Dr. O.

M Ogundana
Dept of Oral and Maxillofacial Pathology/Biology
 INTRODUCTION
 Anomaly: deviation from normal
 Abnormalities of size, number or shape of
teeth
 CLASSIFICATION
I. Anomaly in size
II. Anomaly in number
III. Anomaly in shape
IV. Disturbances in Enamel structure
V. Disturbances in Dentine structure
 I. ANOMALY IN SIZE
1. Microdontia
2. Macrodontia
 II. ANOMALY IN NUMBER
1. Total anodontia
2. Partial anodontia
3. Supernumerary teeth
 III. ANOMALY IN SHAPE
 Peg shaped lateral  Enamel pearl
 Talon cusp  Hutchinson’s teeth
 Gemination  Concrescence
 Fusion  Dilaceration
 Taurodontism  Hypercementosis
 Dens invaginatus  Supernumerary
 Dens evaginatus roots
 IV. DEFECT OF ENAMEL
1. Hereditary enamel defect (Amelogenesis
imperfecta)
2. Acquired enamel defect
 V. DEFECT OF DENTINE
1. Dentinogenesis imperfecta
2. Dentine dysplasia
 ANOMALY IN SIZE
 Microdontia: very small but normally
shaped tooth
 Affects mostly the maxillary lateral incisors
or maxillary third molars
 Occur in pituitary dwarfism.
 Can cause spacing in primary and
permanent dentition
 Macrodontia: larger than normal but
normally shaped teeth
 Seen in hemifacial hypertrophy
 It may lead to crowding in primary and
permanent dentition.
 ANOMALY IN NUMBER
 Anodontia: congenital absence of teeth
because of failure of development of tooth
germs.
 Total anodontia: congenital absence of all
teeth, it is however rare
 Partial anodontia (hypodontia): some
teeth are congenitally missing, it is more
common
 Total anodontia is usually occurs in
association with an hereditary condition
called ectodermal dysplasia
 In this condition all ectodermally dervied
structures are defective e.g hair, sweat
glands and teeth
 Most commonly missing permanent
dentition: Third molars (maxillary >
mandibular), followed by maxillary lateral
incisor and mandibular second premolar
Supernumerary teeth
 Additional number of teeth, over and above
the usual number for the dentition
 Most common location in mandible for
supernumerary tooth: mandibular 2nd
premolar area
 Mostly seen in Gardner's syndrome,
Cleidocranial dysplasia, and cleft palate or
cleft lip
Types of supernumerary teeth:

 Mesiodens: small supernumerary tooth

between the maxillary central incisors.
 Most common supernumerary teeth
 Distomolar: 4th molar, it happens more
often in maxillary than mandibular arch
 They rarely erupt into oral cavity
 Paramolars: supernumerary tooth distal to
third molar
 ANOMALY IN SHAPE
 Peg lateral incisor: most common anomaly
in tooth shape, found in anterior region of
permanent dentition
 Peg laterals most commonly happen in the
maxillary arch
 Talon Cusp: small enamel projection in
cingulum area of maxillary or mandibular
anterior permanent teeth
 They appear like the beak of an eagle
 Some have pulp horns in their cusps
Gemination (Twinning)
 Results from splitting of a single forming tooth
 Geminated tooth has 1 root but appears as 2
crowns
 Most common area is; maxillary central and
lateral incisor region
 Gemination is the opposite of fusion
 Associated teeth are prone to decay and may
cause delayed eruption of permanent teeth.
Fusion
 Is the union of 2 adjacent tooth germs, and
always involves the dentine
 Fused teeth have 2 crowns and 2 roots
 A groove runs down the back of the tooth
that is prone to decay and may necessitate a
filling.
Taurodonts or “Bull" teeth

