‘’Abnormalities of teeth , Developmental alterations of teeth’’

Subject : therapeutic dentistry

name : negin soltani

ug code : 1702217

1
INTRODUCTION
INTRODUCTION

Dental anomalies represent a wide spectrum of disorders divided into two subgroups:
 acquired
 developmental abnormalities

The etiology of dental anomalies has not been known thoroughly yet, but it seems that
both environmental and genetic factors could be involved . Developmental anomalies
are categorized into five groups including abnormalities in size, number, morphology,
structure, and position of teeth .

 DEVELOPMENTAL DISORDERS
1. Teeth Number Anomalies
2. Size Abnormalities
3. Positional Anomalies
4. Morphological Anomalies
5. Taurodontism
6. Dilaceration
7. Structural Anomalies
8. Amelogenesis Imperfecta
9. Tooth Impaction
 Acquired Tooth Disorders
1. RESORPTION
2. Hypercementosis
3. Pulp Stone
4. Pulpal Sclerosis
5. Tooth Fluorosis
6. Attrition
7. Abrasion
8. Erosion

2
 9. Syphilitic Hypoplasia
10. Molar Incisor Hypomineralization
1. Teeth Number Anomalies
Hypodontia :
Lack of tooth formation is one of the most common developmental disorders with a
prevalence of 1.6-9.6% in permanent teeth. However, this rate increases to 20% when
third
molar is considered. Hypodontia is uncommon among deciduous teeth with a
prevalence of
0.5-0.9%, and if happens usually lateral incisors are involved. Missing of a primary tooth
increases the chance of its succeeding permanent tooth to be missed .
Hyperdontia
Prevalence of supernumerary teeth is 0.1-3.8% among white people, and a little higher
in
Asian population. Hyperdontia affects primary teeth less often (0.3-0.8%). Although
single
tooth hyperdontia occurs more frequently in permanent teeth and in 95% of cases in the
anterior maxilla, numerous non-syndromic supernumerary teeth are quite common in
mandible. Most supernumerary teeth are seen in the jaws;however some have been
reported
in gingiva, maxillary tuberosity, soft palate, maxillary sinus and nasal cavity. Despite
hypodontia, hyperdontia is associated to macrodontia and is twice more common as in
men
than women . The etiology is unknown, but it is seen in some families more commonly.
2. Size Abnormalities

Microdontia
This term is just used when teeth are smaller than usual; when the jaw is bigger than
usual as a result of spacing between teeth and teeth look smaller this is called relative
microdontia, which represents jaw enlargement but not true microdontia.

Macrodontia

3
The term macrodontia (megalodontia, megadontia) is justified when teeth are larger
than
usual, and not when teeth with normal size are placed in a small jaw or in case of
gemination
and fusion.

3. Positional Anomalies

Transposition
This is a situation in which two teeth displace when teeth are not in their proper position
in dental arch. Transposition is common in canines and first premolars followed by
lateral
incisors. Sometimes second premolar erupts between the first and second molar.
Transposition of central and lateral incisors is rare. Transposition has not been reported
among primary teeth

4. Morphological Anomalies

Concrescence
Concrescence occurs when root of two or more teeth attach to each other by
cementum.
Both primary and permanent teeth can be affected. Although etiology is unknown, many
authors believe that lack of enough space during development, trauma, abnormal
occlusal
forces and local infections after development have important roles

Fusion
Tooth fusion arises from union of tooth germs. Some experts believe that this happens
when tooth germs come too close to each other or contact while erupting or connect to
each
other before calcification. However, the others believe that physical forces and pressure
Tooth Abnormalities 351
during tooth formation make tooth germs contact. Genetic basis of this anomaly is
probably

4
autosomal dominant with low penetration. Women and men are affected equally.

Gemination (Double Teeth)

It often involves anterior teeth; however premolars and molars can be affected. In most
cases there is a deep groove with various depths involving all or a part of crown or root.
This
groove indicates attachment line between two tooth germs

5. Taurodontism
Taurodontism is enlargement of root trunk and pulp chamber of multi- root teeth as a
result of apical movement of pulp floor and tooth furcation. Diagnosis is usually based
on radiographic findings. Some researchers have reported taurodontism in premolar
teeth though others believe that taurodontism does not affect premolars .
Taurodontism is found in primary and permanent dentition, but it is more common in
permanent teeth (molars and premolars). This entity could be observed in single or
multiple teeth both unilaterally and bilaterally.
6. Dilaceration
Dilaceretion is an angulation or an abnormal curve in root or rarely in crown. Although
most of cases are idiopathic, it seems that in some cases calcified portion of tooth germ
is displaced after trauma and the rest of tooth forms with an abnormal angulation.
Dilaceration often occurs as a result of avulsion or intrusion of deciduous teeth at the
age of four.
Supernumerary Roots
This term is used when there are extra roots compared to tooth normal anatomy. All the
teeth and both dentitions can be affected. The most involved teeth are maxillary and
mandibular permanent molars especially third molar and mandibular canine and
premolars.

Dens Evaginatus
It is a rare dental anomaly, which features an extra cusp or tubercle on the occlusal

5
surface of the tooth. It is mostly seen in premolars; however it can also affect canines,
molars and incisors. Mandible is involved five times more often than maxilla. It results
from abnormal proliferation of inner enamel epithelium into stellate reticulum.

Dens Invaginatus
This anomaly also known as dens in dent is a developmental problem resulting from
enamel organ invagination into dental papilla before calcification stage. It begins from
crown and sometimes extends down to root. It is most frequent in the maxillary lateral
incisors and with lower possibility in maxillary centrals, premolars, canines, and rarely
molars.
7. Structural Anomalies
Dentinogenesis Imperfecta
It is a primary developmental disorder in dentin, which enamel may be thinner than
normal as well. The prevalence of dentinogenesis imperfecta is equal in both sexes,
and it can affect primary and permanent dentitions .
Dentinogenesis imperfecta is one of the most common hereditary disorders in dentin
formation.

8. Amelogenesis Imperfecta
Amelogenesis imperfecta is a series of genetic defects affecting the structure and
clinical appearance of all or most of teeth by a rather similar pattern, and may be along
with structural or biochemical changes in other parts of the body. It is enamel
developmental disorder featured by hypoplasia, hypomineralization or both. Patients
have discolored hypersensitive teeth, which are prone to destruction. This may occur
before or after eruption. Hereditary patterns of this disorder can be autosomal dominant,
autosomal recessive, X-linked or sporadic.
9. Tooth Impaction
Eruption is a continuous process of tooth movement from the start point to the functional
position. Teeth with delayed eruption before emerging in the mouth are considered
impacted.

6
Some authors call un erupted teeth due to a physical barrier as impacted and those
having no necessary erupting forces as embedded .Impaction in deciduous teeth is
rare, but second molars are mostly affected.

REFERENCES

[1] Neville R, Damm D, Alen C, Bouquot J. Oral and maxillofacial pathology. St.
Louis:Saunders, 2009; 49-106.
[2] Dahlberg AA. Dental morphology and evolution. Chicago: University of Chicago Press,
2000; 257-62.
[3] Jones JH, Manson DK. Dental manifestation of systemic disease. J. Oral Manif. Sys.
Dis. 1998; 19; 3-24.