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 Ankyloglossia:
- Extensive adhesion of the tongue to the floor of the mouth or the lingual aspect of the anterior portion of the mandible.
- Complete or partial fusion of the lingual frenum.
- Predilection: male
- Treatment: Frenectomy
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Anomaly:
Marked deviation from normal. especially as a result of congenital or hereditary defects.
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Commissure:
the site of union of corresponding parts (e.g., the corners of the lips) (labial commissure, commissural lip pits).
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Congenital disorder:
A disorder that is present at and existing from the time of birth.
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Cyst:
An abnormal sac or cavity lined by epithelial and surrounded by fibrous connective tissue.
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Dentiogenesis:
the formation of dentin.
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Differentiation:
the distinguishing of one tissue from another.
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Hypodontia:
- Partial anodontia; the lack of one or more teeth.
- permanent dentition is most commonly affected
- most often missing are max & mand. 3rd molars and max. lateral incisors
- Oligodontia- subcategory of hypodontia in which 6 or more teeth (excluding the 3rd molars) are congenital missing
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Hypercementosis: AKA cemental hyperplasia
- excessive cementum on the roots of the teeth.
- occurs in adults, incidence increases w/ age
- frequently seen in Paget disease of the bone
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Macrognathia:
Enlarged jaw.
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Multilocular:
A radiographic appearance in which many circular radiolucencis exist; these can appear "soap-bubble-like" or "honeycomb-like".
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Nodule:
A small solid mass that can be detected through touch.
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Oligodontia:
a subcategory of hypodontia in which six or more teeth are missing.
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Predilection:
A disposition in favor of something; preference.
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Proliferation:
The multiplication of cells.
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Stomodeum:
The embryonic invagination that becomes the oral cavity.
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Supernumerary:
In excess of the normal or regular number , as in teeth.
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Development of the face is a process of______.
selective growth, or proliferation and differentiation.
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All of the face and most of the structures of the oral cavity develop from ______.
frontal process or the first branchial arch.
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The first branchial arch divides into ______.
two maxillary processes and the mandibular process.
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The maxillary processes give rise to _____.
- upper part of the cheeks
- the lateral portion of the upper lip
- part of the palate
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The mandibular arch forms ______.
- the lower part of the cheeks
- the mandible
- part of the tongue
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Olfactory pits:
- future opening s of the nose that develop on the surface on the frontal process.
- They divide the frontal process into three parts:
- 1. median nasal process
- 2. right lateral nasal process
- 3. left lateral nasal process
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Lateral nasal processes form ______.
sides of the nose
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The first brachial arch divides into:
two maxillary processes and one mandibular process.
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median nasal process form:
- the center and tip of the nose.
- Later, it grows downward btw the maxillary process to form a pair of bulges called glubular process.
- This continues to grow dwnwrd to form the philtrim (upper lip).
- gives rise to the nasal septum
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The tongue develops from _____.
- the first three branchial arches.
- - body of the tongue forms from the 1st branchial arch
- - the base forms from the 2nd & 3rd branchial arches.
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Tooth development or odontogenesis begins at about the ___ week of embryonic life and involves _____and ____.
- fifth
- ectoderm
- ectomesenchyme
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The tooth germ is composed of three parts:
- 1. enamel organ (developed from ectoderm)
- 2. the dental papilla ( developed from mesoderm)
- 3. the dental sac or follicle (dev. from mesoderm)
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Enamel organ progresses to produce ____.
ameloblasts, which form enamel.
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Amelogenesis:
- the formation of enamel.
- - enamel is highly mineralized epithelial tissue, and 90% of its volume is hydroxyapatite crystals.
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Dental sac (fillicle):
provides cells that form cementum, PDL, & alveolar bone
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Herwig epithelial root sheath:
- proliferates to shape the root of the tooth and includes the formation of root dentin.
- cells must break up & pull away from root surface before cementum can be produce.
- very little cementum is produced until tooth has erupted & its in occlusion & functioning.
- Root is completed 1-4 yrs after tooth eruption.
