Veterinary Dentistry 2: Malocclusion - Lecture 5
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Questions and Answers

A retained tooth that doesn't erupt can lead to which of the following complications?

  • Dentigerous cysts forming from enamel epithelium (correct)
  • Localized enamel hypoplasia
  • Gemination of adjacent teeth
  • Hypocalcification of enamel

Gemination, a split in a tooth, always significantly reduces tooth integrity.

False (B)

What is the primary difference between hypocalcified and hypoplastic enamel defects?

Hypocalcified enamel has a normal amount of enamel but low calcium content making it soft, while hypoplastic enamel has normal hardness but insufficient quantity, either as a thin layer or pitted.

Environmental enamel defects affecting deciduous teeth typically occur during the period from day 42 of gestation to ______ days post-partum.

<p>15</p> Signup and view all the answers

Match the enamel defect with its description:

<p>Hypocalcified Enamel = Soft enamel with normal amount but low calcium. Hypoplastic Enamel = Normal hardness but insufficient amount of enamel. Localized Enamel Defect = Affects a few teeth generally due to trauma. Generalized Enamel Defect = Affects most teeth due to fever or systemic disease.</p> Signup and view all the answers

In a normal occlusion, what is the relationship between the maxillary and mandibular incisors?

<p>The maxillary incisors are in front of the mandibular incisors. (C)</p> Signup and view all the answers

What is the key consideration when cleaning the teeth of a patient with hypocalcified enamel?

<p>Being very gentle to prevent enamel from sloughing off (D)</p> Signup and view all the answers

Dental interlock refers to the concept that jaw growth is a fully synchronized process, where the maxilla and mandible grow in perfect unison.

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

A radiographic examination is unnecessary when a tooth is believed to be missing.

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

Distemper in early life is most likely to cause which type of enamel defect?

<p>Generalized enamel hypoplasia (A)</p> Signup and view all the answers

Define the term 'brachygnathia'.

<p>shortened jaw</p> Signup and view all the answers

In the context of tooth position abnormalities, 'disto-' refers to movement ______ from the midline.

<p>away</p> Signup and view all the answers

Why might you monitor a case of gemination rather than intervene immediately?

<p>If the split in the tooth does not extend past the gingival line and appears stable, monitoring is preferred unless the structural integrity is compromised.</p> Signup and view all the answers

Match the malocclusion classification with its corresponding description:

<p>Class I = Normal jaw length, with one or more teeth out of alignment. Class II = Mandible is shorter than normal, creating an overbite. Class III = Mandibular prognathism (underbite) or maxillary brachygnathism. Class IV = Uneven jaw lengths on the same jaw (wry bite).</p> Signup and view all the answers

Hereditary enamel defects are often categorized under the umbrella term ______ imperfecta.

<p>amelogenesis</p> Signup and view all the answers

Which of the following is a characteristic of skeletal malocclusion, as opposed to dental malocclusion?

<p>It is generally bilateral and often breed-specific. (B)</p> Signup and view all the answers

Labioversion refers to a tooth being angled towards the cheek.

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

What is the primary concern with malocclusions that warrants veterinary intervention?

<p>trauma</p> Signup and view all the answers

In cats, caudal traumatic malocclusion often involves contact between the mandibular first molar (M1) and the maxillary ______.

<p>PM4</p> Signup and view all the answers

Which of the following is most important when classifiying/diagnosing and then treating malocclusions?

<p>Patient comfort and teeth functionality (B)</p> Signup and view all the answers

Flashcards

Normal Occlusion

Normal alignment of teeth where maxillary incisors are in front of mandibular incisors, canines have slight outward title, and teeth fit together like a puzzle.

Malocclusion

Misalignment of teeth that can cause trauma or cosmetic issues.

Dental Interlock

Independent growth of each quadrant of the jaw.

Skeletal Malocclusion

Malocclusion due to inherited/breed-specific jaw length or width discrepancies.

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Dental Malocclusion

Malocclusion resulting from malposition of teeth, e.g., retained deciduous teeth.

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Prognathia

One jaw is forward compared to the other.

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Retrognathia

One jaw is caudal (backward) compared to the other.

