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Anomalies of Structure Enamel
Dentin
Cementum
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Enamel Tooth structure abnormalities result from disruption
during the histodifferentiation, apposition, andmineralization stages of tooth development.
Enamel defects manifested as:
Hypoplasia
Hypocalcification
Can be:Heritable defects
Environmental defects
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Hypoplasia: disturbance of matrix deposition,characterized by irregular enamel in thickness ordeficient in structure.
Hypocalcification: disturbance in mineralization,characterized by normal enamel in thickness but partof it is poorly mineralized
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Amelogenesis Imperfecta Distinct patterns of inheritance.
Defective enamel, so on radiograph the pulpal outline
appears normal and root morphology. Hypoplastic vs hypomaturation vs hypocalcified
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Hypoplastic AmelogenesisImperfecta
Occurs in histodifferentiation
stage of tooth developmentThin Enamel resulting in highsensitivity to thermal stimuli
Lack of contact points between
teethRough smooth or randomlypitted enamel
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Hypomaturation AmelogenesisImperfecta
Defect in enamel matrix
apposition normal enamel thickness
a low value of radiodensity andmineral content
porous surface that becomesstained
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HypocalcificationAmelogenesis Imperfecta
Defect in the calcification
stage of enamel formation Qualitatively the matrix is
poorly calcified with aresultant fracturing of the
enamel surface exposingdentin surface especially atincisal edge
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Environmental Enamel HypoplasiaSystemic causes
Nutritional deficiencies (Vit. A ,C, D, Ca+ PO4)
Severe Infections, Fever ( Rubella , Syphilis ..)Asthma
Neurologic defects as cerebral palsy
Radiation
Flouride
Syndromes ??
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Localized Enamel Hypoplasia Local infection,
Local trauma,
Iatrogenic surgery as occurs in cleft palate closure Primary tooth overretention.
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Turner hypoplasia Turner hypoplasia is a
classic example ofhypoplastic defects inpermanent teethresulting from localinfection or trauma tothe primary precursor
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Pre-operativePost-operative
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Full mouth rehabilitation of
Amelogenesis Imperfecta
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DentinDentinogenesis Imperfecta
defect during the histodifferentiation stage of toothdevelopment
defect of predentin matrix results in amorphic,disorganized, and atubular circumpulpal dentin(which is high in organic content and containsinterglobular calcification)
The mantle dentin is normal.
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Dentinogenesis Imperfecta Shields type 1 occurs with osteogenesis imperfecta.
Defect in collagen formation
Blue sclera, brittle bones, bowing of limbs Periapical radiolucencies
Bulbous crowns
Obliteration of pulp chambers
Root fractures
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Dentinogenesis Imperfecta Shields type 2, (hereditary opalescent dentin)
Periapical radiolucencies
Bulbous crowns Obliteration of pulp chambers
Root fractures
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Dentinogenesis imperfecta (Hereditary opalescent dentine)
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Dentinogenesis Imperfecta Shields type 3
a predominance of bell-shaped crowns
involves teeth with a shell-like appearance andmultiple pulp exposures.
It has occurred exclusively in a triracial isolated groupin Maryland known as the Brandywine population
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Dentin Dysplasia Inherited dentin disorders resulting in characteristic
features involving the circumpulpal dentin and rootmorphology.
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Dentin DysplasiaShields type 1 (Radicular Dentin
Dysplasia, rootless teeth)
Normal crown morphology with
an amber translucency). The roots tend to be short and
sharply constricted.
Multiple periapical
radiolucencies and absent pulpchambers.
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Dentin DysplasiaShields type 2
Involves amber-colored primary teeth closelyresembling dentinogenesis imperfecta
Permanent teeth appear normal, but radiographicallythey demonstrate thistle-tube-shaped pulp chamberswith multiple pulp stones
no periapical radiolucencies are visible
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Regional Odontodysplasia Localized arrest in tooth development thought to
result from a regional vascular developmentalanomaly.
Affected teeth have thin layers of poorly calcifiedenamel and dentin with large, diffusely calcified pulpchambers and shortened, poorly defined roots
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Regional Odontodysplasia Ghost teeth radiographic appearance with shortened
roots and shell-like crowns
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Cementum Epidermolysis bullosa dystrophica, an inherited
vesicular and bullous disease of the skin and mucousmembranes,
involves formation of fibrous, poorly calcified acellularcementum and overproduction of cellular cementum.
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Hypophosphatasia
Failure of bone to mineralize properly, which isassociated with low serum alkaline phosphatase levels.
Osteoporosis
bone fragility
premature loss of primary incisors
Failure of cementum formation
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REFERENCES:
Pediatric Dentistry : Infancy through AdolescencePinkhamCh. 4 (Anomalies of Developing Dentition)
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