developmental defectsof the oral and maxillofacial region
DESCRIPTION
Shahad 2 AaeshahTRANSCRIPT
DEVELOPMENTAL DEFECTSOF THE ORAL
AND MAXILLOFACIAL REGION
DISORDERS OF DEVELOPMENT OF THE TEETH
• Abnormalities in number•Disturbances in form of teeth•Disorders of eruption•Defects of structure•Developmental anomalies of several dental tissue
ABNORMALITIES IN NUMBER
• Isolated hypodontia or anodontia•Hypodontia or anodontia with systemic defects• Anhidrotic (hereditary) ectodermal dysplasia•Down's syndrome
HYPODONTIA. MULTIPLE DEVELOPMENTALLY MISSING PERMANENTTEETH AND SEVERAL RETAINED DECIDUOUS TEETH IN A FEMALE
ADULT
HYPODONTIA. RADIOGRAPH OF THE SAME PATIENT. NO UNERUPTED TEETH WERE NOTED WITH IN
THE JAWS,
HYPODONTIA . DEVELOPMENTALLY MISSING MAXILLARYLATERAL INCISORS. RADIOGRAPHS REVEALED NO UNDERLYING TEETH , AND
THERE WAS NO HISTORY OF TRAUMA OR EXTRACTION.
ABNORMALITIES IN NUMBER
• Additional teeth: hyperdontia• Supernumerary teeth• Supplemental teeth
• Syndromes associated with hyperdontia: cleidocranial dysplasia
HYPERDONTIA (MESIODENS) . ERUPTED SUPERNUMERARY,RUDIMENTARY TOOTH OF THE ANTERIOR MAXILLA.
HYPERDONTIA (MESIODENS). UNILATERAL SUPERNUMERARYTOOTH OF THE ANTERIOR MAXILLA, WHICH HAS ALTERED THE
ERUPT ION PATH OF THE MAXILLARY RIGHT PERMANENT CENTRAL INCISOR
HYPERDONTIA (MESIODENS). BILATERAL INVERTEDSUPERNUMERARY TEETH OF THE ANTERIOR MAXILLA.
HYPERDONTIA. RIGHT MANDIBULAR DENTITIONEXHIBITING FOUR ERUPTED BICUSPIDS
DISTURBANCES IN FORM OF TEETH
• Dilaceration• Taurodontism• Double teeth• Fusion • Gemination
• Concrescence
DILACERATION
TAURODONTISM. MANDIBULAR MOLAR TEETH EXHIBITINGINCREASED PULPAL APICOOCCLUSAL HEIGHT WITH APICA LLY
POSITIONEDPULPAL FLOOR AND BIFURCATION
FUSION. DOUBLE TOOTH IN THE PLACE OF THEMANDIBULAR RIGHT LATERAL INCISOR AND CUSPID.
FUSION. RADIOGRAPHIC VIEW OF DOUBLE TOOTH IN THEPLACE OF THE MANDIBULAR CENTRAL AND LATERAL INCISORS. NOTE
SEPARATEROOT CANALS.
FUSION. RADIOGRAPH OF THE SAME PATIENT.NOTE THE BIFID CROWN OVERLYING THE SINGLE ROOT
CANAL; THE CONTRA LATERAL RADIOGRAPH REVEALED A SIMILAR PATTERN
BILATERAL GEMINATION. TWO DOUBLE TEETH. THETOOTH COUNT WAS NORMAL WHEN EACH ANOMALOUS TOOTH WAS
COUNTEDAS ONE.
GEMINATION. MANDIBULAR BICUSPID EXHIBITING BIFIDCROWN.
GEMINATION. SAME PATIENT. NOTE THE BIFID CROWN AND SHARED ROOT CANAL
CONCRESCENCE. UNION BY CEMENTUM OF ADJACENTMAXILLARY MOLARS.
CONCRESCENCE. UNION BY CEMENTUM OF MAXILLARYSECOND AND THIRD MOLARS. NOTE THE LARGE CARIOUS DEFECT OF
THESECOND MOLAR.
