Dental Anomalies Quiz

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Questions and Answers

Which dental anomaly is characterized by an extraordinary curving or angulation of the tooth root?

  • Taurodontism
  • Dilaceration (correct)
  • Enamel pearl
  • Dens invaginatus

What is another term for dens invaginatus?

  • Enamel pearl
  • Supernumerary teeth
  • Tooth within a tooth (correct)
  • Dens evaginatus

Which teeth are most commonly affected by dens invaginatus?

  • Maxillary lateral incisors (correct)
  • Mandibular molars
  • Mandibular canines
  • Maxillary premolars

Which anomaly is described as an anomalous tubercle or cusp located in the center of the occlusal surface?

<p>Dens evaginatus (A)</p> Signup and view all the answers

What is a key characteristic of taurodontism?

<p>An enlarged body and pulp chamber (C)</p> Signup and view all the answers

Which of the following best describes the term 'mesiodens'?

<p>A supernumerary tooth in the anterior midline (B)</p> Signup and view all the answers

Where are enamel pearls most commonly found?

<p>At the furcation area of the roots (C)</p> Signup and view all the answers

Which of the following is LEAST likely to harbor supernumerary teeth?

<p>Incisors (A)</p> Signup and view all the answers

What is a key characteristic of enamel pearls?

<p>They are often located on the root surface. (C)</p> Signup and view all the answers

Which type of tooth wear is primarily caused by an external chemical process not involving bacteria?

<p>Erosion (D)</p> Signup and view all the answers

A patient presents with teeth that appear chipped at the gum line. Which condition is MOST likely the cause?

<p>Abfraction (D)</p> Signup and view all the answers

Complete anodontia is MOST strongly associated with which condition?

<p>Ectodermal dysplasia (B)</p> Signup and view all the answers

What is the primary difference between abrasion and attrition?

<p>Abrasion is due to mechanical forces other than opposing teeth, while attrition involves opposing teeth. (C)</p> Signup and view all the answers

Which of these situations is classified as 'false anodontia'?

<p>A patient has lost teeth due to extraction. (A)</p> Signup and view all the answers

What is the main cause of abfraction lesions?

<p>Microfractures from heavy loads on the cervical area. (C)</p> Signup and view all the answers

A patient presents with worn down teeth which are also translucent. Which condition MOST likely accounts for this?

<p>Erosion (D)</p> Signup and view all the answers

In which condition do all teeth appear smaller than normal?

<p>Generalized Microdontia (D)</p> Signup and view all the answers

What is a key characteristic of gemination?

<p>Fusion of two teeth from a single enamel organ (B)</p> Signup and view all the answers

Which of the following best describes the term concrescence?

<p>Joining of adjacent teeth by cementum. (B)</p> Signup and view all the answers

What is a likely consequence of generalized macrodontia due to insufficient space?

<p>Overcrowding and abnormal eruption patterns (A)</p> Signup and view all the answers

What distinguishes localized microdontia from generalized microdontia?

<p>Localized microdontia affects a single tooth only, while generalized affects all teeth. (D)</p> Signup and view all the answers

Which teeth are most commonly affected by concrescence?

<p>Maxillary second and third molars (C)</p> Signup and view all the answers

In fusion, what structures might be shared between teeth?

<p>Cementum and dentin maybe shared; root canals may or may not be shared. (C)</p> Signup and view all the answers

What is a key feature of localized macrodontia?

<p>One single tooth is seen as abnormally large. (C)</p> Signup and view all the answers

Which of the following is NOT a typical cause of tooth impaction?

<p>Localized trauma (D)</p> Signup and view all the answers

What type of enamel defect is characterized by a normal amount of enamel, but with impaired mineralization?

<p>Enamel hypocalcification (C)</p> Signup and view all the answers

Which of the following factors does NOT influence the effects of enamel hypoplasia?

