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PERAN RADIOLOGI dalam ANALISA TUMBUH KEMBANG

dr. Lila Indrati, SpRad

ODONTOGENESIS
Odontogenesis is the complex process by which teeth form from embryonic cells, grow, and erupt into the mouth.

Dentition
Primary dentition develops during prenatal period
20 teeth

Permanent dentition develops as the jaw grows and matures


32 teeth

period in between during the preteen years


mixed dentition period

ODONTOGENESIS
Enamel, dentin, cementum, and the periodontium must all develop during appropriate stages of fetal development. Primary (baby) teeth start to form between the sixth and eighth weeks Permanent teeth begin to form in the twentieth week

Normal dental development


deciduous - 20: permanent - 32:
incisors
-8 incisors - 8 canines - 4 premolars - 8 molars - <12

canines - 4 premolars - 0 molars - 8

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Dental age
Panoramic radiograph dental age chronological age.

The Growth

DEMIRJIAN

Bone age assessment


Bone age : degree of maturation of bones
G r o w s skeleton change : size & shape x-ray. At birth : Only metaphyses are present epiphysis elongation
(end of the growing bone)

epiphyses calcified x-rays

Bone age assessment


Radiological examination of skeletal development of the left-hand wrist bone age chronological age. The Growth accelerating or decreasing? social true age

universally used

simplicity, minimal radiation exposure, the availability of multiple ossification centers for evaluation of maturity.

Method
Greulich and Pyle (GP method)
: faster, easier
: more accurate

Tanner and Whitehouse (TW2 method)

Greulich and Pyle based on a single x-ray of the fingers, hand, and wrist
easily x-rayed with minimal radiation shows many bones in a single view.

compared to the bones of a standard atlas

Development of the ring finger


from a baby- 19 Y. In the fifth image, the epiphysis appears, which becomes wider and in the final images fuses with the metaphysis. from the Greulich and Pyle atlas

Tanner and Whitehouse ("TW2" method) doesnt use a scale based on the age based on a set of bones standard maturity for each age population. 20 regions of interest (ROIs) located in the main bones are considered for the bone age evaluation

1. First metacarpal 2. Proximal phalanx of the thumb 3. Distal phalanx of the thumb 4. Third metacarpal 5. Proximal phalanx of the third finger 6. Middle phalanx of the third finger 7. Distal phalanx of the third finger 8. Fifth metacarpal 9. Proximal phalanx of the fifth finger 10. Middle phalanx of the fifth finger 11. Distal phalanx of the fifth finger

Dental development and abnormalities

number
increase or decrease

position form
individual or multiple

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DENTAL AGE

Photography

Age: 15, male

Radiography

Age 19, male Stage H (by DEMIRJIAN)

Age 19, male Stage H (by DEMIRJIAN)

Maturity indicators of individual bones and epiphyses

Age 15, male The epiphysis of the radius has capped it's shaft. All carpals have attained their early adult shape. Fusion is under way in the epiphyses of all distal phalanges.

Age 17, female In the ulna and in the heads of all fingersthe epiphyseal lines have been almost completely obliterated. In the radius thin terminal lines extend completely across the shaft (see arrow).

Age 17, female Epiphysial lines of ulna and radius still smooth marked. The intersticesof ulna and radius mostly ossified,but perceptible. Fusion is nearly complete.

GANGGUAN TUMBUH KEMBANG DENTOKRANIOFASIAL


ANOMALI GIGI 1. ANOMALI JUMLAH ANODONTIA HYPODONTIA SUPERNUMERARI 2. ANOMALI BESAR MICRODONTIA MACRODONTIA 3. ANOMALI BENTUK GEMINASI FUSI DENS INVAGINATUS 4. ANOMALI ERUPSI Gigi sudah ada waktu lahir

Hypodontia
is a lack of some tooth development the most common developmental abnormalities, 3.58.0% of the population (not including third molars). more common in permanent than primary dentition associated with the absence of a dental lamina infection , chemotherapy medications also associated with many syndromes (Down syndrome and Crouzon syndrome )

Severe Hypodontia/Anodontia
complete lack of tooth development jarang biasanya pd Hypohidrotic ectodermal dysplasia

Hyperdontia
is the development of extraneous teeth occurs in 13% of Caucasians, more frequent in Asians 86% involve a single extra tooth in the mouth, most commonly found in the maxilla (incisors) occasionally associated with other developmental defects more common in females than males

Double teeth developmental anomaly teeth usually united by dentine (with or without pulp) more common in primary than permanent dentition anterior teeth mainly involved Concrescence acquired anomaly union by cementum alone following hypercementosis

GERMINASI PREMOLAR

Regional Odontodysplasia Rare maxilla and anterior teeth.

cause : unknown;
disturbance in the neural crest cells Infection radiation therapy decrease in vascular supply

Regional Odontodysplasia
never erupt into the mouth have small crowns yellow-brown irregular shapes. radiographs translucent "wispy," "ghost teeth"

Neoplastic, odontogenic
benign
cementomas cementifying fibroma myxoma

ameloblastoma * adenomatoid odontogenic tumour calcifying epithelial odontogenic tumour


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ameloblastoma *

Neoplastic, odontogenic

male, 15, clinical expansion definite root resorption thinning of cortex lingually no cortex evident buccally findings suggest a locally aggressive lesion

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Terima Kasih

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