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Ankyloglossia:
- Four times more common in boys than girls.
- Gingival recession & bone loss can occur if the frenum is attached high on the lingual alveolar ridge.
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Commissural lip pits:
- May be shallow or they may be several MM deep.
- can be bilateral or unilateral
- more often seen in adult males
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Paramedian lip pit:
- occurs near midline of the vermillion border of the lower lip.
- lateral or bilateral
- referred as congenital fistulas of the lower lip because they may contain salivary secretions.
- seen in pts. w/ cleft lip or cleft palate
- inherited as an autosomal-dominant trait
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Lingual thyroid:
- appears as a smooth nodular mass at the base of the tongue posterior to the circumvallate papillae at midline.
- can be asymptomatic or symtomatic
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Radicular cyst AKA periapical cyst
- MOST COMMON cyst observed in the oral cavity
- ALWAYS associated w/a nonvital tooth
- diagnosis ONLY through microscopic examination
- It is an inflammatory cyst, NOT a developmental cyst
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Intraosseous cyst:
oral cysts that occur within the bone
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extraosseous cysts:
cysts that occur in soft tissue
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Dentigerous cyst AKA follicular cyst:
- forms around the crown of an unerupted or developing tooth.
- MOST COMMONLY occuring type of developmental odontogenic cyst
- most common location is around the crown of an unerupted or impacteed mandibular third molarhigher incidence in males;from 15-30 yrs old
- higher predilection for whites than blacks
- can appear as a well-defined unilocular radiolucency
- microscopically, is a TRUE cyst
- Treatment: removal of cyst and tooth involved. If not removed, risk of carcinoma may develop.
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Eruption cyst:
- similar to a dentigerous, but is found in the soft tissue around the crown of an erupting tooth.
- presents as swelling of the gingival mucosa over crown of erupting tooth.
- If there is blood- purplish color and termed eruption hematomamost commonly associated w/ decedious mand. central incisors & max. 1st permanent molars.
- Does NOT require treatment
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Premordial Cyst:
- develops in place of a tooth.
- found in place of 3rd molar or posterior to an erupted 3rd molar.
- originates from remnants & degeneration of the enamel organ.
- Microscopically, often turn out to be odonogenic keratocyst (OKC)
- seen in young adults
- asymptomatic & discovered in radiographs as well defined radiolucent unilocular or multilocular lesions
- Biopsy & microscoping examinations are essential
Treatment: surgical removal of entire lession
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Odontogenic keratocyst (OKC):
- an odontogenic developmental cyst lesion characterized by its unique microscopic apperance & frequent recurrence.Diagnosis based on histopathologic findings
- lumen lined by 8-10 cell layers thick & surfaced by parakeratinReclassified in 2005 as Keratocystic odontogenic tumorseen on mand. 3rd molar region
- slight predilection for males 10-50 years old
- well-definedmultilocular radiolucent lesion but unilocular can also occur and can be identical to an odontogenic tumor.
- Moves teeth & resorb tooth strcture, but does NOT cause expansion of bone.
- associated w/ nevoid basal cell carcinoma
- Aggressive treatment: surgical excision & osseous curettage are essential because of the high recurrence rate (up to 25%)
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Orthokeratotic odontogenic cyst:
- odontogenic cyst that is lined by orthokeratinmuch lower rate reccurance than OKC/KOT
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Calcifying Odontogenic cyst AKA Gorlin cyst:
- developmental nonaggressive cystic lession lined ny odontogenic epithelium that closely resembles the epithelium of the odontogenic tumor called ameloblastomaMicroscopically characteristics called ghost cells.Avarage age of diagnosis is 30
- usually found in incisor or canine area of either arch.
