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Questions and Answers
What are the three stages of enamel development?
What are the three stages of enamel development?
Remodeling of dental enamel can occur after initial formation.
Remodeling of dental enamel can occur after initial formation.
False
Which of the following is NOT considered a cause of tooth wear?
Which of the following is NOT considered a cause of tooth wear?
Which of the following is a common pattern of enamel defects seen as a result of systemic influences?
Which of the following is a common pattern of enamel defects seen as a result of systemic influences?
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What is the term for the altered tooth caused by periapical inflammatory disease or traumatic injury of the overlying deciduous tooth?
What is the term for the altered tooth caused by periapical inflammatory disease or traumatic injury of the overlying deciduous tooth?
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What does MIH stand for?
What does MIH stand for?
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What are the two types of tooth structure loss that can begin on the dentin or cemental surfaces of the teeth?
What are the two types of tooth structure loss that can begin on the dentin or cemental surfaces of the teeth?
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Tooth wear is always considered pathologic.
Tooth wear is always considered pathologic.
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What is the most common cause of abrasion?
What is the most common cause of abrasion?
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What is the term for the slow deposition of tertiary dentin that helps protect the pulp from exposure during tooth wear?
What is the term for the slow deposition of tertiary dentin that helps protect the pulp from exposure during tooth wear?
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What is the most common pattern of erosion?
What is the most common pattern of erosion?
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Abfraction is a widely accepted and proven cause of cervical tooth loss.
Abfraction is a widely accepted and proven cause of cervical tooth loss.
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What type of defects are often associated with abfraction?
What type of defects are often associated with abfraction?
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Tooth wear can only occur in the permanent dentition.
Tooth wear can only occur in the permanent dentition.
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The incisal and occlusal surfaces of teeth are typically the most affected by attrition.
The incisal and occlusal surfaces of teeth are typically the most affected by attrition.
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Which of the following is NOT a common source of acid in the mouth?
Which of the following is NOT a common source of acid in the mouth?
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Tooth wear is always a multifactorial process.
Tooth wear is always a multifactorial process.
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The treatment for tooth wear is always the same, regardless of the cause.
The treatment for tooth wear is always the same, regardless of the cause.
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Tooth wear is a normal part of aging.
Tooth wear is a normal part of aging.
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What are the two types of enamel opacities?
What are the two types of enamel opacities?
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What is the term used to describe the enamel defects that are more porous and are often associated with post-eruptive enamel loss?
What is the term used to describe the enamel defects that are more porous and are often associated with post-eruptive enamel loss?
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What condition can result in stunting of mandibular incisor roots?
What condition can result in stunting of mandibular incisor roots?
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What is the term for the anterior teeth altered by syphilis?
What is the term for the anterior teeth altered by syphilis?
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What are the posterior teeth that are termed "mulberry molars" altered by?
What are the posterior teeth that are termed "mulberry molars" altered by?
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What is the term used to describe the process of tooth wear caused by the mechanical action of an external agent?
What is the term used to describe the process of tooth wear caused by the mechanical action of an external agent?
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What type of acid can be found in swimming pools with poorly monitored pH?
What type of acid can be found in swimming pools with poorly monitored pH?
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What type of tooth wear is characterized by a central depression of dentin surrounded by elevated enamel?
What type of tooth wear is characterized by a central depression of dentin surrounded by elevated enamel?
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What is the term for the type of tooth wear that occurs when occlusal stresses create repeated tooth flexure?
What is the term for the type of tooth wear that occurs when occlusal stresses create repeated tooth flexure?
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The enamel is more resistant to tensile stress than dentin.
The enamel is more resistant to tensile stress than dentin.
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What type of defect, associated with abfraction, is described as being deep, narrow, and V-shaped?
What type of defect, associated with abfraction, is described as being deep, narrow, and V-shaped?
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Tooth wear always progresses at a rapid rate.
Tooth wear always progresses at a rapid rate.
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The treatment for tooth wear is always reserved for cases that create a pathologic degree of tooth loss.
The treatment for tooth wear is always reserved for cases that create a pathologic degree of tooth loss.
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Study Notes
Oral Pathology 1, Lecture 6
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Environmental Alterations of Teeth:
- Environmental effects on tooth structure development
- Post-developmental structure loss
- Environmental discolorations of teeth
- Localized disturbances in eruption
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Developmental Alterations of Teeth:
- Developmental alterations in the number of teeth
- Developmental alterations in the size of teeth
- Developmental alterations in the shape of teeth
- Developmental alterations in the structure of teeth
1. Environmental Effects on Tooth Structure Development
- Ameloblasts: Extremely sensitive to external stimuli
- Multiple factors can result in enamel abnormalities.
