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Aberration

Deviation, abnormality, anomaly, irregularity, oddness

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Dental anomalies could be in;

Size

Number

or

Morphology

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Variations in tooth size may be local or general.

Crown

Microdontia

Macrodontia

Applicable if deviation is more than 2SD

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Variations in Root Size;

Rhizomicry

Rhizomegaly

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Variations in tooth number

Hypodontia – Less teeth

Hyperdontia – More teeth

Anodontia – No teeth at all

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Variations in tooth morphology

CROWN

Palatal cusp

Dens Invaginatus

Dens Evaginatus

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Variations in tooth morphology

ROOTS

Cynodontia – Fusion multi rooted

Taurodontia – Extra roots

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Variations in tooth morphology

Double formations

Concrescence

Dentes confuse

Dentes germinati

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Tooth smaller than NORMAL

General microdontia is rare

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When it occurs, it is associated with;

Ectodermal dysplasia

Down’s syndrome

Hypopituatarism

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Local microdontia is more common, often associated with hypodontia

Commonly occurring in

Upper lateral incisors

Third molars

Supernumerally

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If microdontial is anteriorly located, it causes COSMETIC problems e.g. peg laterals

Treatment

Crown build up if root size allows

Otherwise may promote plaque retention

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Tooth larger than NORMAL

General macrodontia is very rare, and occurs in connection with gigantism

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Local

Usually due to fusion of two tooth germs

If unilateral, it is associated with hemifacial hypertrophy

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Root length shorter than crown height

Short roots are seen in connection with;

Osteoporosis

Hypoparathyroidism

Dentin dysplasia

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Local

Trauma, pulpal complications, radiation during root development

Genetic (Short root anomaly)

Common among girls than boys

Predominantly affects upper centrals incisors and second premolars

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Abnormally larger root length and root diameter

Is an unusual anomaly

Occurs mainly in canines

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May be symmetrical or asymmetrical

Strongly related to microdontia

Anodontia is extremely rare in secondary dentition

Differences between races exist

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Age is a crucial factor in ruling out or validation of hypodontia (expected crown mineralization) e.g. lower PM2 (6-7 years]

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Management

Orthodontic consultations

Composite build up e.g. of canines

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Prevalence less than 1%

Exclusively to incisors, mostly laterals

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Associated with ectodermal dysplasia

May be followed by aplasia of successor

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More frequent than in primary dentition

Prevalence 6-8% excluding third molars

More in girls

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Frequency of occurrence (in order)

Lower 2nd PM

Upper 2nd PM/Upper lateral incisor

Lower central incisor

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Prevalence 0.3 – 0.6%.

Mostly in upper incisors

Teeth have normal morphology

Usually do not disturb spacing in secondary dentition

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Prevalence: 1-1.5%

Maxilla predominates

Maxillary anteriors

Lower premolars

Upper premolars

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Higher in boys

Usually symmetrical if multiple

Anteriors: normal shape

Posteriors: Usually malformed

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Known as SUPERNUMERALLY TEETH

Effects: eruption problem

Crowding

Deviations

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Management

EXTRACT ONE MOST DEVIATING IN

Shape

Size

Position

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MESIODENS

Midline supernumerally

Intermediate between primary or secondary dentition

Prevalence 0.5 – 0.7%

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MESIODENS

More in boys

Peg shaped, usually smaller than normal incisor

25% erupt spontaneously

More common in maxilla

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MESIODENS

Effects

Delayed eruption of secondary incisors

Deviation of secondary incisors

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Immediate EXTRACTION to prevent

Cyst

Resorption of other teeth roots

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Unlike other dental anomalies and anatomical variations, double formations appear more in primary than secondary dentition

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Genetic influence likely

In primary dentition double formation particulary fusions are followed by aplasia of secondary successor

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Physiological resorption is retarded and may lead to delayed eruption of permanent successor

Most often occur in the anterior region of both mandible and maxilla. Thus, Cosmetic is a priority

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Double formation can frequently be observed in connection to congenital disorders e.g. Down’s syndrome and cleft palate

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Union of two or more teeth by Dentine and Enamel

Pulps may be partially or completely united

Reduces number of teeth in arch

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Union of two teeth by Cementum

Cause: Crowding or dislocation of tooth germs in root formation process

Usually seen in area of M2 and M3 in maxillary adolescent

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Union between a NORMAL tooth and a SUPERNUMERALLY tooth

May be due to incomplete division of tooth germ

Number of teeth in arch not REDUCED

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CAUSE

Local disturbances in induction and differentiation of dental lamina

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Genetic influence e.g.

Hypo: congenital absence of tooth germ

Ano: Total absence of teeth

Hyper: more germs  super numerally

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Perform early diagnosis: to eliminate errors due to extractions

Verify diagnosis by Radiograph

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Incisal anomally

Peg-shaped types, T- and Y- forms due to accentuation of Tuberculus/cusp

The marked palatal cusp may interfere with occlusion

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Maxillary lateral incisors present most varied forms of the crowns.

Treatment: Gradual grinding over a long period and fluoride application, as there is always a pointed pulp horn in palatal cusp.

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Similar to palatal cusp but occurs in premolars (centre of occlusal surface)

In 50% cases pulp extends into cusps

If generalized ≡ LOBODONTIA

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Paramolar cusp: upper molars, buccal side of mesio buccal cusp

Carabelli’s tubercle on maxillary first permanent molars and also maxillary primary second molars. The tubercle is located on the palatal side of mesio palatal cusp

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Distomolar tubercle: Distopalatal cusps of molars

If generalized ≡ GLOBODONTIA

Third molars exhibit the greatest variation of size and morphology of all teeth

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Channel or lumen in tooth surrounded by hard tissues

Enamel centrally

Dentine peripherally “foramen caecum”

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Predominant in permanent upper lateral incisors

Also found on upper centrals, premolars, canines and molars

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Bilateral in 50% cases

Prevalence: 3% of Swedish school children, in Tz not documented

Treatment: If small, can be restored with amalgam or composite

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If deep treat like any deep carious lesion

Early diagnosis: Reduce risk of pulp involvement

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Root stem absent

Roots diverge direct from crown

 DOG MOLARS

Characteristic for primary molars

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Fusion on multirooted teeth

Extra roots

Predominantly in mandibular canines followed by second premolars then first molars

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Rare anomally found in multirooted teeth

Prolonged root stem in multirooted teeth with the furcation more apically than normally

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Genetically determined

Has low clinical importance

Degree increases from first to third molar

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