Developmental Disorders Short Question And Answers

Oral Medicine Developmental Disorders Short Answers

Question 1. Causes of angular cheilitis.

Answer:

Causes of angular cheilitis

• Micro-organisms- Candida albicans, staphylococci, and streptococci
• Mechanical factors:
  • Overclosure of jaws in edentulous patients
  • Nutritional deficiency:
  • Due to Riboflavin
  • Folate deficiency
  • Iron deficiency
  • General protein deficiency
• Diseases of the skin:
  • Atopic dermatitis
  • Seborrhoeic dermatitis
• Other factors
  • Hypersalivation
  • Down’s syndrome
  • Large tongue
  • Presence of developmental sinus

Question 2. Concrescence.

Answer:

Concrescence

It is the union of the roots of two or more adjoining teeth due to the deposition of cementum

Etiology:

• Traumatic injury
• Crowding of teeth
• Hypercementosis

Concrescence Clinical Features:

• It is an acquired defect
• It occurs in both erupted or unerupted teeth
• There is no sex predilection
• Union or fusion does not occur between the enamel, dentin or pulp of the involved teeth
• The union mostly occurs between two teeth, however, there may be a union between more than two teeth
• Permanent maxillary molars are usually affected
• It can occur between the normal molar and supernumerary molar
• It rarely involves the deciduous dentition
• The condition is frequently seen in those areas of the dental arch where the roots of the neighboring teeth lie close to each other

Concrescence Significance:

• It may complicate extraction

Question 3. Taurodontism.

Answer:

Taurodontism

• It is a peculiar developmental condition in which the crown of the tooth is enlarged at the expense of its roots

Pathogenesis:

• It occurs due to failure of the Hertwig’s Epithelial root sheath to invaginate at the proper horizontal level

Taurodontism Clinical Features:

• It involves both the sex
• It commonly affects multi-rooted permanent molar teeth and sometimes premolar
• It rarely occurs in primary dentition
• It was relatively common in Neanderthal men
• The affected tooth exhibits an elongated pulp chamber with rudimentary roots
• The teeth are usually rectangular in shape with mini¬mum constriction at the cervical area
• The furcation area of the teeth is more apically placed
• The teeth often have greater apical-occlusal height
• Clinically the teeth exhibit certain morphological changes

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Taurodontism Associated Syndrome:

• Down’s syndrome
• Klinefelter syndrome
• Poly X syndrome

Taurodontism Treatment:

• No treatment required

Question 4. Four Causes of Macroglossia.

Answer:

• Congenital or developmental
  • Mongolism
  • Lingual thyroid
• Inflammatory
  • Syphilis
  • Ludwig’s angina
  • Typhoid
  • Tuberculosis
  • Infected wound
• Neoplasm
  • Neurofibromatosis
  • Lymphangioma
• Systemic
  • Pellagra
  • Down’s syndrome
  • Acromegaly
  • Uremia
  • Amyloidosis
  • Diabetes
  • Scurvy
  • Hurler’s syndrome

Question 5. Bald tongue/ Differential diagnosis of the bald tongue.

Answer:

• Congenital
  • Familial dysplasia
  • Epidermolysis bullosa
  • Endocrine candidiasis
• Developmental
  • Geographic tongue
  • Median rhomboid glossitis
  • Central papillary atrophy
• Chronic trauma
• Nutritional deficiency
  • Pellagra
  • Riboflavin
  • Conditional deficiency
• Medication
  • Antibiotic
  • Cancer chemotherapy
• Peripheral vascular disease
• Chronic candidiasis
• Tumor
  • Squamous cell carcinoma
  • Epidermoid carcinoma
• Miscellaneous
  • Diabetes mellitus
  • Oral submucous fibrosis

Question 6. Supernumerary teeth.

Answer:

Supernumerary teeth

• The presence of any extra tooth in the dental arch in addition to the normal series of teeth is called supernumer¬ary teet
• Mode of Formation:
  • It may develop either from an accessory tooth bud in the dental lamina
  • It may develop due to the splitting of regular normal tooth bud during the initial phase of odontogenesis

Supernumerary Teeth Clinical Features:

• It can occur in both the sex
• It may resemble the corresponding tooth
• However, most of the teeth exhibit a conical shape
• They may be either erupted or impacted

Supernumerary Teeth Types:

• Mesiodens- Located between two upper central incisors
• Distomolars- Located on the distal aspect of the regular molar teeth
• Paramolars- They are located either in the buccal or the lingual aspect of the normal molars
• Extra lateral incisors- they are more common in the maxillary arch

Supernumerary Teeth Significance:

• It may produce crowding or malocclusion
• They may cause cosmetic problems
• They may be directly or indirectly responsible for increased caries incidence and periodontal problems
• The dentigerous cyst may sometimes develop from an impacted supernumerary teeth

Supernumerary Teeth Treatment:

• They are mostly non-functional and they should be extracted
• Impacted supernumerary teeth should be removed surgically since they interfere with normal tooth alignment or can develop some pathology

Question 7. Dilaceration.