CONCRESCENCE. GROSS PHOTOGRAPH OF THE SAMETEETH. HISTOPATHOLOGIC EXAMINATION
REVEALED THAT UNION OCCURRED IN THE AREA OF CEMENTAL REPAIRPREVIOUSLY DAMAGED BY A PERIAPICAL INFLAMMATORY LESION.
DISORDERS OF ERUPTION
• Metabolic diseases particularly cretinism and rickets• Cleidocranial dysplasia• hereditary gingival fibromatosis• cherubism
CRETINISM
RICKETS
CLEIDOCRANIAL DYSPLASIA
HEREDITARY GINGIVAL FIBROMATOSIS
CHERUBISM
DEFECTS OF STRUCTURE
•HYPOPLASIA AND HYPOCALCIFICATION• Defects of deciduous teeth• congenital porphyria• Tetracycline
• Defects of permanent teeth• Genetic• Amelogenesis imperfecta• Dentinogenesis imperfecta• Shell teeth• Dentinal dysplasia• Regional odontodysplasia• Multisystem disorders with associated dental defects
DEFECTS OF STRUCTURECONTINUED
• Defects of permanent teeth• Infective• Congenital syphilis
• Metabolic• Childhood infections, rickets, hypoparathyroidism
• Drugs• Tetracycline pigmentation• Cytotoxic chemotherapy
• Fluorosis• Other acquired developmental anomalies:Fetal
alcohol syndrome
HYPOPLASTIC AMELOGENESIS IMPERFECTA, GENERAT- EIZED PITTED PATTERN . NOTE THE NUMEROUS PIN POINT PITS SCATTERED
ACROSS THE SURFACE OF THE TEETH. THE ENAMEL BETWEEN THE PITS IS OFNORMAL THICKNESS. HARDNESS. AND COLORATION.
HYPOPLASTIC AMELOGENESIS IMPERFECTA, AUTO SOMALDOMINANT SMOOTH PATTERN. SMALL. YELLOWISH TEETH
EXHIBITING HARD, GLOSSY ENAMEL WITH NUMEROUS OPEN CONTACTPOINTS AND ANTERIOR OPEN BITE.
HYPOPLAST IC AMELOGENESIS IMPERFECTA, AUTOSOMALDOMINANT SMOOTH PATTERN. RADIOGRAPH OF THE SAME
PATIENT . NOTE THE THIN PERIPHERAL OUTLINEOF RADIOPAQUE ENAMEL
HYPOMATURATION AMELOGENESIS IMPERFECTA.DENTITION EXHIBITING MOTTLED, OPAQUE WHITE ENAMEL
WITH SCATTEREDAREAS OF BROWN DISCOLORATION.
HYPOMATURATION AMELOGENESIS IMPERFECTA,SNOWCAPPED PATTERN. DENTITION EXHIBITING ZONE OF WHITE OPAQUEENAMEL IN T HE INCISAL AND OCCLUSAL ONE FOURTH OF THE ENAMEL
SURFACE
HYPOCALCIFIED AMELOGENESIS IMPERFECT A. DENTITIONEXHIBITING DIFFUSE YELLOW-BROWN DISCOLORATION . NOTE NUMEROUS
TEETH WITH LOSS OF CORONAL ENAMEL EXCEPT FOR THE CERVICAL PORTION.
HYPOCALCIFIED AMELOGENESIS IMPERFECTA.RADIOGRAPH OF THE SAME PATIENT. NOTE THE
EXTENSIVE LOSS OF CORONAL ENAMEL AND T HE SIMILAR DENSITY OF ENAMEL
AND DENTIN.
DENTINOGENESIS IMPERFECTA. RADIOGRAPH OFDENTITION EXHIBITING BULBOUS CROWNS, CERVICAL
CONSTRICTION, ANDOBLITERATED PULP CANALS AND CHAMBERS.
