Developmental

1
Developmental Congenital Anomalies

• Dr. Vandana Kumar BDS,MDS,MS

2
DEFINITIONS

• Anomaly Marked deviation from regular
  arrangement or form
• Congenital Existing at or before birth
• Dysostosis Defective ossification of fetal
  cartilages
• Dysplasia ill formed abnormality of dvelopment
• Dystrophy disturbance in bone growth and
  modeling resulting from a disturbance in osseous
  nutrition or metabolism

3
Dental Anomalies

• Variations in Number
• Variations in size
• Variations in shape
• Variations in structure

4
Supernumerary Teeth
5
Most Common Areas For Supernumerary Teeth

• Maxillary central incisor area (mesiodens)
• Fourth Molars or paramolars or distodens
• Premolar region ( most common in the mandible)
  Peridens

• Conditions with supernumerary teeth in
  genetically inherited syndromes
• Cleidocranial dysostosis
• Gardner's syndrome

6
Mesiodens
7
Second Molar and Second Premolar Region
8
Hypodontia,
Oligodontia
Anodontia
9
Anodontia
5 Year Old Boy
10
Oligodontia
11
Hypodontia
12
Ectodermal Dysplasia
13
Ectodermal Dysplasia More examples
14
Dwarfing of teeth
Radiation Therapy for the treatment of malignant
tumors
15
Anomalies of Position/ Transposition
16
Anomalies of Form

• Gemination
• Fusion
• Concrescence
• Taurodontism
• Dens invagination
• Dens evagination
• Dilacerations

17
Gemination/Twinning

• When a single tooth bud attempts to divide
• Formation of a bifid crown caused by
  invagination during tooth formation
• Altered shape of hard tissue and pulp chamber
• More common in primary teeth than in permanent
  dentition

18
Twinning
Complete twinning/ gemination results in normal
plus a supernumerary tooth in the arch

Two maxillary microdontic lateral incisors from
one tooth bud
19
Fusion
Union of two or more teeth in which the dentin
becomes confluent
20
Fusion Contd.
Results in reduced number of teeth in the
arch More common in primary dentition than in
permanent
21
Concrescence
Only cementum is joined
22
Taurodontism

• Molar teeth resemble an ox or bulls head
• Normal shape of crown
• Elongated body Short roots
• Deep extension of the pulp into the root
• Increased distance between the C-E junction and
  furcation
• Increased incidence in Downs syndrome

23
Taurodontism
24
Taurodontism
Apically positioned furcations Enlarged pulp
chamber
25
Dilaceration

• Disturbance in tooth formation that produces
  sharp bent
• Due to injury during development
• Obstacles can cause dilacerations
• Maxillary premolars are most affected

26
Dilacerations examples
27

• Dens-in-dente/ Dens -Invaginatus and dilated
  Odontome
• Caused by Varying degree of invagination or
  infolding of the enamel surface into the interior
  of tooth
• The least severe form is called dens invaginatus
• The most severe form is called dilated odontome

28
Dens-in-dente-contd.

• Two types Coronal and Radicular
• Coronal invagination
• Infolding of enamel organ into dental papilla.
• In mature tooth there is a fold of hard tissue
  within the tooth charcterized by enamel lining
  the fold.
• Lined by enamel
• More common in permanent maxillary lateral
  incisors
• Radicular invagination
• Invagination of hertwigs epithelial root sheath.
• Produces an accentuation of longitudinal groove.
• Defect lined by cementum
• Mandibular first premolars and second molars

29
Dens-in-dente-contd.
30
Dens Evaginatus
31
Anomalies Of Form

• Amelogenesis Imperfecta
• Dentinogenesis Imperfecta
• Dentin Dysplasia
• Regional Odontoplasia
• Enamel Hypoplasia
• Congenital Syphilis
• Turners Hypoplasia

32
Amelogenesis Imperfecta

• Hypoplastic Type
• Enamel matrix is underdeveloped and thin -
  Dentin and root are normal
• Enamel that forms calcifies normally
• Hypomineralized Type
• Normal enamel matrix forms
• Calcification is abnormal

33
Hypocalcified Form of Amelogenesis Imperfecta
34
Hypocalcified Form
35
Hypoplastic Amelogenesis Imperfecta
36
Dentinogenesis Imperfecta

• Imperfect formation of dentin
• DEJ is smooth
• Bulbous crowns
• Constricted necks
• Shortened roots
• Partial/complete obliteration of pulpal chambers
• Sometimes associated with OSTEOGENESIS IMPERFECTA

37
Dentinogenesis Imperfecta Type 1
With Osteogenesis Imperfecta, Blue sclera Wormian
bones Skeletal deformities Progressive osteopenia
38
Dentinogenesis Imperfecta Type 2
Does not occur in association with osteogenesis
imperfecta Referred to as hereditary opalescent
dentin.
39
Dentinogenesis Imperfecta
40
Dentin Dysplasia

• Genetically inherited autosomal-dominant
  abnormality
• Type 1(Radicular)- Short roots, conical in shape.
  Sometimes known as rootless teeth
• Type 2 (Coronal)- Normal roots, flame or chevron
  shaped pulp canals

41
Type I (Radicular)
42
(No Transcript)
43
Dentin Dysplasia Type 2
44
Type 2
45
Regional Odontodysplasia

• Large pulp chambers
• Thin enamel
• Hypocalcified, thin dentin
• Usually restricted to a region such as a single
  quadrant
• Also known as ghost teeth

46
Regional Odontodysplasia
47
(No Transcript)
48
Enamel Pearl
49
Congenital Syphilis
Hutchinsons Incisors
Mulberry molars
50
Turners Hypoplasia
51
Questions