<p>Patient's age at the time of exposure (B)</p> Signup and view all the answers

A patient presents with enamel defects on a permanent tooth due to a periapical inflammatory disease of the overlying deciduous tooth. The affected tooth is known as a:

<p>Turner’s tooth (D)</p> Signup and view all the answers

Why are anterior teeth less frequently affected by Turner's hypoplasia?

<p>Anterior crown formation is usually complete before development of apical inflammatory disease. (C)</p> Signup and view all the answers

Systemic factors generally impact developing teeth if they occur:

<p>After birth and before the age of six. (D)</p> Signup and view all the answers

Which of the following is NOT a cited cause for enamel hypoplasia or hypocalcification?

<p>Osteoporosis (B)</p> Signup and view all the answers

Hutchinson’s incisors are characterized by:

<p>Tapered incisally and notched centrally on the incisal edge. (C)</p> Signup and view all the answers

What is the characteristic feature of 'mulberry molars'?

<p>Lobulated or crenated occlusal surface (D)</p> Signup and view all the answers

Which of the following best describes fluorosis?

<p>A condition caused by excessive fluoride intake during tooth development. (B)</p> Signup and view all the answers

What is a key characteristic of hypoplastic teeth seen in amelogenesis imperfecta?

<p>Insufficient amounts of enamel with pits, grooves, or complete absence (D)</p> Signup and view all the answers

What is the primary difference between hypoplastic and hypocalcified amelogenesis imperfecta?

<p>Hypoplastic enamel has insufficient amount, while hypocalcified enamel has normal quantity but is soft. (A)</p> Signup and view all the answers

Which term is used to describe the unusual translucent, opalescent appearance of teeth seen in dentinogenesis imperfecta?

<p>Opalescent dentin (A)</p> Signup and view all the answers

What is the main difference between Dentinogenesis Imperfecta type I and type II?

<p>Type I is associated with bone disease, while type II is not. (A)</p> Signup and view all the answers

In dentinogenesis imperfecta type III, what is a distinctive feature of the dentine and pulp?

<p>Dentine appears thin and the pulp and root canals are large (D)</p> Signup and view all the answers

How does dentine dysplasia type I differ from type II in terms of color of dentition and periapical lesions?

<p>Type I has normal colored dentition in both primary and permanent, and type II has opalescent in primary dentition, type I has periapical lesions and type II rarely does (A)</p> Signup and view all the answers

What is a common characteristic of type I dentinogenesis imperfecta crowns?

<p>Premature loss due to short roots (B)</p> Signup and view all the answers

In Regional Odontodysplasia, which of the following is NOT typically observed?

<p>Thick and highly mineralized enamel (B)</p> Signup and view all the answers

What are the typical microscopic features of dentin in type II dentinogenesis imperfecta?

<p>Atypical tubular patterns with amorphous, irregular organization (C)</p> Signup and view all the answers

What differentiates true denticles from false denticles?

<p>Composition of dentine (C)</p> Signup and view all the answers

What is the primary cellular activity associated with internal resorption?

<p>Activation of osteoclasts or dentinoclasts (D)</p> Signup and view all the answers

Where does external resorption commonly begin?

<p>Immediately apical to the CEJ (D)</p> Signup and view all the answers

Which of the following can be classified as an exogenous stain?

<p>Stains from food or bacteria (D)</p> Signup and view all the answers

What is the typical color progression associated with tetracycline staining during tooth development?

<p>Yellow to grey to brown (B)</p> Signup and view all the answers

Flashcards

Generalized Microdontia

All teeth in the mouth are smaller than normal, often seen in individuals with pituitary dwarfism.

Localized Microdontia

A single tooth is significantly smaller than its counterparts, with an altered shape.

Generalized Macrodontia

All teeth in the mouth appear larger than usual, often associated with pituitary gigantism.

Localized Macrodontia

One tooth is significantly larger than its counterparts, commonly seen with wisdom teeth.

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Gemination

Two teeth develop from a single enamel organ, resulting in two crowns sharing a single root canal.

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Fusion

Two developing tooth germs fuse together, creating one larger tooth with a shared root canal.

