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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 .

periodontal membrane. thicken. Proliferation (cap stage) Mesenchim cell  proliferation. vascularated dental papillae  Dental papillae  pulp+dentine  Thicken of mesenchime cell cementum. 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 Huchinson’s incisors and mulberry molars Taurodontism .

dentinal dysplasia Enamel : amelogenesis imperfecta Enamel hypoplasia Enamel opacities fluorosis . Matrix deposition      Dentine : dentinogenesis imperfecta.

 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 .

Related to genetic syndromes .Hypodontia     Hypodontia. progressive degrees of missing teeth Oligodontia: >6 missing teeth Anodontia: compolete absence of teeth.

Supernumerary teeth     Arising as a result of budding of dental lamina Frequency in primary teeth 0.0-3.8% Permanent teeth 1.3-0.5% 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 .

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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 .

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Dentinogenesis Imperfecta   Inherited disorder of dentine May be associated with osteogenesis imperfecta .

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