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DEVELOPMENTAL ANOMALIES
OF DENTITION
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Anomalies ofnumber
Anodontia
Hypodontia
Oligodontia
Hyperdontia
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ANOMALIESOF POSITION
Transposition
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GEMINATION
CONCRESCENCE
TALONS CUSP
FUSION
DENS EVAGINATUS
DENS INVAGINATUS
CUSP OF CARABELLI
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ECTOPIC ENAMEL
TAURODONTISM
HYPERCEMENTOSIS
DILACERATION
SUPERNUMERARY ROOTS
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Definition:Total lack of tooth development.
Etiology:Genetic.
CLINICAL FEATURES
-No teeth are present.
-Lack of alveolar growth .
-Associated with ectodermal dysplasia.
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TREATMENTProsthetic
rehabilitation.
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DEFINITION:Lack of development of one or more teeth.
ETIOLOGY:
Genetic
Hereditary
Associated with syndromes eg.Hereditary ectodermal dysplasia
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CLINICAL FEATURES
Prevalence is 3 to 8%.
Female dominance.
Less than 1% in deciduous dentition.
Predominance is 3rd molar>2nd molar>lateralincisor.
Can result in drifting due to excess space.
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Prosthetic and orthodonticrehabilitation.
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DEFINITION:More than 6 teeth
missing.
ETIOLOGY:Genetic
Hereditary
CLINICAL FEATURES:
Rare in primary dentition.Multiple missing teeth from either
arch.Can result in collapse of arch and drifting
due to excess of space
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TREATMENT:
Prosthetic and
orthodonticrehabilitation.
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DEFINITION:Developmental of additional teeth inaddition to normal dentition.
ETIOLOGY:Genetic
Hereditary
Associated with syndromes(cleft lip, cleftpalate,gardeners syndrome. Develop as consequence
of proliferation of epithelial cells from dental lamina.
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Prevalence is 1 to 3%.
80% associated with single tooth
hyperdontia.Occurs mostly in permanent
dentition in maxillary anterior
region.Male predominance.
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Supernumerary in maxillaryanterior region is called asmesiodens,in 4th molar region it isdistomolar and if it is buccal tomolars it is called as paramolar.
Frequent cause of crowding typeof malocclusion.
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Conical Tuberculate
Supplementalodontome
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This small peg-shapedconical tooth is thesupernumerary mostcommonly found in
permanent dentition.
Usually present asmesiodens.
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Possesses more than one
cusp or tubercle.
Described as barrel-shaped or may beinvaginated.
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Tumor of odontogenic origin.
Listed as suppernumerary tooth byHOWARD.
Represents a hamartomatousmalformation rather than neoplasm.
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Types:
Compositeodontoma
Complexodontoma
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Multiplepolyposis oflargeintestines.
Osteomas ofthe bone.
Multipleepidermoid orsebacceos cystof skin.
Occasionaloccurrence ofdesmoid ofscalp and back.
Impacted
supernumeraryand permanenttooth.
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Extraction of supernumerarytooth followed by orthodontic
rehabilitation.
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TRANSPOSITION:
DEFINITION:
Eruption of normal teeth in an inappropriatepositions.
ETIOLOGY:Retained deciduous teeth or lose ofspace.
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Maxillary canine and
premolars are involved.
May cause crowding.
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Orthodontic
rehabilitation.
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FUSION:
DEFINITION:Tooth fusion is defined as union between the dentinand/or enamel of two or more separate developing teeth.
ETIOLOGY:
Pressure produced by physical force prolongs the contact of thedeveloping teeth causing fusion.(shafer)
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LOWELL AND SOLOMAN-
Physical action causes the toothgerms to come into contact,thus
producing necrosis of the interveningtissue,allowing the enamel organ anddental papilla to fuse together.
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The fusion may be partial or totaldepending upon the stage of toothdevelopment at the time of union;fusiontotalis,partialis-radicularis.
If the contact occurs before thecalcification stage,the teeth unitecompletely and form one tooth.
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Incomplete fusion may be at root level ifthe contact and union occurs afterformation of crown.
Prevelance of 0.5-2.5%.
Most commonly occurs in primary teeth withmore predilections for anterior teeth.
Radiographically,the dentin of fused teethalways appears to be joined in some regionwith separate pulp chambers and canals
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May cause malocclusion.
Restorative,periodontaland endodonticconsiderations are
needed beforeproceeding with anytype of treatment.
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DEFINITION:
Abortive attempt by thesingle tooth bud to
divide,with the resultant
formation of bifid crownand common root.
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Genetic
HereditaryEnviromental
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More frequently in the primary
dentition.
Prevelance of 1%.
Prediliction in maxillary primary
incisors and canine.
Two teeth joined in coronal aspect
but with single root and single root
canal.
