Disorders of teeth other than caries

Disorders of eruption and shedding

Natal and neonatal teeth: Normal tooth germs in superficial locations subsequently..prematurely erupt. Enamel and dentine: normal
Enamel may be hypoplastic
Absence

of root formation (dentine, cementum) Prognosis: lost spontaneously or need to be extracted

Retarded eruption
Endocrynopathies Nutritional

deficiencies Chromosomal abnormalities: Down syndrome Traumatic displacement of tooth germs Abnormally large crowns Cleidocrainial dysplasia

Premature loss
Causes: Dental caries Periodontal disease hypophosphatasia

Persistence of deciduous teeth

Failure

of eruption of permanent teeth

Missing Displaced entire dentition: in cleidocrainial dysplasia

Impaction of teeth
Unerupted or partially erupted beyond the time of normal full eruption
Third molars, mandibular premolars, maxillary canines
Local

Causes:

Abnormal position of tooth germ Lack of space in the jaws Supernumerary teeth, cysts, tumors
Complications:

Resorption of impacted teeth or adjacent erupted teeth Development of odontogenic cysts and tumors

Re impaction (infraocclusion)
Submerged

teeth Deciduous second molar is most commonly affected. Cause: not known:
Roots get ankylosed to the bone Followed by deficient development of the alveolar process Adjacent teeth tilt over the submerged tooth leading to reimpaction

Attrition:

Non Bacterial Loss of Tooth Structure

Loss of tooth substance as a result of tooth to tooth contact Physiologic or pathologic Physiologic: Incisal edges of incisors Occlusal surfaces of molars Palatal cusps of maxillary teeth Buccal cusps of mandibular teeth Cup shaped surrounded by enamel Transformation of contact points to contact areas

Attrition
Pathologic:

Abnormal occlusion Bruxism Abnormal tooth structure

Formation

surface Dentine: discolored and hypersensitive

of reactionary dentin on pulpal

Abrasion
Pathologic wearing of teeth by friction of a foreign body- independent of occlusion Tooth brush abrasion:
Exposed root surface and cervical region of teeth Horizontal direction Abrasive dentifrice
Clinically:

wedge shaped with sharp angles

Polished dentine May be accentuated in heavy load leading to abfraction

 abfraction

Abrasion

Abrasion
Pathologic wearing of teeth by friction of a foreign body-independent of occlusion
Habitual

abrasion: pipe smokers Occupational abrasion: hair grips holding

Erosion
Loss of tooth substance by a chemical process other than bacterial action Dietary erosion: acidic beverages
Labial surfaces of maxillary teeth and palatal of posteriors Clinically: shallow broad concavities

Erosion
Occupational

atmospheres Regurgitation of stomach contents:

erosion: exposure to acidic

anorexia nervosa and bulimia nervosa Gastro esophageal reflux

Reactionary

dentine develops

Resorption
Physiologic

resorption: Role of osteoclast like cells

In Primary teeth: Inherited or related to pressure from successors

In permanent teeth: Superficial resorption of roots of permanent teeth Not seen on radiographs

Pathological: resorption sufficient to be seen radiographically External Internal

External Resorption
Causes: 1. Inflammation 2. Mechanical pressure 3. Idiopathic

External Resorption Inflammatory Resorption

Pulp

necrosis periapical inflammation

Apical portion of the roots

Luxation

injuries and reimplantaion

Progressive resorption of the roots and replacement by bone No ankylosis

External Resorption Pressure/mechanical

resorption

Orthodontic

treatment

Excessive force application Occurs apically Reversed when cause is gone

Pressure

associated with tumors

External Resorption Idiopathic resorption

Surrounding

dentine Pulp remains vital Lacunae and channels Resorbed tissue is replaced by granulation tissue
Ankylosis may result Starts at cervical region

pulp leaving a narrow shell of

Internal resorption
Pathologic

resorption starts from pulpal surface Associated with pulpitis Idiopathic type also occur Pink spot occurs when coronal dentin is involved

External resorption of the crowns

Uncommon Impacted

teeth Ankylosis may result