- Simultaneous factors worsen enamel defects.
- Amelogenesis Imperfecta: Hereditary enamel abnormalities unrelated to other disorders.
Systemic Factors
- Birth trauma
- Chemicals (e.g., amoxicillin, antineoplastic chemotherapy)
- Chromosomal abnormalities
- Infections
- Inherited diseases
- Malnutrition
- Medical conditions (e.g., asthma, diabetes, renal disease)
- Neurologic disorders
Local Factors
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Acute mechanical trauma
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Electrical burns
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Irradiation
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Local infection
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Dental Enamel: Unique, non-remodeling structure, permanent abnormalities.
- Three major stages: matrix formation, mineralization, maturation.
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Timing of ameloblastic damage affects enamel defect location and appearance.
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Clinical and Radiographic Features:
- Hypoplasia
- Diffuse opacities
- Demarcated opacities
- Enamel enamel defects can be localized or present on multiple teeth.
- Enamel hypoplasia: quantitative defects (pits, grooves, missing enamel)
- Enamel opacities: qualitative defects (diffuse or demarcated, variations in translucency, normal thickness).
- Diffuse opacities: increased white opacity without clear boundaries.
- Demarcated opacities: decreased translucence, increased opacity, sharp boundaries.
(1) Turner Hypoplasia
- Frequent enamel defect in permanent teeth.
- Due to periapical inflammatory disease or traumatic injury of a deciduous tooth.
- The enamel defects vary from white, yellow or brown discoloration to extensive hypoplasia.
- Frequently occurs in permanent bicuspids due to relationship to overlying deciduous molars.
(2) Molar-Incisor Hypomineralization (MIH)
- Predominantly affects permanent first molars.
- Characterized by hypomineralization of 1-4 permanent first molars.
- Enamel may appear white, yellow or brown with sharp demarcation.
- Associated with post-eruptive enamel loss, increased sensitivity, and difficulty with anesthetic.
- Incisor involvement correlates with the number of affected molars
- Etiology unclear, possibly multifactorial
(3) Hypoplasia Caused by Antineoplastic Therapy
- Dental developmental alterations due to therapeutic radiation or chemotherapy.
- Severity depends on patient age, treatment type, and dose.
- Associated defects include hypodontia, microdontia, radicular hypoplasia, and enamel hypoplasia.
- Radiotherapy can cause mandibular hypoplasia and reduced vertical development of the lower third of the face.
- Chemotherapy can cause enamel hypoplasia and discoloration.
(4) Dental Fluorosis
- Enamel defects due to excessive fluoride intake.
- Can cause hypomineralized enamel, which leads to white, chalky areas (mottled enamel)
- Severity is dose- and time-dependent.
- Affected teeth are often caries resistant.
- Definitive diagnosis requires bilateral symmetry, prior excessive fluoride intake or elevated fluoride levels.
- Fluorapatite crystal formation is a former thought process that fluoride reduces caries. The current understanding is post-eruptive effects that control demineralization and remineralization. Consumption of properly fluoridated water is associated with a low frequency of mildly altered enamel. Monitor fluoride intake intensely in the first three years of life.
(5) Syphilitic Hypoplasia
- Congenital syphilis causes enamel hypoplasia, though it is rare.
- Anterior teeth (Hutchinson incisors): Crowns that are shaped like screwdrivers, prominent in the middle third aspect
- Posterior teeth (mulberry molars): Disorganized occlusal surfaces
Tooth Wear
- Attrition: Loss of tooth structure due to tooth-to-tooth contact during occlusion and mastication.
- Abrasion: Loss of tooth structure due to mechanical wear by external agents (e.g., tooth-brushing with abrasive materials).
- Erosion: Loss of tooth structure due to chemical processes (e.g., acids in foods and drinks).
- Abfraction: Loss of tooth structure due to occlusal stresses creating repeated tooth flexure at locations away from the point of loading.
Treatment and prognosis
- Normal levels of attrition require no therapy.
- Interventions are reserved for pathologic cases
- Resolve tooth sensitivity and pain.
- Identify causes and protect remaining dentition.
- Treatment varies based on the cause
- Patient education about possible issues with tooth wear is important.
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Description
Explore the environmental and developmental alterations of teeth in this comprehensive quiz. Focus on how factors like trauma, chemicals, and genetics influence tooth structure. Test your understanding of enamel defects and their implications in dental health.
