non carious disease

1
?????

• non carious disease

2

• ?????
• (developmental abnormality of teeth)

??? (injury of teeth)
?????? (chronic injury of teeth)
?????? (dentine hypersensitivity)
3
?????

• developmental abnormality of teeth

4
???? Summary
??????(enamel organ in bell stage)

• ????? Abnormalities of histodifferentiation
• ????? Abnormalities of morphodifferentiation
• ????? Disturbances in number of teeth
• ????? Disturbances in germination of teeth

5
dentine
enamel
external enamel epithelium
stellate reticulum
dental papilla
6
????? Abnormalities of histodifferentiation

• ?????? enamel hypoplasia
• ??? dental fluorosis
• ???? tetracycline stained teeth
• ?????????? hereditary dentinogenesis imperfecta
• ?????? congenital syphilitic teeth

7
?????? enamel hypoplasia
8
?? definition

• ??????,???????????????????????????????????(enamel
  abnormalities of histodifferentiation result from
  systematic disease, nutrition deficiency or
  severe apical affection of deciduous dentition
  during teeth formation)

??????????????(dyspoiesis of
enamel
matrix)
enamel agenesis
??????(with enamel loss)
????????????,?????

(hypomineralization)
enamel hypocalcification
???????(without enamel loss)
9
?? Aetiology

• ???? nutrition deficiency
• ????? incretion disorder
• ??????? infant maternal disease
• ???? localized causes

10
??(Aetiology)
?????? (enamel hypoplasia)
11
??????? infant maternal disease

• ??? Prenatal
• ??? Neonatal
• ?? Postnatal

12
??? Prenatal

• ??(infection)??(rubella)???(syphilis)
• ????????(maternal systemic disease)

13
??? Neonatal

• ????????(haemolytic disease of the newborn)
• ???? (hypocalcaemia)
• ???/???(premature birth/prolonged labour)

14
?? Postnatal

• ???????????(severe childhood infections
  especially the viral exanthemata)
• ??????????????????????(chronic diseases in
  childhood,e.g. congenital heart disease,
  gastrointestinal and endocrine diseases)
• ???????D??(nutritional deficiency, e.g. vitamin
  D)
• ????(cancer chemotherapy)
• ???(excess fluoride ions)

15
???? localized causes

• ??(Infection)
• ?? (Trauma)
• ?? (Radiotherapy)

16
???? clinical features

• ?? mild type
• ?? severe type

17
?? mild type

• ????????(smooth-surface enamel)
• ??????????? (white, opaque spots, brown-stained
  after eruption)

18
?? severe type

• ??(???)?? (horizontal grooves in the enamel
  surface)
• ???? (pits in the enamel surface)
• ???? (general reduction in the thickness of the
  whole enamel)

???(exception)
?????? (symmetrical)
19
???? (symmetrical)
20
?? Note

• ?? 631136 ??????1???
• 6321 1236(damage occur at age 1)
• ??2 2 ???????????2?(damage occur at age 2)
• ??754457 ???????2-3???
• 754457 (damage occur at age 2-3)

21
??? Turner teeth

• ????????????????????(infection or trauma related
  to the deciduous predecessor resulting in damage
  to the ameloblasts of the permanent successor)
• ????????(yellowish or brownish pigmentation of
  the enamel)
• ????????(pits and irregularity of the surface)
• ???(the smaller crown than normal)

22
?? Therapy

• (?)

23
???

• Dental Fluorosis

24
??definition

• ?????????,???????????,??????????????????????(inges
  tion of excessive fluoride during teeth formation
  result in enamel hypoplasia or hypocalcification)

25
??Aetiology

• ????????(ingestion of excess fluoride ions)
• ?????,???1ppm(1 part per million of fluoride
  in the drinking water)
• ???????(fluoride in diet)
• ??????????????(damage ameloblasts during the
  tooth formation)
• ????????,????(result in hypomineralized enamel
  pigmentation)

26
?? Mechanism
???????????
?????(fluoride increasing)

• ???(phospholipid)?????(inorganic phosphate)

?????(Alkali phosphatase)
??(inhibition)
????ATP?????(mineralization)
(pyrophosphoric acid and Adenosine Triphosphate)
????(ameloblast)
??(result)??????(hypomineralized enamel)
?
???????(excess fluoride result in dental
fluorosis)
27
?? Mechanism

• ???????,?????????????(dental fluorosis result
  from a high intake during the period of tooth
  formation)
• ?????????,???????(Placenta barrier can resist
  fluoride, dental fluorosis seldom appear in
  deciduous dentition)
• ??6-7???,????????? !
• (Ingestion excess fluoride no more than
  6-7 age is prone to high prevalence)

28
?? Mechanism
???(dental fluorosis)
29
???? clinical features

• ?????????????????????(fluoride opacities occur
  symmetrically around the arch characterized by
  faint white flecking of the enamel, white patches
  or striations)
• ??????????????(in severe cases may associate with
  loss of the normal tooth form)
• ??????????????????(??)????(??)????(??)3????

30
???? clinical features

• ?????,????????,?????????????????????????,?????????
  ???????,?????????,????????,????????????,??????????
  ???(mainly found in the permanent dentition, but
  the deciduous teeth may be involved in severe
  cases and in areas of endemic fluorosis)
• ????????,??????????(high acid-resist, rapid loss
  by abrasion and attrition)
• ????????(severe cases)

31
???? clinical features
32
?? Classification

33
??Therapy

• ??(bleaching)
• ????(composite resin)
• (?)