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Brachygnathia

Shortened jaw, often resulting in an underbite and crowding.

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Mesioversion

A tooth angled towards the midline.

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Class 1 Malocclusion

Normal jaw length with one or more teeth out of alignment.

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Retained Tooth

A tooth that has not erupted fully and remains embedded in the bone.

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Dentigerous Cyst

A fluid-filled sac that develops around the crown of an unerupted tooth, potentially degrading bone integrity.

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Gemination

Single tooth bud appears to have divided, resulting in a tooth with a notched or twinned crown. One root.

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Hypocalcified Enamel

Enamel defect where the enamel is soft due to a lower-than-normal calcium content, but the quantity of enamel is normal.

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Hypoplastic Enamel

Enamel defect where the enamel is hard but thin or pitted due to insufficient enamel formation.

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Amelogenesis Imperfecta

A hereditary condition resulting in defective enamel formation.

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Environmental Enamel Defects

Enamel defects caused by external factors such as trauma or disease during tooth development.

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Localized Enamel Defects

Enamel defects that affect only a few teeth, typically due to localized trauma.

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Generalized Enamel Defects

Enamel defects that affect most or all teeth, often caused by fever or systemic diseases like distemper.

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Enamel Sloughing

When compromised enamel easily peels away, exposing the sensitive pulp cavity, increasing the risk of infection and sensitivity.

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Study Notes

  • Malocclusion is covered in Veterinary Dentistry 2 - Lecture 5

Normal Occlusion

  • Maxillary incisors are in front of the mandibular incisions
  • Mandibular canines are between the maxillary canine and 3rd incisor with a slight tilt outward
  • Zig zag pattern where teeth fit together like a puzzle
  • Maxillary premolar and molar on the buccal aspect of the mandibular premolar and molar (behind)

Malocclusions

  • Defined as a misalignment of the teeth
  • It can be cosmetic or cause trauma like oronasal fistulas (ONF), attrition, fracture, and tooth death
  • Caused by skeletal deformity or tooth-related issues
  • Pet must be comfortable and teeth functional

Dental Interlock

  • Jaw growth is independently regulated
  • Each quadrant grows separately
  • Proper mandible-maxilla relationship should be maintained throughout adulthood
  • Examine the canine and incisor teeth on a model skull
  • Close relationship of the canine and incisor teeth enable a "push-pull" system, allowing normal jaw growth
  • Maxillary grows
  • Canine pushes on bottom canine to encourage it to grow as well

Skeletal vs Dental Malocclusion

  • Skeletal malocclusion is inherited/breed-specific and related to jaw length or width discrepancy
  • An animal is born with it
  • Results in crowding and rotation
  • Bowing of the mandible suggests shortening of the jaw
  • Extra space between premolars suggests lengthening, uneven occlusions of canine teeth
  • Generally bilateral
  • Dental malocclusion results from malposition of teeth that push other teeth out of their normal position
  • Can result from retained deciduous teeth
  • Adult maxillary canine erupts rostral to baby teeth
  • Permanent mandibular canine erupts medial to baby teeth
  • Permanent incisors erupt palatal to baby ones
  • Maxillary premolar 3 & 3 erupt palatal to baby teeth
  • Maxillary premolar 4 erupts Bucco mesial to baby tooth
  • Mandibular premolar erupts lingual to baby

Terminology: Jaw Abnormalities

  • Prognathia: one jaw is in the forward position compared to the other
  • Retrognathia: one jaw is in the caudal position compared to the other
  • Brachygnathia: shortened jaw (underbite & crowding/rotation of teeth to be classified as such)

Tooth Position Abnormality Terminology

  • -version (tipping/angled)
  • Mesio: Toward Midline = MV
  • Disto: Away from Midline = DV
  • Labio: Towards lips = LABV
  • Bucco: Towards Cheek = BV
  • Linguo: Towards Tongue = LV
  • Palato: Towards Palate = PV

