dental anomalies
DESCRIPTION
hahTRANSCRIPT
RADIOGRAPHIC INTERPRETATION
OF DENTAL ANOMALIES
DRG. SHANTY CHAIRANI
CHANGES IN NUMBER OF TEETH
ANODONTIA Total anodontia: congenital absence of all
teeth Partial anodontia (hypodontia,
oligodontia): congenital absence of one or more teeth, usually a maxillary lateral incisor or mandibular bicuspid or a third molar tooth.
Total anodontia
Partial anodontia
SUPERNUMERARY TEETH Teeth in excess of the normal number Clinical Features:
90% in maxilla Single or multiple, impacted or erupted Mesiodens most common, paramolar,
distomolar Numerous supernumerary teeth are found
in such developmental disturbances as cleidocranial dysplasia, craniofacial dysostosis, mandibulofacial dysostosis.
Supernumerary Teeth
Supernumerary Teeth
SUPERNUMERARY ROOTS Extra roots; more than the expected
number. Clinical Features: more common in
mandibular bicuspids and permanent molars from either arch
Radiographic Features: not always visible on a radiograph
Supernumerary Roots
MACRODONTIA One or more teeth that are larger than normal. Clinical Features:
Generalized - all of the teeth are affected True generalized - all teeth in both arches larger
(pituitary gigantism) Relative generalized - small jaw size relative to
the teeth makes teeth seem larger crowding of teeth)
Localized - isolated teeth affected Only occasionally found and is often associated
with hemifacial hypertrophy Radiographic Feature: large tooth
CHANGES IN SIZE OF TEETH
Macrodontia
MICRODONTIA One or more teeth that are smaller than normal. Clinical Features:
Generalized - all of the teeth are affected True generalized - all teeth in both arches
smaller (pituitary dwarfism) Relative generalized - large jaw size relative
to the teeth makes teeth seem smaller; space between teeth)
Localized - one or two teeth affected, usually :maxillary lateral incisors (peg laterals), maxillary third molars
Often conically shaped Radiographic Feature: small tooth
Microdontia
GEMINATION Abnormally shaped crown that is extra wide due to the
development of two crowns from one tooth germ. Radiographic Feature : a tooth with a single root
canal and either a large crown or two crown.
FUSION An abnormally shaped tooth that may appear as an
extra wide crown, a normal crown with an extra root, or other combinations resulting from the union of two adjacent tooth germs by dentin during development.
Radiographic Feature : a tooth with two root canals and either a large crown or two crowns.
CHANGES IN SHAPE OF TEETH
Fusion
Gemination
CONCRESCENCE Union of the roots of two or more normal teeth
caused by confluence of their cemental surfaces.
DILACERATION A sharp bend or angulation of the root portion
of a tooth. Radiographic Features : abnormal angulation
anwhere along the length of the tooth
Concrescence Dilaceration
ENAMEL PEALR (ENAMELOMA) Ectopic nodular deposits of enamel that
primarily occur in the bifurcation or trifurcation areas on the roots of molars.
Radiographic Feature : usually found near the root furcations of single or multirooted teetH
Enamel Pearl (Enameloma)
DENS INVAGINATUS (DENS IN DENTE) Developmental anomaly in which a focal area of the
crown is folded inward (invaginated) for various distances.
When severe, this results in a conically shaped tooth with a small surface opening (dens in dente) that quickly becomes subject to caries, pulpitis, and periapical inflammation.
Clinical Features: Rare in primary teeth Most often permanent maxillary lateral incisors, central
incisors, proemolars, canines and molars Lingual surface may have pits
Radiographic Features: May resemble a tooth within a tooth Enlargement of the root Dilated invagination lined by enamel with the opening
of the invagination situated along the lateral aspect of the root
Dens in Dente (Dens Invaginatus)
DENS EVAGINATUS A developmental anomaly in which a focal
area of the crown projects outward and produces what appears as an extra cusp or an abnormal shape to existing cuspal arrangements.
Radiographic Feature : an extension of a dentin tubercle on the occlusal surface
TALON CUSP A form of supernumerary cusp which arises
from the cingulum portion of the tooth and extends to the incisal edge as a prominent projection of enamel that imparts a T shape
Clinical Features: Lingual of maxillary central incisors Arises from the cingulum portion of the tooth and
imparts a T shape Radiographic Feature: cusp contains a pulp
horn
Talon Cusp
TAURODONTIA An anomalous form of teeth that is
characterized by a clinical and anatomic crown of normal shape and size, an elongated body, and short roots with a longitudinally enlarged pulp chamber.
Radiographic features : The extension of the rectangular pulp
chamber into the elongated body of the tooth.
The shortened roots and root canals.
Taurodontia
AMELOGENESIS IMPERFECTA A spectrum of hereditary defects in the function of
ameloblasts and the mineralization of enamel matrix that results in teeth with multiple generalized abnormalities affecting the enamel layer only.
Clinical Features: Teeth vary in color from white opaque to yellow to
brown All teeth are affected, smaller and pitted Normal pulps and dentin but reduced enamel
Radiographic Features: The squarish shape of the crown, the relatively
thin layer of enamel, the low or absent cusps, and in some cases advanced abrasion.
