PERAN RADIOLOGI dalam

ANALISA TUMBUH KEMBANG

dr. Lila Indrati, SpRad

Odontogenesis is the complex process by which teeth form from embryonic cells, grow, and erupt into the mouth.

ODONTOGENESIS

Dentition

• Primary dentition – develops during prenatal period– 20 teeth

• Permanent dentition – develops as the jaw grows and matures– 32 teeth

• period in between – during the preteen years– mixed dentition period

Enamel, dentin, cementum, and the periodontium must all develop during appropriate stages of fetal development.

Primary (baby) teeth start to form between the sixth and eighth weeks

Permanent teeth begin to form in the twentieth week

ODONTOGENESIS

© l.m.brocklebank

Normal dental development

• permanent - 32:– incisors - 8

– canines - 4– premolars - 8– molars - <12

• deciduous - 20: – incisors - 8

–canines - 4–premolars - 0–molars - 8

Dental agePanoramic radiograph

The Growth

dental age chronological age.

DEMIRJIAN

Bone age assessment

At birth :

Only metaphyses are present epiphysis elongation

(end of the growing bone) epiphyses calcified x-rays

Bone age : degree of maturation of bones

G r o w s skeleton change : size & shape x-ray.

Bone age assessmentRadiological examination of skeletal development of the left-hand wrist

• The Growthaccelerating or decreasing?

bone age chronological age.

• social true age

universally used

simplicity, minimal radiation exposure, the availability of multiple ossification centers for evaluation of maturity.

Method

Greulich and Pyle based on a single x-ray of the fingers, hand, and wrist

easily x-rayed with minimal radiation shows many bones in a single view.

Greulich and Pyle (GP method) : faster, easier

Tanner and Whitehouse (TW2 method) : more accurate

compared to the bones of a standard atlas

Development of the ring finger from a baby- 19 Y.In the fifth image, the epiphysis appears, which becomes wider and in the final images fuses with the metaphysis.

from the Greulich and Pyle atlas

Tanner and Whitehouse ("TW2" method) doesn’t use a scale based on the agebased on a set of bone’s standard maturity for each age population. 20 regions of interest (ROIs) located in the main bones are considered for the bone age evaluation

1. First metacarpal2. Proximal phalanx of the thumb3. Distal phalanx of the thumb4. Third metacarpal5. Proximal phalanx of the third finger6. Middle phalanx of the third finger7. Distal phalanx of the third finger8. Fifth metacarpal9. Proximal phalanx of the fifth finger10. Middle phalanx of the fifth finger11. Distal phalanx of the fifth finger

Dental development

andabnormalities

© l.m.brocklebank

• number – increase or

decrease • position• form

– individual or multiple

DENTAL AGE

Age: 15, male

Photography

Radiography

Age 19, male Stage H (by DEMIRJIAN)

Age 19, male Stage H (by DEMIRJIAN)

Age 15, maleThe epiphysis of the radius has capped it's shaft. All carpals have attained their early adult shape. Fusion is under way in the epiphyses of all distal phalanges.

Maturity indicators of individual bones and epiphyses

Age 17, femaleIn the ulna and in the heads of all fingersthe epiphyseal lines have been almost completely obliterated.In the radius thin terminal lines extend completely across the shaft (see arrow).

Age 17, femaleEpiphysial lines of ulna and radius still smooth marked. The intersticesof ulna and radius mostly ossified,but perceptible. Fusion is nearly complete.

GANGGUAN TUMBUH KEMBANG DENTOKRANIOFASIAL

ANOMALI GIGI

1. ANOMALI JUMLAH• ANODONTIA• HYPODONTIA• SUPERNUMERARI

2. ANOMALI BESAR• MICRODONTIA• MACRODONTIA

3. ANOMALI BENTUK• GEMINASI• FUSI• DENS INVAGINATUS

4. ANOMALI ERUPSI• Gigi sudah ada waktu lahir

Hypodontia is a lack of some tooth development the most common developmental abnormalities, 3.5–8.0% of the population (not including third molars).

more common in permanent than primary dentition

associated with the absence of a dental lamina

infection , chemotherapy medications

also associated with many syndromes

(Down syndrome and Crouzon syndrome )

Severe Hypodontia/Anodontia complete lack of tooth developmentjarang biasanya pd Hypohidrotic ectodermal dysplasia

Hyperdontia is the development of extraneous teeth

occurs in 1–3% of Caucasians, more frequent in Asians

86% involve a single extra tooth in the mouth, most commonly found in the maxilla (incisors)

occasionally associated with other developmental defects

more common in females than males

Double teeth· developmental anomaly· teeth usually united by dentine (with or without pulp)· more common in primary than permanent dentition· anterior teeth mainly involvedConcrescence· acquired anomaly· union by cementum alone following hypercementosis

GERMINASI PREMOLAR

Regional Odontodysplasia

Raremaxilla and anterior teeth.

cause : unknown; disturbance in the neural crest cellsInfectionradiation therapydecrease in vascular supply

Regional Odontodysplasia

never erupt into the mouthhave small crownsyellow-brownirregular shapes.

radiographs translucent "wispy," "ghost teeth"

© l.m.brocklebank

Neoplastic, odontogenic• benign

– cementomas– cementifying fibroma– myxoma

• ameloblastoma *• adenomatoid odontogenic tumour• calcifying epithelial odontogenic tumour

© l.m.brocklebank

Neoplastic, odontogenic• ameloblastoma *

• male, 15, clinical expansion• definite root resorption• thinning of cortex lingually• no cortex evident buccally• findings suggest a locally

aggressive lesion

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