- does NOT recur
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Lateral periodontal cyst:
- developmental odontogenic cyst that occurs on the lateral root surface of mand and max canine and premolar teeth
- asymptomatic, unilocular or multilocular radiolucent lesion
- males btw 50-70 yrs old
- Treatment: surgical excision
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Botryoid odontogenic cyst:
- considered a variant of the lateral periodontal cyst
- usually multilocular but can be unilocular
- most common in mand. cuspid & premolar area
- greater recurrence potential than lateral periodontal cyst
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Gingival cyst:
- appears as a small bulge or swelling of the attached gingiva or interdental papillae
- Treatment: surgical excision
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Glandular odontogenic Cyst:
- a rare developmental odontogenic cyst
- was called sialo-odontogenic cystdistinctive microscopic apperance usually multicystic lesionsoften presents enlargement of the bone
- anterior & posterior mandible and anterior maxilla are the most common reported areas
- peak incidence in the 5th decade
- when not completely surgically removed recurrence of up to 30% has been reported
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Nasopalatine canal cyst (incisive canal cyst):
- developmental cyst located w/in the nasopalatine canal or the incisive papilla
- when found in the papilla it is called a cyst of the palatine papillaarises from epithelial remnants of the embryonal nasopalatine ducts.
- adults 40-60 yrs old
- predilection for males
- asymptomatic, small pink bulge near the apices & btw the roots of the max central incisors on the lingual surface.
- adjacent teeth are usually vital
- well-defined radiolucent heart-shaped lesion, 1-2 cm in diameter
- Treatment: surgical enucleation especially on edentulous patient before fabrication od dentures.
- recurrence is rare
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Median palatine cyst:
- rare fissural cyst that appears as a well-defined unilocular radiolucency and is located in the midline of the hard palate.
- firm mass in the midline of hard palate
- young adults
- Treatment: surgical enucleation
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Globulomaxillary cyst:
- a well-defined, pear-shaped radiolucency found btw the roots of the maxillary lateral incisor and cuspid
- size can vary; however, when large enough, a divergence of the roots can result
- treatment: surgical enucleation
- recurrance depends on final diagnosis
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Median mandibular cyst:
- A soft tissue cyst
- Thought to originate from the lower anterior portion of the nasolacrimal duct
- Observed in adults 40 to 50 years of age
- 4:1 ratio in favor of females
- Clinical
- An expansion or swelling in the mucobuccal fold in the area of the maxillary canine and the floor of the nose
- Treatment: Surgical excision
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Cervical lymphoepithelial cyst (branchial cleft cyst):
- located on the lateral neckat the ant. border of the sternocleidomastoid muscle
- common in children and young adults
- stratified squamous epithelial lining surrounded by a well-circumscribed component of lymphoid & connective tissue
- treatment: surgical excision
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intraoral lymphoepithelial cyst:
- young adults
- on floor of the mouth, ventral tongue, and lateral borders of the posterior tongue
- appears pinkish-yellow, raise nodulemay contain creamy material
- treatment: surgical excision
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Epidermal cyst:
- A raised nodule on the skin of the face or neck
- May be noted intraorally on occasion
- Treatment: Surgical excision
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Dermoid cyst:
- developmental cyst that is often present at birth or noted in young childrenmore common in other parts of the body than in head and neck area
- in the oral cavity, usually found in the ant. floor of the mouth
- may cause displacement of the tongue and may have a doughlike consistency when palpated.
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benign cystic teratoma:
- Histologic: hair follicles, sebaceous glands, and sweat glands may be seen in the cyst wall
- resembles a dermoid cyst
- teeth, bone, muscle, and nerve may be found in the walls of this lesion.
- teeth are usually NOT found in the malignant form of the teratoma
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Thyroglossal tract (duct) cyst:
- forms along the same tract that the thyroid gland follows in development.
- most of these cysts occur bellow the hyoid bone
- young individuals under the age of 20
- treatment: complete excision of the cyst and the tract, usually including a part of the hyoid bone and muscle
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Psedocyst:
- intraosseous lesions that appear as radiolucencies.
- NOT true cysts because they are not lined by epithelium.
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Stafne Defect (lingual mandibular bone concavity or static bone cyst)
- NOT a true cyst
- often reffered to as a psedocyst
- seen in adults and RARE in children
- anatomic depression may be felt on post. lingual area of mandible
- Rad. a well-defined radiolucency in post. region od mandible inferior to the mandibular canal.
