ORAL1050

• hereditary
• acquired - through trauma
• congenital

• Absence of mandible or maxilla
• incompatible with life

• small mandible or maxilla
• profile is straight

larger mandible or maxilla - look at angle of the nose with the lip

• Bony outgrowths of mature bones
• happens to high school kids +
• e.g. Torus palatinus: in midline of palate, is autosomal dominant with 100% penetrance. Happens after puberty and is more common in females! Hard to clean and fit dentures
• e.g. Torus mandibularus - area of premolars raised, adults and has high penetrance

• gingival overgrowth
• very firm - stippling is present but paler in colour
• normally due to reactions with medications e.g. dilanses, anti epileptic drugs and bone marrow transplants (antirejectionary drugs)
• can completely cover the teeth so oral hygiene is extremely important

• Congential lip pits
• cleft lips and alveolar palates:
• - areas do not close when born
• - causes difficulties with eating, swallowing and speach
• - 0.17% of live births
• - never really cleft lip on its own, usually with palae
• - they cant suck when born so plastic surgeons need to come in straight away
• - they go deaf quickly as food and things get stuck in the cleft causing infection and detrimently affect the ears (use chlorhexidine mouthrinse!)

• It can result in abnormalities in the teeth such as supernumeracy, size, morphology and calcification differences and eruption times are often delayed
• Lateral Incisors are generally missing

small tongue

• big tongue
• decreased muscle tone in tongue
• down syndrome or other syndrome patients

• frenal attachment is thicker or tighter than normal
• tongue movements and speach are restricted
• surgery releases it but only on request of speach pathologist

• Cleft tongue - midline there is a gap
• geographic tongue - benign migratory glossis, spots of thin epithelium which comes and goes
• hair tongue - elevated filiform pappilae that may become pigmented, just have to keep it clean

• if too tight can cause diastema and prevent eruption of central incisors
• some frenulums attach to lip

• osteogenesis imperfecta is where there has been an imperfection in bone development.
• It causes: fragile bones, loss of hearing, blue sclera of the eye and lax ligaments

Oral complications are Dentinogenesis imperfecta where the dentine has a bluey brown or amber opalescent colour. Primary teeth are more affected than the perm and basically odonotoblasts lay down abnormal matrix which screws up the proper formation of dentine. Enamel chips and wears easy as it is not supported by strong dentine underneath

• Small teeth
• can either be true (which they are smaller than normal) or relative (where jaws are larger)
• teeth that are affected are the laterals, 3rd molars and supernumeracy teeth
• more common in females

peg laterals are conical in shape and have shorter roots, 0.5 % in primary dentition and 2.0% in perm = reshape with resin

• bigger teeth
• either true or relative
• localised due to isolated disturbances of the tooth gum

double tooth = two joined togher, either normal or an added one attached, pulp chambers are joined and is important to seal when come through as theres high caries risk

gemination = spilts into two to form separate crows - mirror image. This is hereditary and is common with incisors and canines. Seal them = high caries risk

Fusion = 2 tooth germs fuse to one (similar to double tooth)

concrescence = roots joined together, common in the upper molars of the elderly

dilaceration = caused by trauma, causes displacement of the tooth so crown may be deformed or roots. Prosthetic dentistry is used to help remodel and reshape. Trauma to primarys can affect the perm

taurondontism = enlarged crown and big pulp chambers. Some syndromes are associated with this. Root canal treatments are difficult and prevention of caries is a must

dens evaginatus = lower premolar, extra cusp that has pulp in it! hereditary and racial

talon cusp = incisors cingulum is larger. hereditary - lower incisors bite against and grooves in between tooth and talon = high caries risk

Dens invaginatus = invagination of layers of the enamel organ into dental papilla before calcification occurs, abscesses can occur. Must seal cingulum pit or root canal treatment/ extraction. Common with lateral incisors. Take xrays to see it 5% of the population!

• agenesis:
• - anodontia = all teeth missing with ectodermal dysplasia
• - hypodontia = fewer teeth than normal, last one in the series is generally missing, hereditary. When one lateral incisors missing it is common to extract the other and then reshape and cut canines to incisor shape or do ortho treatment to creat a gap where the lateral incisor should be. And then put an implant in

Supernumeracy = excess number of teeth, variable in size, upper midline is very common area (mesio dens). They are often weird shapes and erupt weirdly, can even prevent the eruption of perm teeth