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Concrescence

Adjacent teeth are joined by cementum, forming a single tooth.

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Eruption Anomaly

A condition where teeth erupt outside of their normal position due to insufficient space.

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Attrition

Physiologic wearing of teeth due to chewing, making teeth appear worn down.

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Abrasion

Abnormal tooth wear caused by habits, like using abrasive substances, resulting in rough and worn-down teeth.

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Erosion

Loss of tooth structure due to acids, not bacteria, making teeth appear worn and translucent.

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Abfraction

Wedge-shaped defects at the gum line caused by tooth flexing under heavy loads.

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Complete anodontia

Complete absence of all teeth.

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Partial anodontia

Absence of one or a few teeth.

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Pseudoanodontia

A tooth that's present but doesn't erupt, making it seem absent.

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False anodontia

Teeth that have fallen out or been extracted.

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Dilaceration

An unusual curving or angulation of tooth roots, making extractions and root canal treatments challenging.

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Dens Invaginatus

A rare condition where a tooth develops with an extra, inward fold, forming a 'tooth within a tooth'.

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Dens Evaginatus

An uncommon tooth anomaly with an extra cusp or bump located in the middle of the chewing surface.

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Taurodontism

A condition where teeth have an enlarged body and pulp chamber, with the root portion abnormally short.

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Supernumerary Teeth

The presence of extra teeth in the mouth, often caused by the formation of an additional tooth germ.

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Enamel Pearls

Small, enamel-like deposits found on the roots of teeth, usually at the point where the roots split.

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Mesiodens

The most common site for supernumerary teeth is the anterior midline, where an extra tooth called a 'mesiodens' is found.

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Supernumerary (Location)

Extra teeth are often found in canines, premolars, and molars, especially the third molars.

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Enamel hypoplasia

A condition where the enamel of a tooth is thinner than normal, often due to disturbances during enamel formation.

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Enamel hypocalcification

A condition where the enamel is present in normal amounts but is softer or weaker than normal, due to insufficient mineral deposition.

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Impact of external factors on enamel formation

The developmental stage of a tooth when enamel is formed is crucial for its health. If external factors disrupt the ameloblasts during this period, enamel defects can occur.

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Turner's Hypoplasia

A specific type of enamel hypoplasia characterized by discoloration, irregularities, and pitting of the enamel, often affecting a permanent tooth due to infection in the overlying deciduous tooth.

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Timing of systemic factors in enamel development

Systemic factors that influence tooth development must act after birth and during early childhood (before age six) to impact the developing enamel.

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Infectious diseases and enamel defects

Infectious diseases during childhood can significantly influence enamel formation, potentially leading to defects such as hypoplasia or hypocalcification.

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Hutchinson's Incisors

A specific type of enamel defect characterized by a narrowed incisal edge and central notch, often seen in children with congenital syphilis.

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Other causes of enamel defects

Nutritional deficiencies, birth trauma, fluorosis, and idiopathic factors can also contribute to enamel defects like hypoplasia and hypocalcification.

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Hypoplastic teeth

A condition where the enamel is abnormally thin or absent due to incomplete enamel formation during tooth development.

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Hypocalcified teeth

Characterized by enamel that is present but is soft and easily chipped, often appearing opaque, yellow, or brown.

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Amelogenesis Imperfecta

A group of inherited disorders affecting the formation of enamel in both sets of teeth. It can manifest as hypoplastic (thin enamel), hypocalcified (soft enamel), or hypermaturation (abnormal enamel structure).

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Dentinogenesis Imperfecta

An inherited condition affecting the dentin of both baby and adult teeth. It is characterized by translucent, opalescent teeth that may appear yellow to gray. Affected individuals are prone to enamel fractures, and the crowns may have a constricted appearance.

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Dentin Dysplasia

A rare inherited condition that affects the dentin. Type I, or radicular type, affects both sets of teeth and is characterized by normal-colored teeth with periapical lesions. Type II, or coronal type, affects only the permanent teeth and is characterized by opalescent primary teeth with a normal-colored permanent dentition, large coronal pulps, and few periapical lesions.