- NO treatment is required
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Simple bone cyst (traumatic bone cyst, hemorrhagic bone cyst):
- a pathologic cavity in bone that is not lined w/ epithelium
- cuase is uncertain
- young individuals
- mandible is most common location
- scalloping around the roots of teeth
- asymptomatic and discovered during routine xrays
- Treatment: a curettage is performed on the wall lining the void to establish bleeding. The void or space fills up w/ bone in 6 months -a year
- prognosis is excellent and recurrence is unusual
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Aneurysmal bone cyst:
- a pseudocyst that consists of blood-filled spaces surrounded by multinucleated giant cells and fibrous conective tissu
- NO epithelial lining
- radiolucent lesion appears as "honey-comb" or "soap bubble"individuals less than 30 yrs of age
- slight predilection for females
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Hypodontia:
- The lack of one or more teeth
- The most common missing permanent teeth are:
- Mandibular and maxillary third molars
- Maxillary lateral incisors
- Mandibular second premolars
- The most common missing deciduous tooth is the mandibular incisor
- Tends to be familial
- May be a component of a syndrome
- Treatment
- May require prosthetic replacement
- Orthodontic evaluation and treatment may be necessary
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Supernumerary teeth:
- Extra teeth
- May result from formation of extra tooth buds in the dental lamina or from the cleavage of already existing tooth buds
- May occur in either deciduous or permanent dentition
- Most often seen in the maxilla
- Mesiodens:
- The most common supernumerary tooth
- Located between the maxillary incisors
- May be inverted when seen on radiographs
- Distomolar:
- The second most common supernumerary tooth
- Located distal to the third molar
- Treatment:
- Erupted teeth may require removal if they cause crowding, malposition of adjacent teeth, or noneruption of normal teeth
- Nonerupted teeth should be extracted because a risk exists for cyst development around the crown
- Multiple supernumerary teeth may be associated with cleidocranial dysplasia or Gardner syndrome
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Microdontia:
- One or more teeth is (are) smaller than normal
- Microdontia involving a single tooth is far more common
- Maxillary lateral incisor and maxillary third molar are the most commonly involved teeth
- True generalized microdontia
- Seen in a pituitary dwarf; all teeth are smaller than normal
- Generalized relative microdontia
- Normal-size teeth appear small in a large jaw
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Macrodontia:
- One or more teeth are larger than normal
- True generalized macrodontia
- Seen in cases of pituitary gigantism
- Relative generalized macrodontia
- Large teeth in a small jaw
- Macrodontia affecting a single tooth
- May be seen in cases of facial hemihypertrophy
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Gemination:
- A single tooth germ attempts to divide in two
- Appears as two crowns joined together by a notched incisal area
- Radiographically, usually one single root and one common pulp canal exist
- The patient has a full complement of teeth
- fusion ot deciduous teeth occur more often than fusion of permanent teeth
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Fusion:
- The union of two normally separate adjacent tooth germs
- Appears as a single large crown that occurs in place of two normal teeth
- Radiographically, either separate or fused roots and root canals are seen
- The patient is usually short one tooth
- True fusion ALWAYS involves confluence of dentin
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Hypercementosis:
- Excessive cementum on the roots of the teeth
- Occurs in adults; incidence and amount increase with age
- Feature associated with several local and systemic factors
- No treatment necessary
- Frequently seen in Paget disease of bone.
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Concrescences:
- Two adjacent teeth are united by cementum
- Form of fusion on the roots
- Usually discovered on radiograph
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Dilaceration:
- an abnormal curve or bend in the root of tooth.
