larger mandible or maxilla - look at angle of the nose with the lip
What are bony exotoses? Give examples
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
What is gingival Fibromatosis?
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
What are some defects with Lips?
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
What is microglossia?
what is macroglossia?
decreased muscle tone in tongue
down syndrome or other syndrome patients
what is ankyloglossia?
frenal attachment is thicker or tighter than normal
tongue movements and speach are restricted
surgery releases it but only on request of speach pathologist
What are three types of defects that you see when looking at the superior surface of the tongue?
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
what are some problems with the fraenal attachment?
if too tight can cause diastema and prevent eruption of central incisors
some frenulums attach to lip
What is osteogenesis imperfecta and what oral complications can be seen?
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
What is microdontia? Describe peg laterals:
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
What is macrodontia?
either true or relative
localised due to isolated disturbances of the tooth gum
Name some defects with teeth
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
Problems with morphology of the teeh:
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!
Problems with the number of teeth:
- 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