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Fluorosis (hypocalcification)

A condition caused by excessive fluoride intake during tooth development, resulting in enamel defects. The severity of fluorosis can range from mild white spots to severe pitting and discoloration.

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Mulberry molars

A term used to describe teeth with a lobulated or crenated (irregularly scalloped) occlusal surface.

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Dentinogenesis Imperfecta Type I

A type of dentinogenesis imperfecta that is associated with osteogenesis imperfecta (brittle bone disease).

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Regional Odontodysplasia

A dental anomaly affecting enamel, dentine, and cementum, resulting in short roots, open apical foramina, and enlarged pulp chambers. The enamel and dentine are poorly mineralized, leading to 'ghost teeth'. Permanent teeth are more affected than primary, with maxillary anterior teeth being the most vulnerable. Eruption is delayed.

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Pulp Calcification

Common with aging, pulp calcifications can be microscopic or large enough to be visualized radiographically. These calcifications can be linear or nodular (pulp stones). True denticles are composed of dentine, while false denticles represent foci of dystrophic calcification.

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Internal Resorption

Resorption of dentine on the pulpal walls. This can occur due to pulpal injury or without a clear trigger. It is caused by the activation of osteoclasts or dentinoclasts on the internal surfaces of the root or crown. Resorption lacunae are visible, and reversal lines indicate attempts at repair. Perforation can occur, and teeth may appear pink.

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External Resorption

Resorption of dentine on the external surfaces of the tooth. This can be triggered by various factors like inflammation, cysts, tumors, trauma, or reimplantation. Chemical mediators, increased vascularity, and pressure contribute to this process. It typically occurs apical to the cementoenamel junction (CEJ).

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Exogenous Stains

Stains that are caused by external factors and can be removed by abrasive methods. These stains can originate from diet or bacterial byproducts.

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Endogenous Stains

Stains that arise from systemic factors during tooth development and cannot be removed by abrasive methods. An example is tetracycline staining, which appears yellow, gray, or brown.

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Regional Odontodysplasia: Type I & II

In type I, crowns appear normal but may be lost prematurely due to short roots or periapical lesions. Radiographically, type I roots are short with obliterated pulps. In type II, pulp chambers appear enlarged. Microscopically, deeper layers of dentine exhibit atypical tubular patterns.

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Atypical Dentine Tubular Patterns

The deeper layer of dentine in Regional Odontodysplasia shows abnormal tubular patterns, characterized by irregular organization and a lack of proper structure. Think of the dentine tubules being misaligned and disorganized.

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Study Notes

Anomalies of Teeth

  • Teeth anomalies can be categorized by alterations in size, shape, or number.

Alterations in Size (Microdontia)

  • Generalized Microdontia: All teeth are smaller than normal, often associated with pituitary dwarfism. They may appear small relative to a large jaw.
  • Localized Microdontia: A single tooth is smaller than normal, and its shape is also altered. Examples include peg lateral incisors, maxillary third molars, and supernumerary teeth.

Alterations in Size (Macrodontia)

  • Generalized Macrodontia: Teeth appear enlarged, for example, in pituitary gigantism. This enlargement can lead to overcrowding and abnormal tooth eruption patterns due to insufficient space.
  • Localized Macrodontia: An abnormality affects a single tooth, often a third molar, and shows an unusually enlarged size.

Alterations in Shape

  • Gemination: Two teeth form from a single enamel organ. Two crowns share the same root; partial or complete cleavage may cause two separate teeth.
  • Fusion: Two developing tooth germs join, creating a single, large tooth structure. Fusion may involve the entire length of the teeth or only the roots. Root canals may be separate or fused.

