Developmental

disorders
Dr. Chakshu Aggarwal (MDS)
Snr Lecturer
Oral Pathology
Developmental disorders
 1. Teeth

 2. Jaws

 3. Clefts

 4. Oral soft tissue

Anomalies of Teeth
 Alterations in Size
 Shape
 Number
 Structure
 Growth (Eruption)
Teeth(Size)
 Microdontia …. teeth < normal
 True generalized
 Relative generalized
 Single tooth
 Macrodontia …teeth > normal
 True generalized
 Relative generalized
 Single tooth/localized
 Microdontia
 Teeth appear smaller than normal
 Most commonly seen in maxillary lateral
 incisors (cone or peg shaped) peg lateral.
 Autosomal dominant condition.
 Nil significance except cosmetic appearance
 2nd most common is maxillary 3rd molar followed by
supernumerary teeth.
 Macrodontia

 Appearance of enlarged teeth throughout dentition.

 Causes:
 Pituitary gigantism
 Disproportionate max/ mand
 Relatively uncommon
 Seen in mandibular 3rd molars
 Also in a condition known as hemifacial hypertrophy.
Alterations in Shape
Shape

 Gemination
 Fusion
 Concrescence
 Dilaceration
 Talon’scusp
 Dens in Dente
 Dens Evaginatus
 Taurodontism
 Supernumerary Roots
 Gemination
 Division of a single tooth germ by invagination
 Result == incomplete formation of two teeth
 Appearance of 2 crowns sharing the same root
canal.
 Complete division== Twinning
 Cause unknown (trauma suggested as possible
cause)
 Problems:
 Cosmetically acceptable
 Crowding
 Teeth number Increase
 Fusion

 Joining of two developing tooth germs.

 Btwn Normal & Supnm Tooth (wd Mesio/distoM)
 Incomplete/ complete fusion
 May involve entire length of teeth or roots only.
 Resulting in a single large tooth/ Root fused
 Root canals can be separate or shared.
 Dentin fusion is present
 Cause is unknown/ pressure, physical force.
 Teeth Number Decrease
 Concrescence
 Isa form of fusion whereby already formed teeth
are joined by cementum.
 Take place before or after eruption.
 After calcification
 Related to trauma or overcrowding.
 Common in max 2nd and 3rd molars.
 Diagnoses by Radiographs
 Nil significance except during extraction
 Surgical sectioning maybe be required
Dilaceration
 Curving or angulation of tooth roots.
 Cause due to trauma during tooth development.
 Position of calcified portion is changed
 Nil problems with eruption.
 Difficult extractions.
 Challenging Endodontics
Talon Cusp
 Anomalous structure projects lingually from the cingulum area
of Max/Mand 2* Incs.
 Smooth blending of cusp with tooth but have a deep
developmental groove
 Composed of N Enamel, dentin and pulp horn
 Prob : esthetics
 Caries
 Occlusion interfernce
 Rubinstein-Taybi syndrome
 Dens Invaginatus
 Dens in dente or tooth within a tooth.
 Uncommon anomaly
 Invagination in the surface of tooth crown before
calcification
 Causes
 Increased localised external pressure
 Focal growth retardation/ stimulation in tooth bud
 Range in severity:
 Superficial crown affected
 Both crown & root affected (deep)
 Commonly involved tooth is maxillary lateral
(bilaterally involvement)
 Radigraphs
 Pear shaped invagination of enamel and dentin closely
approximating pulp
 Invagination extending near the apex of root

 Problems:
 Problems with plaque control
 Early tooth decay
 Pulpal infections
Prevention and early identification
important
 Dens Evaginatus/Leong’s
Premolar/Occlual Enamel Pearl
 Developmental condition affecting premolar.
 Defect is Uni/bilateral.
 Tubercle or cusp is located on the occlusal surface.
 Similar to talon cusp
 Pathogenesis
 Proliferation & evagination of Inn Enm Orgn & odontogenic mesenchyme
 Problems:
 Occlusal abrasion causes exposure of an accessory pulp horn.
 Resulting in p.a pathology in caries- free teeth
 Occurs before root development and apical closure making RCT difficult.
 Treatment:
 Selective grinding of opposing tooth or the tubercle to stimulate
secondary dentine formation
Taurondontism
 Teeth with elongated crowns or apically displaced
furcations.
 ‘Bull like’ teeth
 1*/2* dentition, molar single/multiple
 Increased apical-occlusal height of pulp ch.
 Various degrees of severity are present.
 Appearances in Downs and Klinefelter’s syndrome.
 Little clinical significance
 No treatment required.
 Supernumerary Roots

 Accessory roots commonly seen in mandibular

canines,premolars,molars.
 Significant during tooth extraction and RCT.
Number
 Anodontia
 Supernumerary teeth
 Predeciduous Dentition
 Post Permanent Dentition
Abnormalities of number
 Isolated hypodontia – common
 hereditary
 3. M + 2. P + 2.I
 Oligodontia

 Anodontia – very rare

Supernumerary Teeth

 Extra teeth in the dentition

 Continued proliferation of primary or permanent
dental lamina to from a third tooth germ.
 Present with normal morphologhy or or maybe
miniture.
 Mostly isolated occurrence but some associated
with syndromes :
 Gardner Syndrome or Cleidocranial dysplasia
 Supernumerary Teeth
 More common in primary teeth then permanent teeth.
 More frequent in maxilla than in mandible (10:1).
 Anterior midline of mandible is most common site
(mesiodens).2nd common is max molar area (4th molar).
 Significance:
 Crowding
 Malocclusion
 Perio problems
 Esthetics