Anomalies of Size

1) Microdontia
a) ectodermal dysplasia
b) hemifacial microsomia
c) Down syndrome
d) Peg lateral incisor
2) Macrodontia
a) facial hemihypertrophy
b) otodental syndrome
3) Fusion: union of two teeth/tooth buds (primary or permt; more common in primary teeth)
-fused teeth have 2 pulp chambers and 2 pulp canals
-results in large crown
-occurs almost always in anterior teeth
-can be detected by counting teeth b/c fusion results in one less tooth entity in arch
4) Gemination: division of single tooth bud into bifid crown (2 crowns on single root)
-more common in primary teeth
-b/c it occurs on a single tooth, there will be a normal complement of tooth entities
5) Concrescence: form of fusion w/ cementum contact (only cementum is fused)
-usually results from trauma
Anomalies of Shape
1) Dens evaginatus: extra cusp (talon cusp in incisors)
-extra cusp has enamel, dentin, and pulp so must be careful in restorative procedures
2) Dens invaginatus (dens in dente): caused by invagination of inner enamel epithelium
-termed tooth within a tooth
-most common in permt max. lateral incisors
-if enamel and dentin not formed correctly within defect, a direct communication with pulp can occur
-treated w/ small restoration or sealant to prevent pulpal involvement
3) Taurodontism: long vertical pulp chambers and short roots
4) Dilaceration: bent/twisted root occurring as result of intrusive or displacement injury to primary predecessor
-dilaceration also common in congenital ichthyosis
Anomalies of Structure
1) Enamel hypoplasia: refers to deficiency in QUANTITY of enamel
-no interproximal contact btw teeth
-causes: 1) genetic: amelogenesis imperfecta
2) environmental: systemic dx (fever), fluorosis, nutritional defic. (vit A, C, D, Ca, Ph)
2) Enamel hypocalcification: refers to deficiency in QUALITY of enamel
-also has genetic and environmental causes
3) Amelogenesis imperfect (AI): related to enamel only and dependent on stage of enamel formation (enamel
hypoplasia)
-normal root and pulp morphology
1) Type I: Hypoplastic (inadequate QUANTITY of enamel)
2) Type II: Hypomaturation (inadequate MATURATION of enamel)
3) Type III: Hypocalcified (inadequate QUALITY/mineralization of enamel
4) Dentinogenesis imperfect (DI): predentin matrix is defective, resulting in amorphic, atubular dentin
-teeth are reddish-brown to gray color
-slender roots
-small or absent pulp chambers/canals
1) Type I: osteogenesis imperfecta, blue sclera, hearing loss
2) Type II: no osteogenesis imperfecta (most common type)
3) Type III (Brandywine type): multiple periapical radiolucencies
5) Dentin dysplasia
-Shield type I: Normal anatomy. Short, pointed roots. Absent pulp chambers/canals. Multiple periapical
radiolucencies