Answer:

Dilaceration

• It refers to an angulation or sharp bend or curve anywhere along the root portion of the tooth
• Pathogenesis
  • Trauma to partially calcified tooth germ may cause displacement of the hard calcified crown portion
  • It may occur as a result of continued root formation during curved or tortuous path
  • Idiopathic cause

Dilaceration Clinical Features:

• It may involve both the dentition
• There is no sex predilection
• It is observed at the coronal portion of the teeth

Dilaceration Treatment:

• Such teeth are extracted as they are prone to fracture

Question 8. Fordyce’s granules.

Answer:

Etiology:

• It is a developmental variation
• It is caused by an accumulation of sebaceous glands in the submucosal connective tissue

Fordyce’s granules Features:

• Multiple, small, white to yellow nodules
• Usually located on the Buccal mucosa, occasionally on the labial mucosa
• Commonly bilateral
• It is a painless and persistent lesion

Fordyce’s granules Treatment:

• No treatment is required

Question 9. Name papillae of the tongue.

Answer:

• Fungiform
  • They are round in shape
  • They are situated over the anterior surface of the tongue near the tip
  • The number of taste buds in each is moderate
• Filiform
  • They are small and conical in shape
  • They are situated over the dorsum of the tongue
  • They contain less number of taste buds
• Circumvalate papillae
  • They are large structures present on the posterior part of the tongue
  • They are many in number
  • They are arranged in the shape of’V’
  • They contain up to 100 tastebuds

Question 10. Natal teeth.

Answer:

Natal teeth

• They are the teeth that are present at the time of birth

Etiology:

• Hereditary- superior position of the tooth bud
• Hormonal influence

Natal Teeth Clinical Features:

• Teeth may appear conical or may be normal in size and shape
• They may be opaque or yellow-brownish in color
• They are hypermobile
• Teeth appear to be attached to a small mass of soft tissue
• There may be a danger of aspiration of the teeth
• Riga fede ulcer- develops on the ventral surface of the tongue due to sharp edges of the incisors
• It leads to interference with the proper suckling and feeding activities

Associated Syndromes:

• Ellis van Creveld syndrome

Natal Teeth Management:

• Extraction- to avoid interference with feeding activities
• Rounding of the sharp angles
• Retaining of the tooth- if it doesn’t create any problem

Question 11. Median rhomboid glossitis

Answer:

Median rhomboid glossitis

• It is an asymptomatic, elongated, erythematous patch of atrophic mucosa on the middorsal surface of the tongue

Median rhomboid glossitis Clinical Features:

• Age: it is seen in adults
• Sex: it is common in males

Site:

• Anterior to the foramen cecum and circumvallate papillae
• In the midline on the dorsum of the tongue
• It starts as a narrow mildly erythematous area located along the median fissure of the tongue
• The lesion is asymptomatic
• It enlarges slowly often remaining unnoticed by the patient
• The fully developed lesion appears as a diamond or lozenge-shaped area devoid of the papilla
• The color of the lesion varies from pale pink to bright red
• There is the presence of a white halo
• The surface is usually smooth, flat or slightly raised
• It is sometimes fissured or lobulated
• The lesion exhibits an erythematous and nodular hyperplasia
• Some patients may develop similar lesions over the midline of the palate
• It may cause slight soreness or burning sensation
• It may regress spontaneously

Median rhomboid glossitis Management:

• Antifungal and antiseptic agents are used during irrita¬tion

Question 12. Etiology of median rhomboid glossitis.

Answer:

• Developmental
  • Persistent tuberculum impar
• Fungal infection
  • Candida albicans is many times found in the lesion
• Metabolic
  • It is more common in diabetic patients than in nondiabetic patients

Question 13. Mesiodens.

Answer:

Mesiodens

• They are the most common type of supernumerary teeth
• It is located between the two maxillary central incisors

Mesiodens Mode Of Formation:

• It may develop either from an accessory tooth bud in the dental lamina
• It may develop due to the splitting of regular normal tooth bud during the initial phase of odontogenesis

Mesiodens Clinical Features:

• It can occur in both the sex
• It may resemble the corresponding tooth
• However, most of the teeth exhibit a conical shape
• They may be either erupted or impacted

Mesiodens Significance:

• It may produce crowding or malocclusion
• They may cause cosmetic problems
• They may be directly or indirectly responsible for increased caries incidence and periodontal problems
• The dentigerous cyst may sometimes develop from impacted supernumerary teeth

Mesiodens Treatment:

• They are mostly nonfunctional and they should be ex¬tracted
• Impacted supernumerary teeth should be removed surgically since they interfere with normal tooth alignment or can develop some pathology

Question 14. Black hairy tongue.

