Atlas of Pediatric Oral and Dental Developmental Anomalies

A quick reference diagnostic guide for students and clinicians, covering a wide range of oral and dental developmental anomalies in children and adolescents

Written by world-renowned pediatric dentists, this easily accessible, well-illustrated reference covers a wide range of oral and dental developmental anomalies in children and adolescents, and includes rare as well as more common conditions.

Divided into two parts, the first part is dedicated to normal tissue initiation, formation, and development in the orodental region. The second part offers comprehensive pictorial descriptions of each condition and discussions of the treatment options available.

• A useful, quick reference atlas helping students and clinicians diagnose a wide range of oral and dental developmental anomalies in children and adolescents
• Highly illustrated with clinical photographs
• Describes both common and rare conditions, and explores treatment options

Atlas of Pediatric Oral and Dental Developmental Anomalies is an excellent resource for undergraduate dentistry students, postgraduate pediatric dentistry students, and pediatric dental practitioners.

About the Authors

Ghassem Ansari DDS, MSc, PhD (Glas), FHD (UCLA), is Professor of Pediatric Dentistry, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and Adjunct Professor of Pediatric Dentistry, European University College, Dental School, Dubai, UAE.

Mojtaba Vahid Golpayegani DDS, MS, FICD, is Professor of Pediatric Dentistry, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Richard Welbury MBBS, BDS, PhD, FDS (RCPS), FDSRCS, FRCPCH, FFGDP (Hon.), is Professor and Research Lead, Department of Pediatric Dentistry, School of Dentistry, College of Clinical and Biomedical Sciences, University of Central Lancashire, Preston, UK.

Preface xi

About the Companion Website xiii

1 Oral and Dental Anatomy 1

1.1 The Lips: Macro Anatomy 1

1.2 The Palate 1

1.3 The Tongue 3

1.4 The Cheek and Floor of the Mouth 4

1.5 The Periodontium 5

1.6 The Periodontal Ligament (PL) 5

1.7 The Alveolar Bone 6

1.8 The Teeth: Dental Anatomy 7

1.9 Normal Occlusion 9

1.10 Classification of the Occlusion 10

2 Histology and Embryology of the Teeth and Periodontium 13

2.1 Tooth Histology 13

2.1.1 Enamel 13

2.1.1.1 Striae of Retzius 13

2.1.1.2 Hunter‐Schreger Bands 13

2.1.1.3 Gnarled Enamel (Spiral Enamel) 13

2.1.1.4 Enamel Tufts and Lamella 13

2.1.1.5 Enamel Surface 13

2.1.2 Dentine 14

2.1.2.1 Dentinal Tubules 14

2.1.2.2 Intratubular Dentine 15

2.1.2.3 Intertubular Dentine 15

2.1.2.4 Interglobular Dentine 15

2.1.2.5 Incremental Lines 15

2.1.2.6 Granular Layer of Tomes 15

2.1.3 Cementum 15

2.1.3.1 Cementum Connective Tissue 15

2.1.3.2 Fibrous Matrix 15

2.1.4 Dental Pulp 16

2.1.5 Periodontium 16

2.2 Embryology of Teeth: Life Cycle of the Tooth 16

2.2.1 Initiation (Bud) Stage 16

2.2.2 Proliferation (Cap) Stage 16

2.2.3 Histodifferentiation and Morphodifferentiation (Bell) Stage 16

2.2.4 Apposition and Calcification 16

3 Epidemiology and Diagnosis of Teeth Developmental Disturbances 17

3.1 Prevalence and Incidence 17

3.2 Diagnosis and Classification of Defects in Teeth 17

3.2.1 Cause of Disturbance 17

3.2.2 Extent of Involvement of the Dentition 18

3.2.3 The Structure Involved 18

3.2.3.1 Enamel Defects 18

3.2.3.2 Dentine Defects 18

3.2.3.3 Cementum Defects 18

3.2.3.4 Entire Tooth Structures Involved 18

3.2.4 Teeth Morphology 19

3.2.5 Teeth Size 19

3.2.6 Teeth Count 19

3.2.6.1 Hypodontia 19

3.2.6.2 Hyperdontia 19

3.2.7 Color of the Teeth 20

4 Etiology and Pathology of Teeth Disturbances 21

4.1 Genetically Originated Defects 21

4.1.1 Disturbances in Teeth Count 21

4.1.1.1 Reduced Numbers; Missing Teeth 21

4.1.1.2 Increase in Numbers; Extra Teeth 24

4.1.2 Disturbances in Proportion and Size of the Teeth 30

4.1.2.1 Large Size – Macrodontia 30

4.1.2.2 Small Size – Microdontia 30

4.1.2.3 Short Roots 32

4.1.3 Disturbances of Teeth Morphology 32

4.1.3.1 Dens Invaginatus 32

4.1.3.2 Dens Evaginatus (Talon Cusp) 33

4.1.3.3 Peg‐shaped Laterals 34

4.1.3.4 Fusion 34

4.1.3.5 Gemination 36

4.1.3.6 Dilaceration 38

4.1.3.7 Concrescence 39

4.1.3.8 Taurodontism 39

4.1.3.9 Hutchinson Incisors and Mulberry Molars 40

4.1.3.10 Odontomes 40

4.1.4 Defects of Teeth Structures 40

4.1.4.1 Enamel Defects 40

4.1.4.2 Dentine Defects 45

4.1.4.3 Cementum Defects 45

4.1.4.4 Enamel Dentin Cementum Defects 49

4.2 Congenital Diseases (in Utero) 50

4.2.1 Erythroblastosis Fetalis 50

4.2.2 Measles 51

4.2.3 Rubella 51

4.2.4 Pneumonia 52

4.2.5 Porphyria 52

4.2.6 Syphilis 52

4.2.7 Dehydration and Liquid Imbalance 52

4.3 Acquired (Environmental) Defects 53

4.3.1 Food and Diet 53

4.3.2 Vitamins and Minerals 53

4.3.3 Ions 55

4.3.4 Diseases and Drugs 56

4.3.4.1 Infantile Jaundice 56

4.3.4.2 Liver Disease, Liver Transplant 56

4.3.4.3 Cystic Fibrosis and Antibiotic Therapy 57

4.3.4.4 Lead Poisoning 59

4.3.4.5 Iron Intake 59

4.3.5 Primary Teeth Trauma and Tooth Infection 59

4.3.6 Short Roots 61

5 Eruption Disturbances of Teeth – Etiology and Diagnosis 63

5.1 Definition 63

5.2 Delayed Eruption 63

5.3 Early Eruption 63

5.4 Failed Exfoliation (Primary Dentition) 63

5.5 Early Exfoliation/Loss of Primary Teeth 65

5.5.1 Localized Factors 65

5.5.2 Systemic Factors 65

5.6 Failed Eruption and Impaction 66

5.7 Eruption Cysts 67

5.8 Ectopic Eruption and Transposition 69

5.9 Labial Frenulum and Lingual Frenulum 70

5.10 Under ‐eruption – Infraocclusion 70

5.11 Over ‐eruption 71

5.12 Palatal and Labial Cleft and Teeth Eruption 74

5.13 Malocclusion 76

5.13.1 Class I Malocclusion 76

5.13.2 Class II Malocclusion 76

5.13.3 Class III Malocclusion 77

5.13.4 General Spacing and Diastema Formation 78

5.14 Gingival Overgrowth 80

6 Self‐evaluation Section 81

Bibliography 109

Self‐evaluation Answer 115

Index 119

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