Dev dental anomolies.pdf

Developmental Dental Anomalies Angela C. Chi, DMD Professor [email protected] taking photos or video recording during this live class session is not permitted  Learning Objectives  1. Identify developmental dental...

Developmental Dental Anomalies Angela C. Chi, DMD Professor [email protected] taking photos or video recording during this live class session is not permitted  Learning Objectives  1. Identify developmental dental anomalies, including alterations in number, size, shape, and structure of teeth.  2. Discuss the etiopathogenesis, clinical and/or radiographic features, management, and prognosis of developmental dental anomalies. Thesleff, I. and Tummers, M., Tooth organogenesis and regeneration (January 31, 2009), StemBook, ed. The Stem Cell Research Community, StemBook, doi/10.3824/stembook.1.37.1, http://www.stembook.org., CC BY 3.0 , via Wikimedia Commons; https://commons.wikimedia.org/wiki/File:Histology_of_important_stages_of_tooth_development..jpg ALTERATIONS IN NUMBER SIZE SHAPE STRUCTURE  Small Group Activity  1st half of class: prepare a short PowerPoint presentation (approx. 5 to 7 minutes)  Define terms  Discuss etiopathogenesis, clinical and/or radiographic features (include significance or potential disease associations, if any), management, prognosis  Include images / examples  List references (e.g., oral path textbook, Pubmed articles)  Small Group Activity  2nd half of class: give your presentation !!  Email a copy of your presentations (without images) to me ([email protected]), so I can upload them to Elentra case hx GROUP 1 Number *Hypodontia --Oligodontia --Anodontia *Hyperdontia GROUP 2 Size *Macrodontia *Microdontia GROUP 3 Shape *gemination, fusion, concrescence GROUP 4 Shape *accessory cusps (cusp of Carabelli, talon cups, dens evaginatus) *shovel-shaped incisors GROUP 5 Shape *Dens invaginatus *Cervical enamel extensions *Enamel pearls *Taurodontism GROUP 6 Shape *Tooth root anomalies (Hypercementosis, Dilaceration, Supernumerary roots) Dr. Chi Shape *Globodontia Struc- *Regional odontodysplasia ture  Globodontia  Giant globe-shaped teeth  Seen in otodental syndrome (along w/ sensorineural hearing loss)  AD, chr 11q13, FGF3 gene  Globodontia (6 yo M w/otodental syndrome)  Major clinical features:  Cuspids/molars (both dentitions): large & bulbous, “tied end of sausage” Su, Jm., Zeng, Sj., Ye, Xw. et al. Three years of follow-up of otodental syndrome in 3- year-old Chinese boy: a rare case report. BMC Oral Health 19, 164 (2019). https://doi.org/10.1186/s12903-019-0860-z; Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/); images cropped  Globodontia  Additional features:  Globodonts w/ short roots, hypomaturation of cuspid crowns (facial)  Premolars: missing/ small/ NL or conical  Globodontia  Tx and Px:  tendency for malocclusion and endo- perio lesions  endodontic tx difficult  stress preventive care  Regional Odontodysplasia  Nonhereditary developmental abnormality of enamel/dentin/pulp  Etiology: mostly idiopathic but various proposed factors (altered migration of neural crest, altered vascular supply, local trauma/infection, latent virus, RTX, meds during pregnancy)  Regional Odontodysplasia  Disease associations:  Ectodermal dysplasia  Epidermal nevi or vascular nevi  Hydrocephalus  Hypophosphatasia  Neurofibromatosis  etc.  Regional Odontodysplasia  Clinical features:  Bimodal peak: 2-4 yrs & 7-10 yrs (eruption deciduous & perm teeth)  Often affects several contiguous teeth in a focal area  Delayed/failed eruption  Yellow-brown, misshapen teeth  Gingival enlargement Neto, A. , Siqueira, F. , Martins, F. , Parreira, T. and Siqueira, P. (2013) Regional odontodysplasia: Account of clinical case in permanent teeth. Open Journal of Stomatology, 3, 268-272. doi: 10.4236/ojst.2013.34045. Creative Commons 4.0 License (CC-BY-NC 4.0)  Regional Odontodysplasia  “ghost teeth” (thin enamel/dentin, enlarged pulp) de Sá Cavalcante D, et al. Mandibular Regional Odontodysplasia in an 8-year-old Boy showing Teeth Disorders, Gubernaculum Tracts, and Altered Bone Fractal Pattern. International Journal of Clinical Pediatric Dentistry. 2018 Mar-Apr;11(2):128-134. DOI: 10.5005/jp-journals-10005-1498. PMID: 29991866; PMCID: PMC6034052; Creative Commons 4.0 License (CC-BY-NC 4.0)  Regional Odontodysplasia  Decreased density of adjacent bone  Pulpal necrosis common de Sá Cavalcante D, et al. Mandibular Regional Odontodysplasia in an 8-year-old Boy showing Teeth Disorders, Gubernaculum Tracts, and Altered Bone Fractal Pattern. International Journal of Malhotra R, Singla S, Shashikiran N D, Verma A. Regional odontodysplasia: A classical case Clinical Pediatric Dentistry. 2018 Mar-Apr;11(2):128- report. SRM J Res Dent Sci [serial online] 2013 [cited 2021 Aug 24];4:86-9. Available 134. DOI: 10.5005/jp-journals-10005-1498. PMID: from: https://www.srmjrds.in/text.asp?2013/4/2/86/120186 , Creative Commons Attribution- 29991866; PMCID: PMC6034052; Creative NonCommercial-ShareAlike 4.0 License Commons 4.0 License (CC-BY-NC 4.0)  Regional Odontodysplasia  Tx:  Individualized  Removable prosthesis, SSC or resin restorations  Avoid tooth preparation  Non-salvageable teeth: extract  Px:  Risk for loss of vitality; if maintained: canals and apices may continued to develop/approach normalcy  Reading / References  Section on “Developmental Alterations of Teeth” in Oral and Maxillofacial Pathology (5th Edition) by Neville BW, Damm D, Allen CM, Chi AC. Available from VitalSource Bookshelf, Elsevier Health Sciences (US). Pages.