in individuals younger than calcifying odontogenic cyst?
40 years. No significant sex
preference is noted. All ages, but most common in those
younger than 40.
- Lesions occur equally in the
maxilla and mandible, most
often in the incisor and cuspid
area.
 Calcifying Odontogenic Cyst contin… - Microscopic examination
usually reveals a cystic
structure lined by
- Radiographically, that may
odontogenic epithelium with
present either radiolucent or
an associated and
mixed radiolucent radiopaque
characteristic ghost cell
lesion.
keratinization. The epithelium
resembles that seen in
- Presents radiographically as a
ameloblastoma, consisting of
well-defined, unilocular or
ameloblast- like cells and
multilocular radiolucency.
stellate reticulum- like areas.
Calcifications can occur and are
The ghost cells that are
seen as radiopaque areas within
characteristic of this lesion
the radiolucency
exhibit a clear central area.
They are thought to
- Treated by surgical enucleation
represent degenerating
(removal of entire globe). Rarely
epithelial cells or atypical
recur
form of keratinization
 Lateral Periodontal Cyst
- Is a developmental odontogenic cyst

- Occurs most often on the lateral root surface of the

mandibular canine and premolar teeth. Can be seen in the
same area in the maxilla

- Presents as asymptomatic, unilocular or multilocular

radiolucent lesion that is most often seen in adults
between the ages 50 and 70 years.

- Generally treated by conservative enucleation of the cyst.

- microscopically, the lateral periodontal cyst shows a thin

epithelial lining with focal epithelial thickenings.

- Found most often in males.

- Treated by surgical excision.

- Few cases of recurrence of lateral periodontal cysts have

been reported.
- Not related to tooth development.
Globulomaxillary Cyst
- Type of developmental cysts that actually arises in the
bone suture between the maxilla and premaxilla

- Develops from the result of proliferation of the

epithelium, entrapped along the line of fusion
between maxilla and premaxilla

- Site: between lateral incisor and canine

- Usually asymptomatic

- Causes pain and discomfort only when it is

secondarily infected

- Radiographically: we’ll circumscribed unilocular

radiolucency . Roots reveals divergence

- Microscopically: lined by either a stratified/

pseudostratified ciliated columnar epithelium or thin
squamous epithelium

- Enucleation
Developmental
Abnormalities of
Teeth
ANODONTIA
● Congenital LACK of teeth
● Total anodontia is the lack of
ALL teeth, may affect the
deciduous or permanent
dentition
● Associated with hereditary
disturbance called hereditary
hypohidrotic ectodermal
dysplasia
● Teeth may not be identified
missing until :
○ Time of normal eruption
○ Radiographic exam
HYPODONTIA
➔ Lack of one or more teeth may affect
either detention but more commonly
seen in permanent dentition
➔ Can affect ANY tooth
➔ Most often teeth are missing bilaterally
➔ Teeth most often missing include:
◆ Max. + Man. 3rd molars
◆ Max. lateral incisors
◆ Man. 2nd premolars
◆ Man. incisor is the most commonly
missing tooth in the deciduous
dentition
➔ Missing teeth may be familial
➔ Missing teeth may be a sign of a
syndrome and should be evaluated
further
➔ Prosthetic replacements or ortho
evaluation required
 Oligodontia

Subcategory of hypodontia in which SIX or

more teeth are missing (not including 3rd
molars)
SUPERNUMERARY TEETH
★ EXTRA teeth, result from either the formation of
extra tooth buds in the dental lamina OR the
cleavage of already existing tooth buds
★ May occur in either dentitions, most commonly
seen in the maxilla
★ Most common supernumerary teeth is the
Mesiodens (located between midline 8/9)
followed by the distoden (distal to 3rd molar)
★ Erupted supernumerary teeth may require
removal if crowding, malpositioning, or non
eruption of other teeth occur. Unerupted
supernumerary teeth require removal to prevent
cyst development.
★ Multiple supernumerary teeth are associated
with cleidocranial dysplasia or Gardner
syndrome.
TRUE OR FALSE?
Distodens are extra teeth
located between the midline.

FALSE, Distodens are

located behind the
3rd molars!