7/23/2019 Pedo2013-14
1/189
PEDI TRIC DENTISTRY
Topic
Cards
LEG ND
Topic
abnormal teeth
1 4
primary dentition
behavior management
5 10
pulp treatment
diseases
conditions
11 31
restorative
drugs
32 34
tooth development
fluoride
35 43
tooth trauma
general information
44 57
space management
miscellaneous
58 60
7/23/2019 Pedo2013-14
2/189
abn of teeth
Radiographs of a preschool child with
will show obliteration
of the pulp chambers with secondary dentin, a characteristic finding.
amelogenesis imperfecta
dentinogenesis imperfecta
fluorosis
enamel hypoplasia
copyright 2013-2014 - Dental Decks
PEDIATRIC DENTISTRY
7/23/2019 Pedo2013-14
3/189
dentinogenesis imperfecta
Dentinogenesis imperfecta
(DI) is an autosomal dominant trait, its frequency of occurrence is about I in 8000.
This inherited dentin defect originates during the histodifferentiation stage of tooth development. The predentin
matrix is defective resulting in amorphic, disorganized, and atubular circumpulpal dentin. Teeth are blue-gray
or brown and abrade rapidly. Occasionally, these teeth become abscessed as a result of exposure of pulp horns
caused by w ear. Full coverage is the treatment of choice. Both the primary and permanent den titions are affected
in dentinogenesis imperfecta. Important: Radiographs of a preschool child with dentinogenesis imperfecta will
show obliteration of the pulp
chambers with secondary dentin, a characteristic finding. Roots of teeth usually
are narrower and appear more fragile. Crowns generally appear more bulbous than usual due to the smaller
roots. Dentinogenesis imperfecta can be subdivided into three basic types:
Shields Type I:
occurs with osteogenesis imperfecta. As a result of an inherited defect in collagen forma-
tion, there is brittle bones, bowing of the limbs, and blue sclera. Periapical radiolucencies, bulbous crowns,
obliterated pulp chambe rs, and root fractures are common. Teeth hav e
amber translucent color. Primary teeth
affected more than perma nent teeth.
Shields Type II:
also known as
hereditary opalescent
dentin, tends to occur as a separate entity apart from
osteogenesis imperfecta. Same characteristics as Type I. Both primary a nd perma nent teeth affected equally.
Shields Type III: quite rare, demonstrates teeth with a shell-like appearance and multiple pulp exposures.
Seen exclusively in a triracial isolated group in Maryland known as the Brandywine population.
Amelogen esis imperfecta is one of the m ajor defects of enamel. It is a hereditary disease characterized by faulty
development of the enamel. There is normal pulpal and root morphology. There are four major categories ac-
cording to the stages of tooth developm ent in which each is thought to occu r.
Hypoplastic Type: occur in the histodifferentiation stage of tooth development. There is an insufficient
quantity of enamel formed due to areas of the enamel organ that are devoid of inner enamel epithelium, caus-
ing a lack o f cell differentiation into ameloblasts. Affects both primary a nd perm anent dentitions. The affected
teeth appear small with open contacts; clinical crowns contain very thin or nonexistent enamel.
Hypomaturation Type: defect in enamel matrix apposition and is characterized by teeth having normal
enamel thickness but a low va lue of radiodensity and mineral content.
Hypoplastic or Hypom aturation Type
with Taurodontism: is an example of inherited defects in both
ap-
position and histodifferentiation stages in enamel formation. The enamel appears mottled with a yellow-
brown color and is pitted on the facial surfaces. Molar teeth demo nstrate taurodontism.
Hypocalcification Type: is an example of inherited defect in the calcification stage of enamel formation.
Quantitatively, the enamel is normal, but qualitatively, the matrix is poorly calcified. The enamel is soft and
fragile and is easily fractured., exposing the underlying dentin, which produces an unesthetic appearance.
7/23/2019 Pedo2013-14
4/189
abn of teeth
is a process in which a single tooth germ splits or shows an
attempt at splitting to form two completely or partially separated crowns.
concrescence
gemination
fusion
dens in dente
copyright 2013-2014 - Dental Decks
PEDIATRIC DENTISTRY
7/23/2019 Pedo2013-14
5/189
gemination
Gemination is a process in which a single tooth germ splits or shows an attempt at splitting to form two
completely or partially separated crowns. This process results in incomplete formation of two teeth. Like
fusion, it is also more common in the primary dentition. It results in a bifid crown with a single pulp
chamber. It most frequently occurs in the incisor region. Concrescence
is a twinning anomaly involv-
ing the union of two teeth by cem entum only. Its etiology is thought to be trauma or adjacent tooth mal-
position.
The term dens-in-dente (also called dens invaginatus)
means a
tooth within
a tooth and results from
the
invagination
of the inner enamel epithelium. Most frequently involves the maxillary lateral inci-
sors. The clinical significance of this anomaly results from potential carious involvement through com-
munication of the invag inated portion of the lingual surface of the tooth with the outside environm ent.
The enam el and dentin in the invaginated portion can be both defective and absent, allowing direct ex-
posure of the pulp.
Dens evaginatus
is an extra cusp, usually in the central groove or ridge of a posterior tooth and in the
cingulum area of central and lateral incisors. In incisors, these cusps appear talon-shaped.
It results
from the evagination
of inner ename l epithelial cells. This extra portion contains not only enam el but
also dentin and pulp tissue; therfore, care must be taken with any operative procedure.
Fusion of teeth is a condition produced when two tooth buds are joined together during development and
appear as a macrodont (a single large crown). It is more comm on in the primary dentition. It may involve
the entire length of two teeth
(enamel, dentin, and cementum)
or just the root
(dentin and cementum). This
condition is usually seen in the incisor area. Although fused teeth can contain two separate pulp cham -
bers, many appe ar as large bifid crowns with one cham ber.
Note: A radiograph is needed to confirm
whether there is fusion or gemination.
1 Taurodont teeth are characterized by a significantly elongated pulp cham ber with short
Notes
stunted roots resulting from the failure of the proper level of horizontal invagination of Her-
twig epithelial root sheath.
2
Dilaceration refers to an abnormal bend of the root during its development;
it is thought
to result from a traumatic episode, usually to the primary dentition. It is a consistent finding
in children with congenital ichthyosis.
7/23/2019 Pedo2013-14
6/189
enamel hypoplasia
erythroblastosis fetalis
nursing bottle caries
dentinal dysplasia
abn of teeth
What condition is depicted below?
Copyright 2000-2004 University of Washington. All rights reserved. Access t