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Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO
Dentistry 123: Pediatric Dentistry
TOOTH ANOMALIES
DR. ELMER ESCOTO

DENTAL ANOMALIES

Anomaly

an aberration or deviation from normal anatomic

growth, development, or function

Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO DENTAL ANOMALIES  Anomaly ∑ an aberration
ATTRITION
ATTRITION
Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO DENTAL ANOMALIES  Anomaly ∑ an aberration

Physiologic wearing of the incisal/occlusal edges resulting

from mastication Influenced by:

Diet quality

Dentition/malocclusion

Chewing habits (e.g. chewing ice)

Improperly placed restorations (esp Porcelain crowns)

by damaging the antagonist tooth Jaw musculature – higher biting force, greater possibility of occurrence

 

ABRASION

 
 Physiologic wearing of the incisal/occlusal edges resulting  from mastication Influenced by: ∑ Diet quality

Pathologic wearing of tooth structure

Influenced by:

Abnormal habits (pipe smoking, nail biting)

Improper brushing technique

EROSION
EROSION
Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO DENTAL ANOMALIES  Anomaly ∑ an aberration

Wearing away of tooth structure due to chemical

substances (commonly acids) Influenced by:

Diet (citrus fruits)

Work-related – concerning acid use

Stomach acids – gastric esophageal reflux, bulimia

 

TALON’S CUSP

 
 Wearing away of tooth structure due to chemical  substances (commonly acids) Influenced by: ∑

Incisor that looks like a “T” on the incisal

Accessory cusp on lingual surface of the incisors

Arises from the cingulum resembling an eagle’s talon

Deep developmental grooves on the sides thus making

the area difficult to clean = prone to caries Cusp is made of enamel, dentin and pulp tissue

 

Injudicious

grinding

of

the

cusp,

may result in

pulp

exposure

 

MAMELONS

 
 
 the area difficult to clean = prone to caries Cusp is made of enamel, dentin
 

Normal condition seen in newly erupted teeth representing

the cusp that have joined together during tooth development (evolved from reptiles) Generally absent in adults due to physiologic wear of the incisal edges (normal attrition)

 

GEMINATION

 
 
 the area difficult to clean = prone to caries Cusp is made of enamel, dentin
 the area difficult to clean = prone to caries Cusp is made of enamel, dentin
 

An attempt to make two teeth from a single enamel organ

Partial cleavage with two crowns but share a single root

canal If cleaving becomes complete, the term is TWINNING

Exact etiology is unknown

Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO
Dentistry 123: Pediatric Dentistry
TOOTH ANOMALIES
DR. ELMER ESCOTO

May be due to trauma

 
 

FUSION

 
 May be due to trauma FUSION  Joining of two developing tooth germs resulting in
 

Joining of two developing tooth germs resulting in a single

large tooth Exact etiology is unknown; trauma is suggested

 

CONCRESCENCE

 
 
 May be due to trauma FUSION  Joining of two developing tooth germs resulting in
 

The fusion of cementum of adjacent teeth

May be due to trauma/ overcrowding

More commonly seen in mx 2 nd and 3 rd molars

 

Problem if one tooth has to be extracted

Sectioning should be done on the tooth

 

TAURODONTISM

 
 
 May be due to trauma FUSION  Joining of two developing tooth germs resulting in
 

Tooth

with

elongated

crowns

and

apically

displaced

furcations Increase in the size of pulp chambers

Teeth that are likely seen in bulls/ungulates, thus the term

 

MICRODONTIA

 
 
 May be due to trauma FUSION  Joining of two developing tooth germs resulting in
 

Teeth that appear smaller than normal

 

Example: Peg shaped laterals

Commonly seen in lateral incisors and 3 rd molar

The cause of the disease is genetic disorder

 

MACRODONTIA

 
 Commonly seen in lateral incisors and 3 molar  The cause of the disease is

Teeth that appear larger than normal

Can cause:

Crowding

Abnormal eruption pattern due to insufficient space

 