34
??(bleaching)
35
????

• tetracycline stained teeth

36
??definition

• ?????????,?????????,???????,????????(discoloration
  of teeth resulting from deposits of tetracycline
  ingestion during tooth development)?

37
?? Aetiology

• ????????(???????8???),?????????,?????????,?????(Te
  tracycline is administrated to pregnant females
  or to children under age of 8, it may be
  incorporated into the dentin of the developing
  teeth)
• ???,????????????????,?????????????????(It
  produces a yellow discoloration, the teeth will
  fluoresce from a bright yellow to brown to gray
  with exposure to light)
• ???????????????(Permeate placenta to affect
  deciduous dentition)

38
?? Aetiology
????(tetracycline stained teeth )
??(deciduous dentition)
???(tetracycline)
??(permanent dentition)
39
???? clinical features

• ??(stain)
• ?????????
• (enamel hypoplasia)

40
???? clinical features
41
??Therapy

• ??????? (composite resin)
• ???? (bleaching)
• ???? (intracoronal bleaching)?

42
??????? (composite resin)
43
???? (bleaching)
44
???? (bleaching)
45
?? comparison

46
??????????

• hereditary dentinogenesis imperfecta

47
?? Aetiology

• ????????(autosomal dominant)
• ????????(equal frequency in males and females)
• ????????(affect both deciduous and permanent
  dentition)

48
??(Pathology)

• ????????,???????????????????(normal enamel
  structure, but amelodentinal junction(ADJ) is
  straight rather than scalloped)
• ????????,??????????(the dentine contains a
  reduced number of tubules, many of which are wide
  and irregular)
• ????????????,???? (exhibit premature closure of
  the pulp chamber and canals)

49
???? clinical features

• ?????????,???????(translucent, opalescent
  amber-like appearance)
• ???????????????????,???????????(enamel is rapidly
  lost and the teeth then show marked attrition)
• X??????????????,????????? (radiological
  examination shows short , blunt roots with
  partial or even total obliteration of the pulp
  chambers and root canals by dentine)

50
???? clinical features
51
??Therapy

• ????

52
??????

• congenital syphilitic teeth

53
?? Aetiology

• ?????????(infection of the tooth germ by
  treponema pallidum )

54
???? clinical features

• ????? ??????(Hutchinson teeth)
• ????
• (Pfluger teeth,Moon teeth)

55
?????

• Abnormalities of morphodifferentiation

56
????

• ???????????
• ????????????
• ????? ????
• ??

57
???( microdontia)
???(conic shaped teeth)
???(macrodontia)
58

• ???(fused teeth)
• ???(geminated teeth)
• ???(concrescence teeth)

59
???(fused teeth)

• ??????????????(joining of two developing tooth
  germs)
• ??????????(completely or incompletely)

60
???(geminated teeth)

• ?????????????????????(one tooth attempts to
  split in two)
• ???????????(two crowns or one large partially
  separated crown)
• ???????(sharing a single root)

61
???(concrescence teeth)

• ????????????????????
• ???????
• ???????
• (the union of two adjacent teeth by excessive
  cementum production)

62
?????

• abnormal central cusp

63
?? Aetiology

• ?????,????????? ,????????(enamel and dentine
  formation for dental papilla protruding into
  enamel organ during tooth formation)

64
???? clinical features

• ????????
• ?????????(5 5)
• ??????????
• ?????????,?????????,??????(???????????????)
• ??????????,?????????? ?????

65
???? clinical features
66
??Therapy

• ????
• ????(grind and desensitization)
• ????????(cavity preparation and pulp capping)
• ???????(apexification)

67
???

• dens invaginatus

68
?? Aetiology

• ?????,??????????????,?????????,????,??????????????
  (deep surface invagination of the crown of tooth
  lined by enamel and dentine)

69
????clinical feature
????????
(maxillary lateral incisor is most commonly
affected )

• ?????(lingual pit deformity)
• ?????(accessory palatal cusp)
• ?????(root groove deformity)
• ???(dens in dente)

70
????clinical feature

• ?????(lingual pit deformity)
• ????????,??????(the defect cannot be kept
  free of plaque and bacteria, the tooth is prone
  to decay and subsequent pulpitis.)

71
????clinical feature

• ?????(accessory palatal cusp)
• ?????????,????,???????,?????????(cingulum
  forms a cusp consists of pulp, easily wear and
  result to pulpitis)

72
????clinical feature

• ?????(root groove deformity)
• ???????,?????,????????????,?????(destroy
  gingival sulcus sealing with infrabony pocket
  ,periodontitis, and accessory root in severe case)

73
????clinical feature

• ???(dens in dente)
• ???????,???X???,???????????(the most severe
  form of this disorder, in which the disturbance
  extends apically into the root)

74
??Therapy

• ??
• ????????
• ????????????
• ????
• ???????

75
??(enamel pearl)

• ??????????,?????(bifurcation or trifurcation of
  molar cementum
• ??????????,??????,????(precludes normal
  periodontal attachment and may lead to hygiene
  problems)

76
?????

• Disturbances in number of teeth

77
?????

• ????
• supernumerary tooth
• ???????
• congenital anodontia

78
???(supernumerary tooth)
79
??????(congenital anodontia)
80
?????

• Disturbances in germination of teeth

81
?????

• ?
• ?
• ??

??????????????????
82
? ?