Dental Anomali

Case 1

This patient presented to the dental clinic, he

suffered from absence of all teeth and sparse hair.
Defective nails were
observed.
 When you asked about
the family background,
you found that his sister
has fine blond hair, fine
eye brows and eye
lashes.

Her oral examination

showed:
1- Diagnose this condition.

2- Mention other oral manifestations

associated with this condition.
■ Hereditary Anhydrotic Ectodermal Dysplasia
(Streeter's Syndrome)
– Xerostomia
– Fissured and inflamed mucosa
– Caries in present teeth
– Malformed teeth if present
– Low vertical dimension due to absence of alveolar
processes secondary to teeth absence which lead to
cracked corners of mouth and inflammation.
Case 2

This patient had

bone anomalies
which chiefly
affected the clavicle
and skull
Radiograph showed delayed closure of
fontanels.
Oral examination
showed retained
deciduous teeth and
delayed eruption of
permanent teeth

Panoramic
radiograph showed
many impacted
supernumerary
teeth.
1- Diagnose this condition.

2- Mention other oral manifestations

■ Cleido-Cranial Dysplasia

– Malformed teeth
– Crowns of teeth show gemination
– Hooked roots
– Multiple dentigerous cysts
– Enamel hypoplasia
Case 3

This patient presented to the dental clinic, he

suffered from absence of many teeth and
deformity of the present teeth
Panoramic radiographic examination showed
the presence of multiple impacted
supernumerary teeth.
Diagnose this condition.
Cleido-Cranial Dysplasia
Case 4
This patient presented by small extra conical
crown between central incisors
Diagnose this condition?
Mesiodens (Supernumerary Teeth)
 Case 5
This patient presented
by accessory cusp on
buccal surface of
mandibular molar
Diagnose this condition.
Paramolar (Supernumerary Teeth)
Case 6

This patient presented by a small extra tooth

behind the last molar
Diagnose this condition.
Distomolar (Supernumerary Teeth)
 Case 7
A newborn has teeth at the anterior mandibular
area, it caused an ulcer in the ventral surface of
the tongue and difficulty during sucking
Diagnose this condition.
Pre-deciduous Dentition
Case 8

This patient has an extra fourth molar in

mandible and maxilla bilaterally.
Diagnose this condition.
Post-permenant Dentition
(Supplemental Teeth)
Case 9

A young patient showing extra teeth germs

for mandibular premolar.
A photograph of an adult patient having extra
mandibular premolars erupting in the oral
cavity.
Diagnose this condition.
Post-permanent Dentition
(Supplemental Teeth)
 Case 10

These are two cases

having a conical
lateral incisors
Diagnose this condition.
Peg Shaped Lateral
(Localized Microdontia involving a single
tooth)
Case 11
This patient exhibits small sized teeth and
spacing.
Diagnose this condition.
Generalized Microdontia
 Case 12

This is a
radiograph of a
patient who has a
larger upper left
central incisor than
the right one.
Diagnose this condition.
 Localized Macrodontia
(Macrodontia of a single tooth)
Case 13

This patient exhibits large sized teeth

Diagnose this condition.
Generalized Macrodontia
 Case 14
This patient had notches in the incisal edges of his
central incisors.
On counting, number of teeth was normal.
Periapical radiograph showed two partially separated
crowns with two pulp chambers and a single root
canal
1-Diagnose this condition?
2- What is the significance of this condition?
• Gemination

• Aesthetic, food entrapment then caries

Case 15
This patient has notch in the incisal edge of lower
lateral incisor and a missing canine.
Radiographs showed
two fused crowns
with two separate
pulp chambers and
root canals
1-Diagnose this condition?
2- What is the significance of this condition?
• Fusion.

• Extraction of one tooth is associated with

extraction of the other tooth and periodontal
problems.
 Case 16

A patient experienced
a significant difficulty
in extraction of
maxillary third molar
which was
unexpectedly joined
to its neighboring
tooth
1-Diagnose this condition.
2- What is the significance of this condition?
• Concrescence.

• Extraction of one tooth is associated with

extraction of the other unaffected tooth.
Case 17

A B C

Patients who have these teeth discovered the

presence of sharp angles in their teeth.
Case 18
A patient experienced a significant difficulty
during root canal treatment of mandibular first
molar
Radiograpgic examination showed severe
bending in the tooth root
1-Diagnose this condition in 17, 18.
2- What is the significance of this condition?
• Dilaceration

• Difficulty in endodontic treatment, needs

endo-surgery.
Difficulty in extraction because the
curved part of root may become fractured
during the extraction.
 Case 19
A patient presented by an
extra cusp on the lingual
aspect of an anterior tooth
1-Diagnose this condition.
2- What is the significance of this condition?
• Talon cusp.

• Malocclusion, food impaction with

subsequent caries.
 Case 20
This mandibular lateral incisor exhibits a
lingual bulbous enlargement of the
cingulum pit
 Which
appeared
radiographically
as if there is a
tooth within
tooth (thin
arrow)
1-Diagnose this condition.
2- What is the significance of this condition?
• Dens in Dent or Dens Invaginatus.