 They resemble teeth seen in bulls

 Taurodont has a long pulp chamber without
constriction at CEJ (cemento-enamel
junction)
 Taurodontia only occurs in permanent teeth
 Dens invaginatum: means tooth within a
tooth, it results from invagination of enamel
organ within crown of tooth
 Most commonly in maxillary Lateral Incisor
 Can cause development and spread of
dental caries
 Dens evaginatus: tubercle or cusp located
in the center of the occlusal surface
 Affect predominantly premolar and molar
teeth
 Tubercle wears off relatively quickly causing
early exposure of the accessory pulp horn
that extends into the tubercle
 Enamel pearl (Enameloma): ectopic mass
of enamel usually found at the furcation
area of roots
 Molars are more frequently affected
(maxillary > mandibular)
 Enamel pearls are mostly found in distal of
third molars and the buccal root furcation
of molars
Hutchinson's teeth
 An unusual incisor and molar shape may
occur in both dentitions as a result of
congenital syphilis
 The maxillary and mandibular incisors may
be screwdriver shaped; broad cervically and
narrowing incisally with a notched incisal
edge and may be referred to as
Hutchinson's incisors
 The molars have multiple tiny tubercles
with poorly developed indistinguishable
cusps and are known as mulberry molars
Concresence
 Superficial fusion of two adjacent teeth at
root through cementum only
Dilaceration
 Abnormal bend in the root and/or crown of
a tooth
 Exact cause is not known result of trauma to
a developing tooth
 Results in difficulties during extraction or
root canal therapy
Hypercementosis
 Excessive formation of cementum around
root of a tooth after tooth has erupted
 Can be due to; trauma, metabolic
dysfunction, periapical inflammation
Supernumerary roots
 Extra roots or accessory roots
 Most often occur in third molars, canines
and premolars
 ENAMEL DEFECT
 Amelogenesis imperfecta: disturbance in
the ectodermal layers of developing teeth
 Hereditary abnormality that affect either the
primary or the permanent dentition.
 Enamel is soft and fractures easily.
 Enamel is dark brown in colour and has the
same radiopacity as the dentine
 Enamel and dentine therefore cannot be
differentiated on a radiograph
 Environmental causes of enamel defect
are: Tetracycline (drugs), fluorosis, coffee,
tea, and red wine etc
 DENTINE DEFECT
 Dentinogenesis imperfecta: hereditary
abnormality in the formation of dentine
 Teeth varies from gray to brownish violet to
yellowish brown colour
 Crown fractures easily because of abnormal
dentino-enamel junction
 The pulp chambers and root canals may be
partially or completely obliterated
 On radiographs, teeth exhibit thin, short
roots
 Dentinal dysplasia: hereditary
abnormality characterized by abnormal
dentine formation
 It is subdivided into type I & type II
 Type I or radicular type; (or rootless teeth)
affects primarily the root portion of a tooth
 Short conical roots and periapical lesions
without any obvious cause are seen on
radiographs
 Premature tooth loss may occur because of
short roots
 Type II or coronal type: (or pulpless teeth)
affects primarily the pulp chambers of a
tooth and frequently contain pulp stones
CAN YOU IDENTIFY THESE
DENTAL ANOMALIES?
Hypodontia
Mesiodens
Supernumerary
teeth (abnormal
number)
Mesiodens
Supernumerary
teeth (abnormal
number)
Supernumerary
tooth
An extra premolar
(abnormal
number)
Supernumerary
tooth
An extra premolar
(abnormal
number)
Peg shaped
maxillary lateral
incisor
Abnormal shape
Talon cusp
Abnormal shape
Talon cusp
Abnormal shape
Talon cusp
Abnormal shape
Gemination or
fusion
Abnormal shape
Gemination
Abnormal shape
Fusion or
Gemination
Fusion
Taurodont
Abnormal shape
Taurodont
Abnormal shape
Hutchinson’s teeth
Seen in congenital
syphilis (Abnormal
shape)
Concrescence
Abnormal shape
Concrescence
Abnormal shape
Dilaceration
Abnormal shape
(Incisor)
Dilaceration
Abnormal shape
(molar)
Generalized enamel
hypoplasia
Solitary Enamel
hypoplasia
Turner’s tooth
(Brownish
discoloration of
the maxillary
canine)
Solitary Enamel
hypoplasia
Turner’s tooth
(Brownish
discoloration of
the maxillary
lateral incisor)
Amelogenesis
imperfecta
Amelogenesis
imperfecta
Dentinogenesis
imperfecta
Dentinogenesis
imperfecta