SUPERNUMERARY TEETH

 
 Commonly seen in lateral incisors and 3 molar  The cause of the disease is
 Commonly seen in lateral incisors and 3 molar  The cause of the disease is

Extra teeth

Can prevent eruption of other teeth

Can cause malocclusion

Can interfere with orthodontic treatment

Inhibit tooth movement

Causes relapse

 

MESIODENS

 
 Commonly seen in lateral incisors and 3 molar  The cause of the disease is

Also a supernumerary teeth

Extra teeth specifically seen between central incisors

May cause malocclusion

May cause diastema between central incisors/ interfere with orthodontic treatment

SUPERNUMERARY ROOTS

  Accessory roots usually seen in mandibular canines, premolars and molars Important consideration when root
Accessory roots usually seen in mandibular canines,
premolars and molars
Important consideration when root canal treatment/
Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO
Dentistry 123: Pediatric Dentistry
TOOTH ANOMALIES
DR. ELMER ESCOTO

extraction of the tooth is concerned

LEONG’S PREMOLAR/ DENS EVAGINATUS

Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO extraction of the tooth is concerned LEONG’S

Seen in patients of oriental/Chinese descent

Presence of an extra tubercle on the occlusal surface of

lower premolars Usually occurs bilaterally

Exposure can result in odontogenic infections

 

DENS INVAGINATUS/ DENS IN DENTE

 
 Seen in patients of oriental/Chinese descent  Presence of an extra tubercle on the occlusal

Tooth within a tooth

Cingulum goes inward

Exaggeration or accentuation of the lingual pit (deeper

concavity inside the tooth) Mx lateral incisor commonly involved

Exact etiology: unknown (idiopathic)

Hard to clean hence high incidence of caries and possible

pulpal exposure Oriental people

 

DILACERATION

 
 
 Seen in patients of oriental/Chinese descent  Presence of an extra tubercle on the occlusal

Extreme curvature in apical root portion of a tooth

May be due to trauma

Can fracture off during extraction procedures or failure to completely perform RCT (the tip is still untreated)

 

INTERNAL RESORPTION

 
 Seen in patients of oriental/Chinese descent  Presence of an extra tubercle on the occlusal
 Seen in patients of oriental/Chinese descent  Presence of an extra tubercle on the occlusal

Wearing away of dentin of pulpal wall

Part of inflammatory response to pulpal injury

May be idiopathic in nature

A pinkish

hue on enamel

if

there is proximity to visible

external surface Can be arrested by root canal treatment as long as no perforation occurred yet

EXTERNAL RESORPTION

Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO extraction of the tooth is concerned LEONG’S

Wearing away of dentin and cementum of root portion

Can be caused by:

Trauma

Pressure from adjacent impacted tooth (can cause

resorption caries on 2 nd and 3 rd molar) Excessive orthodontic forces

Reimplantation/ transplantation

Malignant lesions (oral cancer, causes resorption of

bone) Cystic lesions

Ameloblastoma (condition of odontogenic tumor that

erodes teeth or bone) Chronic inflammatory process

 

ENAMEL PEARL

 
 Wearing away of dentin and cementum of root portion  Can be caused by: ∑

Droplets of ectopic enamel found on the root surfaces of teeth especially at the furcation area of molars

not fully embedded in bone, disease

If

it can cause periodontal

 

HYPERCEMENTOSIS

 
 Wearing away of dentin and cementum of root portion  Can be caused by: ∑

Overproduction of cementum at the root portion of tooth,

usually at apical 1/3 more commonly affected: Bicuspids

can be a problem during extraction

Can fracture off leaving hypercementosed portion

Prevent extraction of teeth

Cause alveolar bone to break off

May be due to:

Tooth repair- improper restoration

Inflammation

Hypoocclusion – teeth not in occlusion so there is

build up of cementum to achieve contact Paget’s disease

Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO
Dentistry 123: Pediatric Dentistry
TOOTH ANOMALIES
DR. ELMER ESCOTO
 

Acromegaly

Pituitary gigantism

 

