Case Study Report

Chapter 5: Developmental Disorders

General and Oral Pathology

DHYG 1339 – Sandusky, Renee

Group 3: Paola Martinez, Shalma Bladeras, Melany Esquivel, Vi Hoang

October 26, 2023

 The embryonic life by the 3rd week the ectoderm forms the primitive oral cavity (which

is called stomodeum). Just above it is a process called the frontal process. Just below it is a

structure called the first branchial arch. All of the face and most of the structures of the oral

cavity develop from either the frontal process or the first branchial arch. Then the first branchial

divides into Maxillary process and mandibular process. By the 4th week, as the development

continues two pits open(called olfactory pits) marking the opening of the nose that develop on

the surface of the frontal process. The frontal process divides into 3 parts: (1)The median nasal

process, (2) the right lateral nasal process, (3) left lateral process. The mandibular arch forms the

lower part of the cheeks, the mandible, and part of the tongue. Lateral nasal processes forms the

side of the nose. The median nasal process forms the center and tip of the nose. Later, the median

nasal process grows downward between the maxillary processes to form the globular process

forming into the philtrum(upper lip). The area of the palate called the premaxilla develops from

the globular process. The lateral palatine processes form from the maxillary process. The lateral

palatine processes fuse with the premaxilla, creating a Y-shaped pattern. The body of the tongue

develops from the first branchial arch. The base of the tongue forms from the second and third

branchial arches.

Lingual thyroid: a small mass of thyroid tissue located on the tongue, an uncommon

condition, results from a failure of primitive thyroid tissue to migrate from the area of the

foramen cecum to its normal location in the neck, lingual thyroid nodules appear clinically as

smooth nodules posterior to the circumvallate papillae. Symptoms include feeling of fullness in

the throat, difficulty swallowing, speaking, or breathing.Diagnosis of a lingual thyroid is best

established by thyroid scan using either iodine isotopes or technetium 99m. Treatment: It is

possible to remove it if it is obstructive, provided that the patient has other functioning thyroid
tissue. Developmental cysts: Developmental cysts are classified as odontogenic or

nonodontogenic. Developmental cysts can vary in size from small, asymptomatic lesions to large

lesions that can cause expansion of bone. When a cyst is found within soft tissue, there is no

radiographic feature. Dentigerous cysts: A dentigerous cyst, also called a follicular cyst, forms

around the crown of an unerupted or developing tooth: after the crown has formed and calcified,

the epithelial lining develops from the reduced enamel epithelium, most commonly occurs

around unerupted or impacted third molar crowns, the most common type of developmental

odontogenic cyst. Treatment: Removal of the cyst, if tooth is not removed, the cyst wall

continues to enlarge. Eruption cysts: Similar to a dentigerous cyst, found in the soft tissue

around the crown of an erupting tooth. Clinically, it presents as a swelling of the gingival mucosa

over the crown of an erupting tooth. No treatment for eruption cysts, eruption cysts are usually

asymptotic and do not require treatment. Primordial cysts: Develops in place of a tooth. Most

commonly in place of a third molar. Most often seen in young adults and discovered on

radiographic examination. Treatment: Surgical removal. Keratocyst: Most often seen in the

mandibular third molar region. Can move teeth and cause resorption. Treatment: Because of the

high recurrence rate, surgical excision and osseous curettage are recommended. It’s epithelium

cells are called ghost cells and affects all ages. Calcifying odontogenic cyst occur mostly in the

incisor and cuspid area of maxilla and mandible. Radiographically, they can be seen as

radiolucent or as radiopaque, treatment is surgical removal. Lateral periodontal cyst occurs on

the lateral root surface of the mandibular canine and premolar teeth. Asymptomatic and can be

either unilocular or multiocular. Treated with surgical removal. Lastly, globulomaxillary cyst is

a type of cyst not related to tooth development and arises in the bone structure between the

maxilla and premaxilla. Develops from the result of proliferation of the epithelium.
Radiographically is well circumscribed unilocular radiolucency and the roots reveal divergence.

Treatment is enucleation.

Anodontia is the congenital LACK of teeth. Total anodontia is the lack of ALL teeth,

may affect the deciduous or permanent dentition. Teeth may not be identified missing until time

of normal eruption or until radiographic exam. It is Associated with hereditary disturbance called

hereditary hypohidrotic ectodermal dysplasia.

Hypodontia is the lack of one or more teeth. It may affect either detention but more

commonly seen in permanent dentition. It can affect ANY tooth most often teeth are missing

bilaterally. Teeth most often missing include: Max. + Man. 3rd molars, Max. lateral incisors,

Man. 2nd premolars. The Man. incisor is the most commonly missing tooth in the deciduous

dentition. Missing teeth may be familial meaning that it may be genetic. Missing teeth may be a

sign of a syndrome and should be evaluated further. Prosthetic replacements or ortho evaluation

required for replacement. Oligodontia is the Subcategory of hypodontia in which SIX or more

teeth are missing (not including 3rd molars).

Supernumerary AKA EXTRA teeth, result from either the formation of extra tooth buds

in the dental lamina OR the cleavage of already existing tooth buds. It may occur in either

dentition, most seen in the maxilla. The most common supernumerary teeth are the Mesiodens

located between midline 8/9. The distoden is fairly common and distal to 3rd molar. Erupted

supernumerary teeth may require removal if crowding, malpositioning, or non eruption of other

teeth occur. Unerupted supernumerary teeth require removal to prevent cyst development.

Multiple supernumerary teeth are associated with cleidocranial dysplasia or Gardner syndrome.
 Works cited

C., Ibsen Olga A, and Scott M. Peters. Oral Pathology for the Dental Hygienist: With General

Pathology Introductions. Elsevier, 2023.

“Hyperdontia: Causes, Diagnosis, and Treatment.” Medical News Today, MediLexicon

International, www.medicalnewstoday.com/articles/hyperdontia. Accessed 24 Oct. 2023.

Sheng, Sally, et al. “Peripheral Calcifying Odontogenic Cyst: A Case Report and Comprehensive

Review of 60 Years of Literature.” Frontiers, Frontiers, 11 July 2023,

www.frontiersin.org/articles/10.3389/froh.2023.1223943/full.