Malocclusions Classification

  • Class 1: normal jaw length, one or more teeth out of alignment
  • Class 2: mandible is shorter than normal
  • Class 3: Mandibular prognathism or maxillary Brachygnathism
  • Class 4: Formally called "wry" bite, with uneven jaw lengths (same jaw) on each side of the mandible
  • MAL 1: Overall normal occlusion except 1 or more teeth out of alignment
    • Charting Code = MAL1/ enter specific type of misalignment
    • Mandibular tooth/teeth have more buccal or labial position than the antagonist maxillary tooth = CB/R or CB/C = Crossbite (Rostral = incisors, Caudal = Pm,M)
    • Caudal Traumatic Malocclusion in Cats: Contact between Mandibular M1 and Maxillary PM4
    • Occurs from Maxillary PM 4 is slightly palatoverted and can result in lesions/gingival recession (Maine Coon & Persians)
  • MAL 2: "overbite"
    • Mandible is shorter than normal
    • Problematic due to the location of mandibular canines
  • MAL 3: "underbite"
    • Mandibular prognathism – mandibular incisors occlude labial to maxillary incisors
  • MAL 4: “wry bite”
    • Uneven length on same jaw (right vs left sides)
    • Central incisors of the maxilla and mandible do not align
    • Many subclasses depending on direction of misalignment
  • Treatment for malocclusions involves removing the problem teeth ASAP, hopefully before adult teeth erupt and before malocclusion occurs
  • Orthodontic correction and alteration of tooth with endodontic work, or ball therapy

MAL

  • MAL1: Class 1 malocclusion (neutroclusion; dental malocclusion with normal upper/lower jaw length relationship)
    • MAL1/BV: Buccoversion
    • MAL1/DV: Distoversion
    • MAL1/LABV: Labioversion
    • MAL1/LV: Linguoversion
    • MAL1/MV: Mesioversion
    • MAL1/PV: Palatoversion
  • MAL2: Class 2 malocclusion (mandibular distoclusion; symmetrical skeletal malocclusion with the lower jaw relatively shorter than the upper jaw)
  • MAL3: Class 3 malocclusion (mandibular mesioclusion; symmetrical skeletal malocclusion with the upper jaw relatively shorter than the lower jaw)
  • MAL4: Class 4 malocclusion (asymmetrical skeletal malocclusion in a caudoventral, side-to-side or dorsoventral direction)
    • MAL4/DV: Asymmetrical skeletal malocclusion in a dorsoventral direction
    • MAL4/RC: Asymmetrical skeletal malocclusion in a rostrocaudal direction
    • MALA/STS: Asymmetrical skeletal malocclusion in a side-to-side direction

Developmental Conditions

  • Variations in the number of teeth, size, and their shape or how enamel forms
  • Retained Teeth: Can become a big issue if not dealt with, particularly if you believe a tooth is missing
    • If a tooth doesn't erupt, it can lead to Dentigerous Cysts from enamel epithelium of the tooth continuing to produce a fluid creating a pocket of fluid under the surface of the bone, degrading alveolar bone integrity
    • Not fixing can lead to facial swelling and complete loss of bone integrity
  • Gemination: Small split in a tooth that doesn't typically reduce tooth integrity unless it surpasses the gingival line. If this occurs, monitor

Structural defects in enamel

  • Hypocalcified: soft, low calcium, normal amount of enamel
  • Hypoplastic: normal hardness, not enough of it, thin layer or very pitted

Two Main Causes

  • Hereditary - amelogenesis imperfecta
  • Environmental enamel defects – trauma or disease early on in life
  • Affecting deciduous teeth: day 42 of gestation – 15 days post-partum
  • Affecting permanent teeth: 2 weeks – 12 weeks (ex from distemper)
  • Localized: a few teeth, generally due to trauma
  • Generalized: most teeth, from fever or systemic disease (i.e. Distemper)

Clinical Significance & Treatment

  • Hypocalcified or hypoplastic enamel sloughs off if not cleaning gentle enough, exposing pulp cavity
  • Soft enamel = must be very careful when cleaning teeth

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Malocclusion in Veterinary Dentistry Lecture Notes PDF

Description

Lecture 5 of Veterinary Dentistry 2 covers malocclusion. Malocclusion is a misalignment of the teeth that can be cosmetic or cause trauma. It is caused by skeletal deformity or tooth-related issues. The pet must be comfortable, and the teeth must be functional.

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