CHANGES IN STRUCTURE OF TEETH
Amelogenesis Imperfecta
ENAMEL HYPOPLASIA A defect in tooth enamel that results in less
quantity of enamel than normal. Etiology : local, systemic or genetic factors Clinical Features:
Pits, grooves, lines or larger areas of missing enamel surface
Reduction in enamel thickness Possible occlusal distortion, aesthetic problems,
sensitivvity Yelllowish or brownish discoloration May be localized or present on numerous teeth and all
or part of the surfaces of each affected tooth may be involved
Radiographic Feature : thin enamel
Enamel Hypoplasia
TURNER’S TOOTH Enamel hypoplasia of a single tooth, most
commonly one of the permanent maxillary incisors or a maxillary or mandibular premolar, resulting from local infection or trauma.
DENTINOGENESIS IMPERFECTA A hereditary defect consisting of opalescent
teeth composed of irregularly formed and undermineralized dentin that obliterates the coronal and root pulpal chambers.
Clinical Features: Opalescent teeth, undermineralized dentin Tooth fractures and chips away easily leads to
exposed dentin and functional attrition Radiographic Features:
Bulb-shaped crowns with constricted CEJ and thin roots
Multilocular May exhibit extremely large pulpal chambers;
obliterated
Dentinogenesis Imperfecta
DENTIN DYSPLASIA (ROOTLESS TOOTH) A hereditary defect in dentin formation in which
the coronal dentin and tooth color is normal; the root dentin is abnormal with a gnarled pattern and associated shortened and tapered roots.
Clinical Features: Normal eruption pattern Bluish in cervical region Types
Type I radicular dysplasia Normal crowns of regular or slightly amber
translucency Tendency toward complete obliteration of
pulp cavities Abnormal spaces between the teeth,
malignment, malpositon and severe mobility
Type II coronal dysplasia Semi-transparent opalescent primary teeth Normal appearance in the permanent teeth Incomplete obliteration of pulp cavities Pulp stones
Radiographic Features: Type I radicular dysplasia
Extremely short roots Obliterated pulp chambers and root canals before
eruption Periapical radiolucencies around the defective roots
Type II coronal dysplasia Complete obliteration of pulp chambers and root
canals after eruption Pulp stones Absence of periapical radiolucencies
Dentin Dysplasia (Rootless Tooth)
REGIONAL ODONTODYSPLASIA (GHOST TEETH) A developmental disturbance of several adjacent teeth
in which the enamel and dentin are thin and irregular and fail to adequately mineralize; surrounding soft tissue is hyperplastic and contains focal accumulations of spherical calcifications and odontogenic rests.
Clinical Features: Not adequately mineralized; enamel and dentin are
soft, thin and irregular Associated with vascular nevi Usually unilateral Irregular surface contour with pitting and grooves on
small teeth, yellowish leathery brown in color Affects teeth sequentially in one or two quadrants,
affects both the primary and permanent dentitions, any tooth, maxilla anterior most common
Radiographic Features: Much less radiodensity Thin layers of enamel and dentin Indistinguishable CEJ Faint, fuzzy outline Ghost Teeth appearance Enlarged pulp chamber, enlarged canals
and wide open apices Short and stubby roots Periapical abscess often present Widened PDL
Regional Odontodysplasia (Ghost Teeth)
ANOMALIES OF ERUPTION TEETH
PREMATURE ERUPTION Teeth present at birth (natal teeth) or shortly
after (neonatal teeth) ; eruption of permanent teeth after premature loss of preceding deciduous teeth.
DELAYED ERUPTION Appearance of deciduous or permanent teeth
relative to the normal age range. Radiographic Features:
Unerupted tooth Usually severe dental crowding in the affected
area
Delayed Eruption
IMPACTED TEETH Teeth continue to form within bone but fail to
erupt into the oral cavity because of a physical obstruction.
Radiographic Features: Completely impacted are totally surrounded by
bone Partially impacted tooth is partly in bone, partly in
soft tissue Embedded teeth are individual teeth that fail to
erupt for no apparent reason (term not used much)
Most common are mandibular and maxillary third molars, maxillary cuspids and supernumerary teeth.
Partial impaction
Complete impaction
REGRESSIVE CHANGES OF THE DENTITION
ATRITION Loss of tooth structure due to mechanical action
of mastication. Clinical Features:
Older adults Flattening of occlusal, incisal and proximal surfaces of
teeth
ABRASION Abnormal loss of tooth structure due to non-
masticatory physical friction. Clinical Features:
Loss of tooth structure at site of wear Sensitivity possible
ATRITION
ABRASION
ROOT RESORPTION Breakdown or destruction of root structure; loss
of root structure. The apex of the tooth appears shortened or
blunted and irregularly shaped.
EXTERNAL RESORPTION A loss of tooth structure that begins on the outer
surface and extends inward toward the pulp. Radiographic Features :
An irregularity in the normal contour of the root. May be uniform and may produce gradual blunting of
the root apex, or it may begin on the sides of the root
External Resorption
INTERNAL RESORPTION A form of tooth loss that begins within the pulpal
chambers of intact teeth, destroying dentin as it extends outward in a uniform pattern toward the tooth surfaces.
Clinical Features: Most are within the crown of the anterior incisors
and are idiopathic. Usually asymptomatic, lesion first detected by
appearance of a pink spot beneath the enamel surface
Radiographic Features : Fusiform enlargement of the pulpal chamber of one or more teeth that appears in either the crown or root pulpal chambers
Internal Resorption
PULP STONE Sperical calcification within the dental pulp lying
free or attached to the pulpal surface of the tooth.
Radiographic Features : radiopaque enlargements within the pulp chamber or canal
HYPERCEMENTOSIS Excessive deposit of cementum on root surface. Clinical Features:
Clinically undetectable Predonimantly adults
Radiographic Features: Root may have a larger circumference
than the upper portion, bulbous or pear-shaped
Most frequently premolar teeth