DEVELOPMENTAL DEFECTS OF 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 PERMANENT TEETH 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 MAXILLARY LATERAL 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 SUPERNUMERARY TOOTH OF THE ANTERIOR MAXILLA, WHICH HAS ALTERED THE ERUPT ION PATH OF THE MAXILLARY RIGHT PERMANENT CENTRAL INCISOR

HYPERDONTIA (MESIODENS). BILATERAL INVERTED SUPERNUMERARY TEETH OF THE ANTERIOR MAXILLA.

HYPERDONTIA. RIGHT MANDIBULAR DENTITION EXHIBITING FOUR ERUPTED BICUSPIDS

DISTURBANCES IN FORM OF TEETH

Dilaceration Taurodontism Double teeth
Fusion Gemination

Concrescence

DILACERATION

TAURODONTISM. MANDIBULAR MOLAR TEETH EXHIBITING INCREASED PULPAL APICOOCCLUSAL HEIGHT WITH APICA LLY POSITIONED PULPAL FLOOR AND BIFURCATION

FUSION. DOUBLE TOOTH IN THE PLACE OF THE MANDIBULAR RIGHT LATERAL INCISOR AND CUSPID.

FUSION. RADIOGRAPHIC VIEW OF DOUBLE TOOTH IN THE PLACE OF THE MANDIBULAR CENTRAL AND LATERAL INCISORS. NOTE SEPARATE ROOT 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. THE TOOTH COUNT WAS NORMAL WHEN EACH ANOMALOUS TOOTH WAS COUNTED AS ONE.

GEMINATION. MANDIBULAR BICUSPID EXHIBITING BIFID CROWN.

GEMINATION. SAME PATIENT. NOTE THE BIFID CROWN AND SHARED ROOT CANAL

CONCRESCENCE. UNION BY CEMENTUM OF ADJACENT MAXILLARY MOLARS.

CONCRESCENCE. UNION BY CEMENTUM OF MAXILLARY SECOND AND THIRD MOLARS. NOTE THE LARGE CARIOUS DEFECT OF THE SECOND MOLAR.

CONCRESCENCE. GROSS PHOTOGRAPH OF THE SAME TEETH. HISTOPATHOLOGIC EXAMINATION REVEALED THAT UNION OCCURRED IN THE AREA OF CEMENTAL REPAIR PREVIOUSLY 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 STRUCTURE CONTINUED

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- E IZED PITTED PATTERN . NOTE THE NUMEROUS PIN POINT PITS SCATTERED ACROSS THE SURFACE OF THE TEETH. THE ENAMEL BETWEEN THE PITS IS OF NORMAL THICKNESS. HARDNESS. AND COLORATION.

HYPOPLASTIC AMELOGENESIS IMPERFECTA, AUTO SOMAL DOMINANT SMOOTH PATTERN. SMALL. YELLOWISH TEETH EXHIBITING HARD, GLOSSY ENAMEL WITH NUMEROUS OPEN CONTACT POINTS AND ANTERIOR OPEN BITE.

HYPOPLAST IC AMELOGENESIS IMPERFECTA, AUTOSOMAL DOMINANT SMOOTH PATTERN. RADIOGRAPH OF THE SAME PATIENT . NOTE THE THIN PERIPHERAL OUTLINE OF RADIOPAQUE ENAMEL

HYPOMATURATION AMELOGENESIS IMPERFECTA. DENTITION EXHIBITING MOTTLED, OPAQUE WHITE ENAMEL WITH SCATTERED AREAS OF BROWN DISCOLORATION.

HYPOMATURATION AMELOGENESIS IMPERFECTA, SNOWCAPPED PATTERN. DENTITION EXHIBITING ZONE OF WHITE OPAQUE ENAMEL IN T HE INCISAL AND OCCLUSAL ONE FOURTH OF THE ENAMEL SURFACE

HYPOCALCIFIED AMELOGENESIS IMPERFECT A. DENTITION EXHIBITING 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 OF DENTITION EXHIBITING BULBOUS CROWNS, CERVICAL CONSTRICTION, AND OBLITERATED PULP CANALS AND CHAMBERS.

DENTINOGENESIS IMPERFECTA . DENT IT ION EXHIBITING DIFFUSE BROWNISH DISCOLORATION AND SLIGHT TRANSLUCENCE.

DENTINOGENESIS IMPERFECTA. DENTITION EXHIBITING GRAYISH DISCOLORATION WITH SIGNIFICANT ENAMEL LOSS AND ATTRITION.

SHELL TEETH . DENTITION EXHIBITING NORMAL THICKNESS ENAMEL, EXTREMELY THIN DENTIN, AND DRAMATICALLY ENLARGED PULPS.

DENTIN DYSPLASIA. DENTITION EXHIBITING ATTRITION BUT OTHERWISE NORMAL CORONAL COLORATION AND MORPHOLOGY.

DENTIN DYSPLASIA. DENTITION EXHIBITING SHORTENED ROOTS, NO PULP CANALS. AND SMALL CRESCENTSHAPED PULP CHAMBERS

DENTIN DYSPLASIA TYPE II. AFFECTED TOOTH EXHIBITING LARGE PULP STONE WITHIN THE PULP CHAMBER.

REGIONAL ODONTODYSPLASIA (GHOST TEETH) . POSTERIOR MANDIBULAR DENTITION EXHIBITING ENLARGED PULPS AND EXTREMELY THIN ENAMEL AND DENTIN.

REGIONAL ODONTODYSPLASIA. FOLLICULAR TISSUE CONTAINS SCATTERED COLLECTIONS OF ENAMELOID CONGLOMERATES AND ISLANDS 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 THREE TYPES OF CORONAL DENS INVAGINATUS.

DENS INVAGINATUS

CORONAL DENS INVAGINATUS. TYPE II . MANDIBULAR LATERAL INCISOR EXHIBITING LINGUAL BULBOUS ENLARGEMENT AT THE SITE OF CORONAL OPENING OF ENAMEL INVAGINATION .

ENAMEL PEARL. MASS OF ECTOPIC ENAMEL LOCATED IN THE FURCATION AREA OF A MOLAR TOOTH.

ENAMEL PEARL . RADIOPAQUE NODULE ON THE MESIAL SURFACE OF THE ROOT OF THE MAXILLARY THIRD MOLAR.ANOTHER LESS DISTINCT ENAMEL PEARL IS PRESENT ON THE DISTAL ROOT OF THE SECOND MOLAR.

GENETIC DISORDERS OF THE JAWS

12345678Hereditary prognathism Clefts of the palate and/or lip Craniofacial anomalies Cleidocranial dysplasia Cherubism Basal cell naevus syndrome Gardner's syndrome 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 THE MIDLINE PALATAL BONE. BUT THE OVERLYING MUCOSA IS INTACT. A BIFID UVULA 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