- Usually discovered on radiograph
- May cause a problem if the tooth must be removed or a root canal performed
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Enamel pearl:
- A small, spherical enamel projection on a root surface
- Usually found on maxillary molars
- Radiographically, it appears as a small, spherical radiopacity
- Removal may be necessary if periodontal problems occur in the furcation
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Talon cusp:
- An accessory cusp located in the cingulum area of a maxillary or mandibular permanent incisor
- Contains a pulp horn
- May interfere with occlusion
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Taurodontism:
- The teeth have elongated pulp chambers and short roots
- May occur in both deciduous and permanent dentition
- Identified on radiographs
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Dens invaginatus: AKA Dens in dente
- Occurs when the enamel organ invaginates into the crown of a tooth before mineralization
- Radiographically, it appears as a toothlike structure within a tooth
- Vulnerable to caries, pulpal infection, and necrosis
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Dens Evaginatus:
- An accessory enamel cusp found on the occlusal tooth surface
- Most often seen on mandibular premolars
- May cause occlusal problems
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Supernumerary roots:
- May involve any tooth
- Most commonly, maxillary and mandibular third molars if multirooted teeth are involved
- May become clinically significant if removal or endodontia is necessary
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Enamel hypoplasia:
- The incomplete or defective formation of enamel
- May be due to many factors, including:
- Amelogenesis imperfecta
- Febrile illness (measles, chickenpox, scarlet fever)
- Vitamin deficiency
- Infection of a deciduous tooth
- Ingestion of fluoride
- Congenital syphilis
- Birth injury, premature birth
- Idiopathic factors
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Enamel Hypoplasia Caused by Febrile Illness or Vitamin Deficiency:
- Ameloblasts are one of the most sensitive cell groups in the body
- Any serious systemic disease or severe nutritional deficiency can produce enamel hypoplasia
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Enamel hypoplasia resulting from local infection or trauma:
- Enamel hypoplasia of an adult tooth may result from infection of a deciduous tooth
- A single tooth is usually affected; it is referred to as a Turner tooth
- The color of the enamel may range from yellow to brown, or severe pitting and deformity may be involved
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Enamel Hypoplasia Resulting from Fluoride Ingestion:
- Affected teeth exhibit a mottled discoloration of enamel
- Ingestion of water with two to three times the recommended amount of fluoride (0.7ppm) leads to white flecks and chalky opaque areas of enamel
- Four times the recommended amount of fluoride causes brown or black staining
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Enamel Hypoplasia Resulting from Congenital Syphilis:
- Congenital syphilis is transmitted from an infected mother to her fetus via the placenta
- Hutchinson incisors are shaped like screwdrivers
- Mulberry molars have a berrylike appearance
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Enamel Hypoplasia Resulting from Birth Injury, Premature Birth, or Idiopathic Factors:
- Enamel hypoplasia may occur as a result of trauma or injury at the time of birth
- Even a mild illness or systemic problem can result in enamel hypoplasia
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Enamel Hypocalcification:
- A developmental anomaly resulting in a disturbance in the maturation of the enamel matrix
- Usually appears as a chalky, white spot on the middle third of smooth crowns
- The underlying enamel may be soft and susceptible to caries
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Endogenous Staining of Teeth:
- The result of deposition of substances circulating systemically during tooth development
- May be due to:
- Tetracycline stain
- Erythroblastosis fetalis: Rh incompatibility
- Neonatal liver disease
- Congenital porphyria: An inherited metabolic disease
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Regional Odontodysplasia (Ghost Teeth):
- Exhibit a marked reduction in radiodensity and a characteristic ghostlike appearance
- Very thin enamel and dentin are present
- Usually treated by extraction
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Impacted and Embedded Teeth:
- Any tooth can be impacted
- Third-molar impactions are classified according to the position of the tooth
- Teeth can be completely impacted in bone or they may be partially impacted
- Partially impacted teeth are prone to infection
- Impacted teeth may be surgically removed to prevent odontogenic cyst and tumor formation or damage to adjacent teeth
- The optimal time is between 12 and 24 years of age
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Ankylosed Teeth:
- Tooth cementum fused to bone
- Prevents exfoliation of the deciduous tooth and eruption of the underlying adult tooth
- The ankylosed deciduous tooth appears submerged and has a different sound when percussed (a kind of dull thud)
- The periodontal ligament space is lacking
- Difficult to extract
- Removal of deciduous teeth is necessary for eruption of the adult successor
- Removal of adult teeth may be necessary to prevent malocclusion, caries, and periodontal disease
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