DENTINOGENESIS IMPERFECTA . DENT IT ION EXHIBITINGDIFFUSE BROWNISH DISCOLORATION AND SLIGHT
TRANSLUCENCE.
DENTINOGENESIS IMPERFECTA. DENTITION EXHIBITINGGRAYISH DISCOLORATION WITH SIGNIFICANT ENAMEL LOSS
AND ATTRITION.
SHELL TEETH . DENTITION EXHIBITING NORMAL THICKNESSENAMEL, EXTREMELY THIN DENTIN, AND DRAMATICALLY
ENLARGED PULPS.
DENTIN DYSPLASIA. DENTITION EXHIBITINGATTRITION BUT OTHERWISE NORMAL CORONAL COLORATION
AND MORPHOLOGY.
DENTIN DYSPLASIA. DENTITION EXHIBITINGSHORTENED ROOTS, NO PULP CANALS. AND SMALL CRESCENT-
SHAPED PULPCHAMBERS
DENTIN DYSPLASIA TYPE II. AFFECTED TOOTHEXHIBITING LARGE PULP STONE WITHIN THE PULP CHAMBER.
REGIONAL ODONTODYSPLASIA (GHOST TEETH) .POSTERIOR MANDIBULAR DENTITION EXHIBITING ENLARGED
PULPS ANDEXTREMELY THIN ENAMEL AND DENTIN.
REGIONAL ODONTODYSPLASIA. FOLLICULAR TISSUECONTAINS SCATTERED COLLECTIONS OF ENAMELOID
CONGLOMERATES ANDISLANDS OF ODONTOGENIC EPITHELIUM.
EHLERS-DANLOS
GARDNER'S SYNDROME
EPIDERMOLYSIS BULLOSA
CONGENITAL SYPHILIS
CONGENITAL SYPHILIS
HYPOPARATHYROIDISM
RICKETS
TETRACYCLINE PIGMENTATION
TETRACYCLINE PIGMENTATION
FLUOROSIS
FLUOROSIS
DENS INVAGINATUS. ILLUSTRATION DEPICTING THE THREETYPES OF CORONAL DENS INVAGINATUS.
DENS INVAGINATUS
CORONAL DENS INVAGINATUS. TYPE II . MANDIBULARLATERAL INCISOR EXHIBITING LINGUAL BULBOUS ENLARGEMENT AT
THE SITE OFCORONAL OPENING OF ENAMEL INVAGINATION .
ENAMEL PEARL. MASS OF ECTOPIC ENAMEL LOCATED INTHE FURCATION AREA OF A MOLAR TOOTH.
ENAMEL PEARL . RADIOPAQUE NODULE ON THE MESIALSURFACE OF THE ROOT OF THE MAXILLARY THIRD MOLAR.ANOTHER LESS
DISTINCTENAMEL PEARL IS PRESENT ON THE DISTAL ROOT OF THE SECOND MOLAR.
GENETIC DISORDERS OF THE JAWS
• 1- Hereditary prognathism• 2- Clefts of the palate and/or lip• 3- Craniofacial anomalies• 4- Cleidocranial dysplasia • 5- Cherubism• 6- Basal cell naevus syndrome • 7- Gardner's syndrome • 8- Osteogenesis imperfect
CLEFT LIP. INFANT WITH BILATERAL CLEFT OF THE UPPER LIP.
CLEFT PALATE. PALATAL DEFECT RESULTING IN COMMUNICATION
WITH THE NASAL CAVITY.
BIFID UVULA.
SUBMUCOUS PALATAL DEFT. THERE IS A CLEFT OF THEMIDLINE PALATAL BONE. BUT THE OVERLYING MUCOSA IS INTACT. A
BIFIDUVULA ALSO IS PRESENT.
MANAGEMENT
• Important aspects of management of clefts• Provision for feeding in infancy when palatal clefts
are severe• Prevention of collapse of the two halves of the
maxilla• Measures to counteract speech defects• Cosmetic repair of cleft lips