Acquired Dental Anomalies

gradual loss of dental hard tissue as a result of chewing; curved surfaces altered to flat planes

attrition

- bruxism/grinding

- diet

2 factors that may accelerate attrition

found on many teeth together in the arch

- incisal/occlusal surfaces are pitted or "dished out" (dentin wears away faster than enamel)

- proximal spaces (contacts) open up

- crowns shortened coronal-apically

- reduced size of pulp chambers/canals

- widening of PDL space

What are 5 effects of attrition on teeth?

attrition

What is this an example of?

attrition

What is this an example of?

attrition

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attrition

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attrition

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attrition

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gradual loss of dental hard tissue as a result of external mechanical action

abrasion

ask clinical questions to determine cause

- parafunctional habits (holding objects like toothpicks b/w teeth)

- poorly fitted partial dentures or retainers

- brushing/floss injuries (hard bristles, abrasive toothpaste, excessive pressure)

3 factors that may accelerate abrasion

- enamel may get worn away, exposing dentin

- deposition of secondary dentin decreases pulpal spaces

What happens to the enamel and dentin layers with attrition and abrasion?

radiolucent defects at cervical level surfaces of teeth

How does abrasion present on radiographs?

abrasion

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abrasion

What is this an example of?

abrasion

What is this an example of?

abrasion

What is this an example of?

abrasion

What is this an example of?

abrasion

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abrasion

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abrasion

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gradual loss of dental hard tissue as a result of chemical injuries (not involving bacteria)

erosion

- excessive intake of acidic beverages

- gastric reflux

- bulimia

3 factors that may accelerate erosion

surfaces affected dependent on cause

- smoothly outlined defects on enamel and underlying dentin

- elevated edges around different layers of enamel, dentin, and restorations

What are 2 effects of erosion on teeth?

well-defined radiolucent defects on crowns

How does erosion present on radiographs?

erosion

What is this an example of?

erosion

What is this an example of?

erosion

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erosion

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erosion

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erosion

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loss of tooth structure from occlusal stresses that create repeated tooth flexure; failure of enamel/dentin away from occlusal loading

abfraction

abfraction

What is this an example of?

removal of tooth structure by odontoclasts

resportion

only sections with soft tissue coverage

What parts of a tooth are susceptible to resorption?

progressive resorption of deciduous tooth; results in shedding and eruption of permanent tooth

physiological root resorption

physiological root resorption

What is this an example of?

odontoclasts resorb the outer surface of the tooth

external resorption

- excessive mechanical/occlusal forces

- localized inflammatory lesions

- re-implanted teeth

- impacted teeth, tumors and cysts

- unknown

5 etiologies of external resorption

external resorption (excessive force, intact PDL space)

What is this an example of?

external resorption (normal w/ ortho tx)

What is this an example of?

external resorption (unknown etiology)

What is this an example of?

external resorption (inflammatory lesion)

What is this an example of?

external resorption (inflammatory lesion)

What is this an example of?

external resorption (impaction)

What is this an example of?

external resorption (impaction from extracted tooth)

What is this an example of?

external resorption (ingrowth of bone/inostosis)

What are these examples of?

external resorption (impacted nonerupted tooth)

What is this an example of?

localized, sub-epithelial, supra-osseous resorptive process of the tooth

invasive cervical resorption

- asymptomatic

- etiology and pathogenesis poorly understood

characteristics of invasive cervical resorption

maxillary central incisors

What teeth are most likely to be affected by invasive cervical resorption?

supracrestal, CEJ level

Class 1 of invasive cervical resorption

coronal 1/3

Class 2 of invasive cervical resorption

subcrestal, into mid 1/3

Class 3 of invasive cervical resorption

apical 1/3

Class 4 of invasive cervical resorption

orthodontic treatment

What is the most likely potential predisposing factor for invasive cervical resorption?

invasive cervical resorption

What is this an example of?

invasive cervical resorption

What is this an example of?

invasive cervical resorption

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invasive cervical resorption

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invasive cervical resorption

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invasive cervical resorption

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invasive cervical resorption

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odontoclasts resorb the dentin wall of pulp chamber or root canal

internal resorption

- inflammation

- acute trauma, pulp capping, pulpotomy

2 possible etiologies for internal resorption

- focal enlargement of the pulp space (can be sharp or diffuse)

- radiolucent localized round/oval/elongated lesion continuous with pulp chamber or root canal

How does internal resorption present on radiographs?

internal resorption

What is this an example of?

internal resorption

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internal resorption

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CBCT

What is an important tool used for diagnosing resorptive lesions and treatment planning?

external resorption

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internal resorption

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changes in pulpal tissue resulting in mineralization

pulpal calcifications

- deposited in pulp structures

- physiologic process, slow and continuous

- related to aging

3 characteristics of secondary dentin

additional deposition related to stimuli

What is a characteristic of tertiary dentin?

tertiary dentin (distal)

What is this an example of?

- common idiopathic calcifications

- freely in tissue or attached to wall

- round radiopacities

- no treatment required

4 characteristics of pulp stones

pulp stones

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pulp stones

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pulp stones

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pulp stones

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- idiopathic calcifications

- associated with older age (may be trauma related)

- diffuse, ill-defined

- no treatment required, difficult for endo

4 characteristics of pulpal sclerosis

pulpal sclerosis

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pulpal sclerosis

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pulpal sclerosis

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pulpal sclerosis

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excessive deposition of cementum on the tooth roots

hypercementosis

- supraerupted tooth (lost opposing tooth)

- periapical inflammation

- Paget Disease of bone and Hyperpituitarism

3 possible etiologies for hypercementosis

- roots appear thickened

- difference in radiopacity cementum vs dentin

- continuity of lamina dura and PDL encompasses extra cementum

How does hypercementosis present on radiographs?

hypercementosis

What is this an example of?

hypercementosis

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hypercementosis

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hypercementosis

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