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May cause malocclusion.
Restorative,periodontal
and endodonticconsiderations are
needed beforeproceeding with any type
of treatment.
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DEFINITION:
Union of teeth by cementum alonewithout confluence of dentin.
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Environmental
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Two separateteeth joined by
cementum.
Posteriormaxillary regionis more involved.
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No treatment requiredif the patient is
asymptomatic.
Extraction if it
interferes with eruptionof succeeding tooth.
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Epithelial cells andtransient focal
hyperplasia ofperipheral cells of
mesensenchymaldental pappilla.
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Prevelance is 0.06% to 7.7%.
The anomaly also appears to be more inpatients with Rubinstein-taybi syndrome.
Lateral incisors and canines are affected.
Pulp horn may project from the cusp.
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Compromised
aesthetics,occlusalinterference,cariousdevelopmental
grooves,displacement ofteeth,periodontalproblems,irritation of thetongue and diagnosticproblems.
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Gradual reduction with flourideapplication as desensitizing agent.
Single appiontment reduction with orwithout pulp therapy.
Sealant application in the dental
grooves.
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Partial reduction
with compositecamouflage.
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Definition: Cusp like
elevation ofenamel in
centralgroove.
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Proliferation and evagination ofan area of IEE and adjacentmesenchyme into the enamel
organ during tooth
development.
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This may contian enamel,dentin,pulplike normal tooth.
Radiolographically pulp extensioncan be seen.
Mostly on molars or maxillaryincisors.
May cause occlusal problems
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TREATMENT
Selective reductionwith subsequent pulp
therapy to removethe cusp and keep
the teeth on position.
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Definition:
Deep surface invagination of crown lined by enamel.
ETIOLOGY
Invagination of crown filled with soft tissue like dentalfollicle and on eruption this loses its blood supply andturns necrosis.
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1-10%.
Predominance is lateral incisor>centralincisor>premolars>molars.
Maxillary predominace.
It can be coronal or radicular type.
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Type 1 confined to crown.
Type 2 extends till root.
Extends inside tooth giving ittooth in a tooth(dens indente)appearance.
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Depending on type of densinvaginatus treatment be
restorative or pulp therapy.
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Definition:
Accessory cusp located on palatal surface of mesiolingual cusp ofmaxillary molars.
ETIOLOGY:
Unknown.
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1st molar.
Deep groovesmay predispose
to caries.
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No treatment
until grooveis deep,mayneed
restorative
intervention.
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Also called as enamel pearl.
DEFINITION:
Presence of enamel in unusual location.
ETIOLOGY:
Localised bulging of odontoblastic layer that provides excesscontact between HERS and dentine triggering induction of enamel
formation.
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May contain only enamel or may even have pulp.
Mostly seen on roots of maxillary molars.
Prevelance of 1-9%.
Seen in furcation or CEJ area.
Radiographically appears as circular well definedarea of radiodensity.
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Meticulous hygiene and
periodontal prevention is must.
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Definition:
Enlargement of bodyand pulp chamber of
multirooted teeth with
apical displacement ofpulpal floor.
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May be as result of
chromosomalabnormality or
associated with asyndrome.
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Tauro-bull,dont-teeth.
Pulp chambers are large with decreased bifurcation of roots.Mostly in molars.
Radiographic identification.
Can be of three types:
1)mild hypotaurodontism.
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2)moderate
mesotaurodontism.
3)severehypotaurodontism.
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Endodontictherapy has to
be donecarefully
because of thedimention of
chamber.
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Definition:
Non-neoplastic deposition of excessive cementum.
Etiology:
Hereditary factor.
Abnormal occlusal trauma.
Nonantagonist teeth.
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Thickening of root .
Localized or generalized.
Increases with age.
Associated with pagets diseaseacromegaly,calcinosis.
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No treatment is needed but suchteeth may have to be sectioned
during exodontia.
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Definition:
Abnormalangulation ofroot or crown
of tooth.
Etiology:
Injury to thecalcifiedportion oftooth germ
duringdevelopment.
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Maxillary incisors are mostaffected.
Rare in primary teeth.
Teeth may have altered pathof eruption,can be associated
with periapical lesions ormay be impacted.
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Treatmentdependsupon thedegree of
dilaceration.
Smalldeviationneeds no
treatment.
Largerdeviationneeds for
hemisectionor even
extraction.
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Definition:
Developmentof increasednumber of
roots
compared tonormal.
Etiology: Unknown.
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Permanent
dentitionand molarsare more
affected.
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No treatment isrequired but
during endodontictherapy dueconsideration hasto be given to thepresence of such
roots.
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DrShallan
kaur MAM
DR TalliaMAM
DR DIVYAMAM
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PRESENTEDBY:
SAKEENAASSAD
PREFINALYEAR
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