ALTERATION IN TEETH NUMBER

 
∑ Acromegaly ∑ Pituitary gigantism ALTERATION IN TEETH NUMBER  Hypodontia ∑ Congenital partial absence of

Hypodontia

 

Congenital partial absence of teeth, unknown etiology

Anodontia

Congenital total absence of teeth, genetically linked etiology Sometimes linked to some genetically linked disorder e.g. ectodermal dysplasia (no proper formation of ectoderm so no teeth and no sweat glands formed)

 

NATAL TEETH

 
∑ Acromegaly ∑ Pituitary gigantism ALTERATION IN TEETH NUMBER  Hypodontia ∑ Congenital partial absence of

Deciduous teeth that appear at birth

Md incisors commonly involved

May cause traumatic ulcers during feeding

If mobile or causes frequent trauma to the soft tissues, needs to be removed

 

PULP STONES

 
∑ Acromegaly ∑ Pituitary gigantism ALTERATION IN TEETH NUMBER  Hypodontia ∑ Congenital partial absence of

Calcifications made of dentin present in pulp chambers or

canals of teeth Can make RCT procedure difficult (can hinder in cleaning the canal efficiently

 

FLUOROSIS

 
∑ Acromegaly ∑ Pituitary gigantism ALTERATION IN TEETH NUMBER  Hypodontia ∑ Congenital partial absence of

Due to intake of excess fluoride (more than 1ppm)

Occurs during crown formation of tooth

Appears as white enamel spots, brownish-whitish-grayish discoloration on tooth

Caries resistant but poor esthetics

DENTINOGENESIS IMPERFECTA/ HEREDITARY OPALESCENT DENTIN

Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO ∑ Acromegaly ∑ Pituitary gigantism ALTERATION IN

Genetically inherited

Primary and secondary dentin may be affected

Can occur in combination with Osteogenesis Imperfecta

Teeth may have translucent appearance

May be opalescent shades of yellow

Enamel is normal but may fracture easily due to poor

dentin support and lacks scallop at DEJ Dentin too soft cannot support enamel enamel may break yellow to brown to gray

 

AMELOGENESIS IMPERFECTA

 
 Genetically inherited  Primary and secondary dentin may be affected  Can occur in combination
 Genetically inherited  Primary and secondary dentin may be affected  Can occur in combination

Genetically linked disorder of enamel

Insufficient amounts of enamel

May be just pits and grooves

Reduced thickness

Abnormal contour

Enamel did not develop normally thin may fracture white to brown to yellow

ENAMEL HYPOPLASIA

Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO ∑ Acromegaly ∑ Pituitary gigantism ALTERATION IN

Hypocalcification Syphilis-related

∑ ∑ Hutchinson’s incisors Bacteria formation during tooth development Mulberry molars
Hutchinson’s incisors
Bacteria formation during tooth development
Mulberry molars
Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO
Dentistry 123: Pediatric Dentistry
TOOTH ANOMALIES
DR. ELMER ESCOTO

Multiple cusps

TURNER’S TOOTH
TURNER’S TOOTH
Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO Multiple cusps TURNER’S TOOTH  Hypoplasia or

Hypoplasia or hypocalcification of permanent tooth that

comes into contact with infected primary teeth Due to infection/ abscess formation

May also be traumatic intrusion of primary tooth

 

TETRACYCLINE STAIN

 
 comes into contact with infected primary teeth Due to infection/ abscess formation  May also

Can be incorporated into dentin of developing teeth if

given to pregnant patients or children under 8 Yellow-grayish-brown discoloration

May fluoresce as bright yellow under UV light

REFERENCES:
REFERENCES:

Dr. Escoto’s lecture Batch 2015 Oral Anat Trans by Anne and Mikka Google Images

Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO Multiple cusps TURNER’S TOOTH  Hypoplasia or
Dentistry 123: Pediatric Dentistry TOOTH ANOMALIES DR. ELMER ESCOTO Multiple cusps TURNER’S TOOTH  Hypoplasia or