Oral Path Ex 1

total lack of tooth development (don’t say partial!)

anodontia

lack of developmenent of many teeth (6+ teeth)

oligodontia

missing 1-5 teeth; ectodermal dysplasia

hypodontia

development of an increased number of teeth (supernumerary); cleidocranial dysplasia and gardenr syndrome

hyperdontia

inherited condition in which 2 or more ectodermally derived structure fail to develop (e.g skin, hair nail, teeth, sweat glands); AD, AR, X-linked; decreased # of teeth, Per > Dec

hypohydrotic ectodermal dysplasia

most commonly occurs max incisors

mesiodens

accessory 4th molar

distomolar

situated lingually or buccally to a molar

paramolar

teeth present at birth

natal teeth

present within the first 30 days

neonatal

syndrome characterized by dental and clavicle abnormalities, AD inheritance, prolonged retention of deciduous teeth, numerous unerupted permanent and supernumerary teeth

cleidocranial dysplasia

AD syndrome with clinical features of colorectal (adenoma) poly that can become malignant (100% if untx), multiple osteoma, 20% have supernumerary teeth. pigmentation ocular fundus (90%)

gardner syndrome

gardner syndrome

Which of the following clinical/ oral manifestations is correctly matched with its associated syndrome?

missing clavicles - cleidocranial dysplasia

found in gardner syndrome (20%) and cleidocranial dysplasia (more common)

hyperdontia (supernumerary teeth)

small tooth size, often associated with hypodontia, small lateral incisor = peg lateral

microdontia

microdontia is associated with __ and __

down syndrome and hypopituitarisim (dwarfisim)

large teeth, isolated is more common, usually incisors and canines (can be bilateral)

macrodontia

generalized macrodontia is rare but may be associated with which systemic conditions?

pituitary gigantism, hemifacial hyperplasia, otodental syndrome (globodontia), XXY males (klinefelter)

single enlarged/ double/ jointed tooth in which the tooth count is normal (NO MISSING TEETH); one tooth bud tried to divide

gemination

defined as a single/ enlarged/ double/ joined tooth in which the tooth count reveals a MISSING tooth; two buds tried to join

fusion

union of two teeth by cementum alone

concrescence

2 teeth joined

fusion

one tooth trying to split

gemination

accessory cusp on palatal surface of ML cusp of maxillary molars

cusp of carabelli

accessory cusp of lingual incisor, usually, max lat incisor, 91% in max, usually has pulp tissue inside

talon cusp

elongated “cusp” extending from central occlusal surface, mand premolars/ maybe molars, usually has pulp tissue, occlusal trauma is a problem

dens evaginatus (occlusal pearl)

deep surface enamel invagination of the crown or root “tooth within tooth”; can be coronal (most frequent) or radicular

dens invaginatus “dens in dente”

“dens in dente” type I

invagination is confined to the crown

“dens in dente” type II

invagination extends below the CEJ

“dens in dente” type III

invagination may extend through the root

prominent marginal ridges on max incisors (esp centrals), associated w/ dens evaginatus, usually bilateral, most common in asians

shovel shaped teeth

enamel nodules at furcation of multi-rooted teeth, most common in max molars, may have pulp tissue usually without dentin

enamel pearl

enlargement of the body and pulp chamber, most common in mand molars/ premolars, no tx necessary

taurodontism

from traume or infection of tooth bud as root is forming, tooth vital, usually 3rd problems, no problem with tooth unless endo is needed

dilaceration

mostly affect mandibular molars followed by 2nd premolars, can be caused by local factors or systemic factors

hypercementosis

Local factors of hypercementosis (localized)

abnormal occlusal trauma, adjacent inflammation, unopposed teeth (super eruption), repair of vital root fracture

Systemic factors of hypercementosis (generalized)

acromeagaly and pituitary gigantism, arthritis, calcinosis, paget disease of bone, rhumatic fever, thyroid goiter, gardner syndrome, vit A deficiency

increase number of roots, both dec & perm, most commonly affect man 3rd molar > cuspids and bicuspids, no tx but detection important if endo needed

supernumerary root

Which feature correctly matches its diagnosis?

enlarged pulp chamber -taurodontism

AD, AR, X-linked; both deciduous and permanent dentition are diffusely involved, affects enamel (soft, thin, easily damaged, susceptible to decay), dentin is exposed

amelogenesis imperfecta (AI)

Types of AI

hypoplastic (pitted), hypomaturation/ hypocalcification (snowcapped) AI with taurodontism

what type of AI

hypomaturation (snowcapped)

what type of AI?

hypoplastic (pitted)

