Developmental(uncarious) anomalies of teeth

Developmental anomalies of teeth are marked deviations from the normal standards in color, contour, size, number, and degree of development of the teeth. Systemic as well as local factors may operate to produce these developmental disturbances. Such influences may begin before or after birth so that either deciduous or permanent teeth may be involved. Usually, it is the permanent teeth that are influenced and, in all instances, only those not completely formed at the time of the disturbance

Classification (by Patrikeev) 1. Before teeth eruption: Fluorosis Hypoplasia Hyperplasia Inherited disturbances of teeth Anomalies of development and eruption 2. After teeth eruption: Erosion of teeth Necrosis of teeth Hyperesthesia of teeth wedge-shaped defect of teeth Pigmentation of teeth Trauma of teeth

fluorosis Dental fluorosis occurs because of the excessive intake of fluoride either through fluoride in the water supply, naturally occurring or added to it; or through other sources. The damage in tooth development occurs between the ages of 6 months to 5 years, from the overexposure to fluoride. Teeth are generally composed of hydroxyapatite and carbonated hydroxyapatite; when fluoride is present, fluorapatite is created. Fluorosis happens when children get too much fluoride while their teeth are developing.fluoridetooth developmentTeeth hydroxyapatitecarbonated hydroxyapatitefluorapatite

Criteria for Dean's Fluorosis Index Normal The enamel represents the usual translucent semivitriform type of structure. The surface is smooth, glossy, and usually of a pale creamy white color.

Questionable The enamel discloses slight aberrations from the translucency of normal enamel, ranging from a few white flecks to occasional white spots. This classification is utilized in those instances where a definite diagnosis of the mildest form of fluorosis is not warranted and a classification of "normal" is not justified.

Very Mild Small opaque, paper white areas scattered irregularly over the tooth but not involving as much as 25% of the tooth surface. Frequently included in this classification are teeth showing no more than about 1-2 mm of white opacity at the tip of the summit of the cusps of the bicuspids or second molars.

Mild The white opaque areas in the enamel of the teeth are more extensive but do not involve as much as 50% of the tooth

Moderate All enamel surfaces of the teeth are affected, and the surfaces subject to attrition show wear. Brown stain is frequently a disfiguring feature

Severe All tooth surfaces affected; discrete or confluent pitting; brown stain present

Nomal

Mild Fluorosis

Moderate Fluorosis

Severe Fluorosis

Treatment Tooth bleaching, Tooth bleaching microabrasion, microabrasion conservative composite restorationsrestorations porcelain veneersporcelainveneers Porcelain crowns

Hypoplasia Hypoplasia is underdevelopment or incomplete development of a tissue or organ. The name is derived from the Greek: hypo, meaning low, and plasis, which refers to molding or forming. The adjective form is hypoplastic. In hypoplasia, there is a lack of development or a defective development of the enamel of the tooth before its eruption.

Classification of hypoplasia System local

System hypoplasia

Local hypoplasia (Turner's hypoplasia)

Turner's hypoplasia Turner's hypoplasia is an abnormality found in teeth. Its appearance is variable, though usually is manifested as a portion of missing or diminished enamel on permanent teeth. Unlike other abnormalities which affect a vast number of teeth, Turner's hypoplasia usually affects only one tooth in the mouth and, it is referred to as a Turner's tooth.teethenamelmouth If Turner's hypoplasia is found on a canine or a premolar, the most likely cause is an infection that was present when the primary (baby) tooth was still in the mouth. Most likely, the primary tooth was heavily decayed and an area of inflamed tissues around the root of the tooth (called a periapical inflammation), affecting the development of the permanent tooth. The tooth most likely affected by this cause is the canine tooth. The appearance of the abnormality will depend on the severity and longevity of the infection.caninepremolarinfectiondecayed inflamedtissuesroot periapicalinflammationdevelopment of the permanent toothcanine tooth

If Turner's hypoplasia is found in the front (anterior) area of the mouth, the most likely cause is a traumatic injury to a primary tooth. The traumatized tooth, which is usually a maxillary central incisor, is pushed into the developing tooth underneath it and consequently affects the formation of enamel. Because of the location of the permanent tooth's developing tooth bud in relation to the primary tooth, the most likely affected area on the permanent tooth is the facial surface (the side closer to the lips or cheek). White or yellow discoloration may accompany Turner's hypoplasia.maxillary central incisorformation of enameltooth budlipscheek hypoplasia

Tooth hyperplasia Tooth hyperplasia or Enamel Pearls (Enamel Drops). In this condition, small islands of enamel 1 to 2 mm in diameter are located on precervical ares of molars and premolars,on the root surface close to the cementoenamel junction. If covered by cementum, they probably will not be noticed on the extracted tooth except histologically. They are of significance only as potential problems in development of periodontal lesions.

Tooth hyperplasia