• Accumulation of food leading to pulp

exposure and subsequent periapical
infection.
Case 21

A patient presented by
an accessory cusp on
the occlusal surface
between the buccal
and lingual cusps of
the premolar
1-Diagnose this condition.
2- What is the significance of this condition?
• Dens Evaginatus

• Malocclusion leading to attrition, pulp

exposure and subsequent periapical
infection.
 Case 22
Radiographic examination of a patient showed
maxillary and mandibular molar teeth exhibiting
increased pulpal apico-occlusal height with
apically positioned pulpal floor and bifurcation
1-Diagnose this condition.
2- What is the significance of this condition?
• Taurodontism

• Difficulty in obtaining a grip during the

extraction thus tooth may be crashed,
• Difficulty in locating root canals during
endodontic treatment which may lead to
periodontal problems.
 Case 23
This mandibular molar had an extra root which
appeared in radiographic examination, it exhibited
some difficulty on extraction
1-Diagnose this condition.
2- What is the significance of this condition?
• Supernumerary Roots

• It may be subjected to fracture

during extraction. If this root
remains in the jaw bone, it may act
as a focus of infection.
 Case 24

This tooth is
showing a
spherical enamel
projection at the
bifurcation area
Radiographic picture showing globule of enamel at the bifurcation
of buccal roots of maxillary second molar.
1-Diagnose this condition.
2- What is the nature of this condition?
● Enamel Pearl

● Ectopic condition (the presence of

normal tissue in abnormal site).
Case 25
A patient presented by abnormally shaped incisors
and first mandibular molars

The affected teeth showed enamel hypoplasia.

Another case showed the same clinical appearance of
the incisors but the first mandibular molars showed a
dome shaped constricted occlusal surface .
1-Diagnose this condition.
2-What is the cause of this condition?
3- Mention the characteristic name of the
central incisors and the first permanent
molars in both cases.
Dental Stigmata of Congenital Syphilis
 Case 26
A patient suffers
from the presence
of vertical pits and
grooves on the
enamel surface of
all his permanent
teeth. These pits
and grooves
acquired stains.
Parts of enamel
surface are lustrous.
1- Diagnose this condition.
2- Explain the pathogenesis of this condition.
• Amelogenesis Imperfecta or (Hereditary
Enamel Hypoplasia).

• It is a quantitative hereditary defect, the

teeth erupt with insufficient amount of
enamel (deficient matrix) but with normal
calcification, hardness and lustrous
surface.
Case 27
This patient suffers from dull colored dentition. His
teeth are friable and undergo attrition easily.
Periapical radiographs show the loss of enamel normal
radio-opacity. In which enamel and dentin show the
same radiodensity.
1- Diagnose this condition?
2- Explain the pathogenesis of this condition.
• Amelogenesis Imperfecta or (Hereditary Enamel
Hypocalcification).

• It is a hereditary condition, the teeth are soft and

dull opaque due to deficient mineralization (a
qualitative defect). Enamel matrix is normal but
the enamel show rapid attrition due to decreased
mineralization.
 Case 28

These patients show

enamel defect affecting
a single permanent tooth
1- Diagnose this condition?
2- What is the possible causes of this condition?
Turner's Hypoplasia or (Localized
Acquired Enamel Hypoplasia).
 Case 29

These patients show horizontal enamel defects

involving the upper and lower incisors only.
Diagnose this condition.
Acquired Enamel Hypoplasia
Case 30

These patients show variable degrees of enamel

defects. They mentioned that they live in the
desert.
1-Diagnose this condition.
2-Explain the pathogenesis of this condition
• Dental Fluorosis or Mottled Enamel.

• The intake of fluoride more than 1.5 part per

million during the time of teeth formation,
causes toxic effect on formative cells
(ameloblasts) which causes acquired enamel
hypoplasia.
• It is generalized (affecting all teeth).
Case 31
These patients show discoloration of some of their
teeth, which ranges from yellow to dark brown.
They mentioned that they all had the same antibiotic
while they were children.
1-Diagnose this condition.
2-Explain the pathogenesis of this condition.
• Tetracyclin Pigmentation.

• Tetracyclin acts as a chelating agent which

binds to calcium causing its precipitation in
inceremental lines. Under ultraviolet light it
shows fluorescence.
 Case 32
A male patient showed small, bulbous and
brownish crowns with distinctive translucence
affecting the whole dentition
Gradually these discolored teeth undergone
attrition till reaching gum line. The patient
mentioned a familial background.
The radiographs showed bulbous crowns,
obliteration of root canals and stunted
roots.
1- Diagnose this condition.
Dentinogenesis Imperfecta Type Two
2- If this patient showed a blue sclera and
increased liability to bone fractures.
What will be the diagnosis?
Dentinogenesis Imperfecta Type One
(associated with Osteogenesis Imperfecta).
Case 33
Radiographic examination of a young patient
showed normal enamel layer, thin shell of dentin,
extremely large pulp chamber and short roots
The histopathological examination showed thin
shell of dentin and extremely large pulp chamber
Diagnose this condition.
Dentiogenesis Imperfecta Type III
(Shell Tooth)
Case 34
A patient showed teeth with normal shape &
color, but they are loose and exfoliated
prematurely. Radiographic examination showed
extremely short pointed roots with periapical
infections.
Pulps are obliterated by pulp stones
Diagnose this condition.
Dentine Dysplasia
(Rootless Teeth)
Case 35

A child presented with unilateral loss of her teeth

Periapical radiographs show
teeth with very thin enamel
and dentine and wide pulp
chambers.
1- Diagnose this condition.
2-What is name of the characteristic
radiographic appearance?
Regional Odontodysplasia