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What is Macrodontia/Microdontia?
- Macrodontia is a type of localised giantism in which teeth are larger than normal.
- Microdontia is when teeth appear snakier than normal (e.g. peg shaped laterals).
- Caused by
- Hormonal imbalance
- Genetics
- Implications:
- Teeth affected by this are usually extracted
- Aesthetics
- Crowding/spacing
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Hyperdontia (supernumerary)
- Teeth appear in addition to the normal amount of teeth, which can appear anywhere on the dental arch.
- Caused by: hereditary, hyperactivity of the dental lamina
- Implications: displacement of adjacent teeth, aesthetics, crowding, resorption of adjacent teeth.
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Anadontia (total of partial agenesis)
- Is a genetic disorder characterised by congenital absence of all or some primary/permanent teeth. it is associated with the skin and nerve syndromes called ectodermal dysplasia.
- Caused by: similar to hyperdontia- hereditary, lack of activity of the dental lamina.
- Implications: aesthetics, can also impact hair, nails, sweat and salivary glands.
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Impaction
- A condition which a tooth fails to fully grow out (erupt) from the gingiva.
- Caused by: crowding, lack of bone space
- Most common: Max. third molars, max. lateral incisors.
- Implications: because of crowding and difficulty cleaning, can cause decay in adjacent teeth, pain, as well as gum disease and more difficult extractions
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Ectopic tooth
- Wrong positioning of tooth due to lack of growth in the jaw and thus, assumes a path of eruption.
- Causes its premature loss
- Caused by: early eruption, lack of forward movement of primary teeth, small arch
- Implications: tooth can be obstructed and therefore unable to fully erupt, or could be obstructive to adjacent teeth, can change occlusion & alignment and change aesthetics.
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Ankylosis
- The fusion of teeth to bone as the PDL space has been lost.
- Caused by: dental trauma, especially occlusal trauma or periodical periodontitis caused by pulp necrosis.
- Implications: orthodontic implications, extraction implications, more difficult for a successor to erupt.
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Dens in Dente
- "Tooth within a tooth" (internal layer of enamel) is a condition found in teeth where the outer surface folds inwards.
- Caused by: a developmental disturbance in tooth formation
- Most commonly seen: max. palatal of lateral incisors.
- Implications: RCT may be difficult due to complex anatomy, early pulp necrosis, could act as an ecological niche for bacteria
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Dilaceration
- Developmental disturbance in shape of teeth. It refers to a sharp bend or curve in the root or crown of a formed tooth.
- Caused by: result of trauma to the predecessors, developmental disturbances, insufficient space
- Implications: often lead to failure of eruption, difficulty extractions, complications with RCT
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Hypercementosis
- Excessive buildup of normal cementum on the roots. A thicker layer of cementum can give the tooth enlarged appearance which mainly occurs at the apex.
- Caused by: localised inflammation, certain metabolic disorders, trauma
- Implications: webbing of roots, caused by excess cementum.
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Concrescence
- The cementum overlying the roots of at least two teeth joined together- similar to fusion.
- Caused by: trauma, crowding, due to close proximity of roots and excessive cementum deposition.
- Implications: surgical separation of teeth may be necessary if one is to be extracted.
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Fusion
- Arises through the union of two normally separated tooth germs. Some cases there are independent root/pulp chambers.
- Implications: difficulty extracting
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Germination
- Division is incomplete and results in large crown that has a single root + canal. - teeth develop from one tooth bud. Appears that the patient has an extra tooth, although have the normal number of tooth roots.
- Prevalent in primary incisors.
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