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

Proliferation (cap stage)

Mesenchim cell proliferation, thicken,
vascularated dental papillae
Dental papillae pulp+dentine
Thicken of mesenchime cell
cementum, periodontal membrane,
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
Huchinsons incisors and mulberry molars
Taurodontism

Matrix deposition

Dentine : dentinogenesis imperfecta, dentinal

dysplasia
Enamel : amelogenesis imperfecta
Enamel hypoplasia
Enamel opacities
fluorosis

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

Hypodontia

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

Supernumerary teeth

Arising as a result of budding of dental lamina

Frequency in primary teeth 0,3-0,8%
Permanent teeth 1,0-3,5%
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

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

Dentinogenesis Imperfecta

Inherited disorder of dentine

May be associated with osteogenesis
imperfecta

Thank
You