Clinical appearance of AI

yellow-brown to white pitted lesions, open bite, loss of contact

types of enamel dysplasia (ED)

hypoplasia and hypomineralization

thickness deficit, quantitative defect (incomplete enamel matrix formation )

hypoplasia ED

mineral deficit, qualitative defect

hypomineraliszation ED

hypomineralization ED can be classified as either

hypomaturation (amelogenin-rich) or hypocalcification (amelogenin- poor)

a hereditary condition of dentin in the absence of any systemic disease (opalescent dentin), AD, genetic mutation is DIFFERENT from osteogenesis imperfecta

dentinogenesis imperfects (DGI)

DGI-I clinical presentation

ostoegenesis imperfecta (for boards), opalescent teeth, BONE FRACTURES

DGI-II clinical presentation

isolated opalescent teeth, most common

DGI-III

isolated opalescent teeth, large pulp = shell teeth, pulp exposure, PA radiolucencies

DGI-I witkop classification

dentinogenesis imperfecta

DGI-II witkop classification

hereditary opalescent teeth

DGI-III witkop classification

brandywine

affects both dentition, steel-grey/ translucent/ opalescent crowns, brittle enamel

DGI

DGI radiographic presentation

bulbous crown, cervical constriction, pulp obliteration varies, expanded pulp = shell teeth

hereditary condition affecting dentin, AD, both dentitions affected, 2-types (coronal and radicular)

dentin dysplasia (DD)

DD-II

coronal dentin dysplasia

DD-I

radicular dentin dysplasia

4 types, normal clinical crown, short roots, periapical radiolucencies, chevron pulp chambers

DD-I

have a blue-amber-brown translucence, bulbous crown, cervical constriction, thin roots, normal length, early obliteration of pulp

DD-II primary teeth

have a normal color clinically, pulp chamber is enlarged = thistle tube or flame shaped, pulp stone, normal root

DD-II permanent teeth

nonhereditary developmental anomaly, most common in max ant teeth, usually involves one quadrant, very large pulps with minimal dentin and enamel

regional odontodysplasia “ghost teeth”

Which feature correctly matches its diagnosis?

opalescent dentin - dentinogenesis imperfecta

tooth-tooth

attrition

tooth-abrasive (mechanical)

abrasion

chemical

erosion

occlusal stress

abfraction

common in apical/ mid root; associated with cysts, tumors, ortho, excessive occlusal stress, reimplantation of avulsed tooth

external resorption

rare, injury to pulpal tissue (trauma)

internal resorption

internal resorption affecting crown

pink tooth of mummery

obstructed by a physical barrier, lack of eruptive force = embedded, rarely occurs in deciduous teeth

impaction localized disturbance in eruption

cessation of eruption after emergence, fusion of cementum with bone, unknown pathogenesis

ankylosis localized disturbance in eruption

enamel can be white, yellow, brown, and or have different degrees of hypoplasia; most commonly in bicuspid because of their relation ship with the deciduous molars; causes fever, PA inflammatory disease of overlying deciduous tooth, trauma

turner’s hypoplasia

intra-oral presentation of congenital syphilis;1st molars develop irregular nodules of enamel on occlusal surface

mulberry molars

intra-oral presentation of congenital syphilis; “screwdriver” incisor

hutchinson’s incisor

H & N effects of congenital syphilis

mental degeneration, cartilage, septal destruction of nose (saddle nose), blindness, deafness (CN 8)

ingestion of excess amount of fluoride, retention of amelogenin protein in enamel, hypomineralization creating chalky white areas, must be bilateral symmetrical distribution with previous exposure to Fl

fluorosis, mottled enamel

pulp death after RCT or trauma, age (gets darker with time), tooth is brittle, rx post and crown

non-vital tooth

rare, injury to pulpal tissue

internal resorption

from use during tooth development; may also discolor skin, sclera, thyroid; RX for acne, cystic fibrosis, RA

tetracycline staining

What is the cause?

tooth-tooth contact

which feature correctly matches its diagnosis

discolored enamel defect - turner’s hypoplasia

All of the following are local factors causing hypercementosis EXCEPT

paget disease

A single enlarged tooth in which the tooth count is normal and tooth bud tried to divide

gemination

what is the dx?

dense invaginatus

Which of the following is not a hereditary condition?

regional odontodysplasia

what is the diagnosis?

regional odontodysplasia

most common teeth to express turner’s hypoplasia

bicuspids

what is the cause of this lesion

trauma to the pulp

which medication can cause bluish staining of teeth?

tetracycline

which is NOT a feature of congenital syphillis?

5th nerve deafness (it’s 8th)

Base of Lesion : flat base

sessile

Base of Lesion : between sessile and pedunculated

polypoid

Base of Lesion : stalk like

pedunculated

Surface Texture : wrinkled

corrugated

Surface Texture : a cleft or groove, normal or otherwise, show prominent depth

fissure

Surface Texture : resembling small projection or elevation found in clusters

papillary