Alterations in Shape (Other)

  • Concrescence: Adjacent teeth fuse together through their cementum, commonly in maxillary second and third molars.
  • Dilaceration: Teeth roots have irregular curving or angulation, making extractions and root canal treatment challenging.
  • Dens Invaginatus (Dens in dente): A tooth within a tooth, manifested as an exaggerated lingual pit, common in maxillary lateral incisors, and often bilateral.
  • Dens Evaginatus: A small tubercle or cusp located centrally on the occlusal surface of a tooth. Often bilateral.
  • Taurodontism: Teeth featuring an enlarged body and pulp chamber; the apical displacement also occurs, commonly in multirooted teeth, appearing 'bull-like' on radiographs.

Alterations in Number (Anodontia)

  • Anodontia: Absence of teeth.
    • Complete anodontia: All teeth are missing.
    • Partial anodontia: One or a few teeth are missing, commonly third molars, followed by second premolars and maxillary laterals.
    • Pseudoanodontia: Teeth are clinically missing due to impaction or delayed eruption.
    • False anodontia: Teeth have exfoliated or been extracted.
  • Complete anodontia is sometimes associated with ectodermal dysplasia.

Other Anomalies (Impaction)

  • Impaction: Third molars and maxillary canines are commonly impacted, often due to crowding or physical barriers. Unusual tooth germ orientation or fusion of bone around the tooth (ankylosis) may also play a role.

Defects of Enamel

  • Environmental Defects: External factors during enamel formation (e.g., prolonged illness, trauma, malnutrition) can cause defects like hypoplasia (quantitatively defective enamel) and hypocalcification (qualitatively defective enamel).
  • Turner's Hypoplasia: Enamel defects due to inflammation of the underlying deciduous tooth. Anterior teeth are less affected as they form earlier.
  • Systemic factors: Factors like congenital syphilis, nutritional deficiencies (like rickets), birth trauma, fluoride exposure, and idiopathic causes can lead to enamel hypoplasia or hypocalcification affecting teeth formed before age six.
  • Fluorosis: Hypocalcification caused by high fluoride levels in drinking water during tooth crown formation. May present as white spots to pitted, irregular, discoloured enamel.

Defects of Dentine

  • Dentinogenesis Imperfecta: Autosomal dominant trait. Affecting both primary and permanent teeth. Three types, primarily affecting primary teeth with dentin abnormality often associated with osteogenesis imperfecta. Characterized by opalescent dentin with easily fractured enamel. Features include a discolored, often translucent or opalescent crown, excessive constriction at the CEJ, and tulip or bell-shaped crowns.

Other Defects

  • Dentine Dysplasia: Rare autosomal dominant trait. Two types, radicular (Type I) and coronal (Type II). Primary teeth are sometimes more affected than permanent teeth in Type I Dentin Dysplasia, with short roots and potential premature loss. Type II has larger pulp chambers and opalescent primary teeth.
  • Regional Odontodysplasia: Anomalies involving both enamel and dentine, affecting the hard tissues derived from epithelial and mesenchymal components. Features include short roots, open apical foramina, enlarged pulp chambers, and sometimes "ghost teeth”. The permanent teeth are more affected, and eruption is often delayed.
  • Pulp Calcification: Calcifications (pulp stones) may be linear or nodular, occurring more commonly with increasing age, and often composed of dentine (true denticles) or foci of dystrophic calcification (false denticles). Often categorized as 'attached' or 'free'.

Resorption

  • Internal Resorption: Resorption of dentin as a reaction to injury or as an unexplained trigger; occurs due to osteoclast or dentinoclast activation on the root's internal surfaces, often followed by reversal lines indicating repair attempts.
  • External Resorption: Resorption of dentin from external factors like chronic inflammation, cysts, benign tumors, malignant neoplasms, trauma, re-implantation, or impaction.

Stains

  • Exogenous Stains: Stainable substances ingested in food or produced by bacteria, removable with abrasives.
  • Endogenous Stains: Caused by substances circulating in the body during tooth development, like tetracycline (causing yellow-gray-brown staining). Other factors include Rh incompatibility (staining green-brown) or congenital porphyria (red-brown staining) due to porphyrin deposition.

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