Answer:

Etiology:

• Formation of excess keratin causes elongation of the filiform papillae on the dorsal tongue
• May be infected with Candida albicans

Black hairy tongue Features:

• Elongation of the filiform papillae
• White to yellow in color
• Located on the posterior dorsal tongue
• Patients often have poor oral hygiene
• Patients may complain of bad taste

Black hairy tongue Treatment:

• Elimination of predisposing factors
• Cleaning the dorsal tongue with a soft toothbrush
• Treat Candidiasis if present

Question 15. Ankyloglossia.

Answer: Ankyloglossia

• It is a result of a short, tight, thick, lingual frenulum

Ankyloglossia Classification:

• Based on the anatomical appearance
  • Type 1: Frenulum attached to the tip of the tongue in front of the alveolar ridge in low lip sulcus
  • Type 2: Attaches 2-4 mm behind tongue tip and at-taches on the alveolar ridge
  • Type3: Attaches to mid-tongue and middle of the floor of the mouth, usually tighter and less elastic the tip of the tongue appears “heart-shaped”
  • Type 4: Attaches against the base of the tongue, is shiny and very inelastic
• Based on the distance of the insertion of the lingual frenum to the tip of the tongue
  • Normal: 16 mm
  • Class 1 [Mild]: 12-16 mm
  • Class 2 [Moderate]: -12 mm
  • Class 3[Severe]: 4- mm
  • Class 4 [Complete]: 0-4 mm

Ankyloglossia Significance:

• In majority of the cases, it resolves spontaneously
• They are asymptomatic
• It may lead to
  • Difficulty in breastfeeding, articulation problems
  • Gingival recession
  • Open bite
  • Abnormal facial development

Ankyloglossia Treatment:

• Frenectomy
• Frenuloplasty

Question 16. Angular cheilitis

Answer:

Etiology:

• It occurs at the angle of the mouth among persons having deep commissural folds secondary to the overclosure of the mouth
• It can occur among persons with lip-licking habits, den¬ture wearing or deficiency of riboflavin, vitamin Bn and folic acid

Angular cheilitis Clinical Features:

• The infection starts due to the colonization of fungi in the skin folds following the deposition of saliva due to re¬peated lip-licking
• Patients often have soreness, erythema, and Assuring at the corner of the mouth
• In some cases, it may extend over the adjacent skin sur¬faces

Question 17. Talon’s cusp.

Answer:

Talon’s cusp

• It is an anomalous projection from the lingual aspect of the maxillary and mandibular permanent incisors

Talon’s cusp Clinical Features:

• This anomalous cusp arises from the cingulum area of the tooth which extends to the incisal edge as a prominent T-shaped projection
• It is usually an asymptomatic condition
• In some cases, it may cause problems in esthetics
• It may be susceptible to caries
• It usually consists of normal-appearing enamel, dentin, and vital pulp tissue
• Occasionally lingual pits develop on either side of the talon’s cusp, where it joins the lingual surface of the tooth

Associated Syndrome:

• Rubinstein Taybi syndrome

Treatment:

• Restorative measures are carried out to prevent caries
• When it interferes with occlusion, it is corrected with endodontic or restorative treatment

Question 18. Neonatal teeth.

Answer:

Neonatal teeth

They are the teeth which are present within 30 days after the birth

Etiology:

• Hereditary- superior position of the tooth bud
• Hormonal influence

Neonatal Teeth Clinical Features:

• Teeth may appear conical or may be normal in size and shape
• They may be opaque or yellow-brownish in color
• They are hypermobile
• Teeth appear to be attached to a small mass of soft tissue
• There may be a danger of aspiration of the teeth
• Riga fede ulcer- develops on the ventral surface of the tongue due to sharp edges of the incisors
• It leads to interference with the proper suckling and feeding activities

Associated Syndromes:

• Ellis van Creveld syndrome

Neonatal Teeth Management:

• Extraction- to avoid interference with feeding activities
• Rounding of the sharp angles
• Retaining of the tooth- if it doesn’t create any problem

Question 19. Fissured Tongue.

Answer:

Synonyms:

• Scrotal tongue
• Lingua plicata

Etiology:

• Hereditary
• Aging
• Chronic trauma
• Vitamin deficiency

Fissured Tongue Features:

• It is seen in childhood
• It becomes prominent with age
• It exhibits multiple grooves or furrows of 2-6 mm depth
• It is of varied patterns on the dorsal surface
• Patients may rarely present with a burning sensation or soreness
• Food debris may get lodged into the furrows and cause irritation

Associated Syndromes:

• Melkersson-Rosenthal syndrome
• Down syndrome

Fissured Tongue Management:

• Advice the patient to use soft bristle brushes over the area
• To cleanse the fissures on a regular basis

Question 20. Actinic cheilitis.

Answer:

Actinic cheilitis

It is a pre-malignant squamous cell lesion resulting from long-term exposure to solar radiation

Actinic cheilitis Clinical Features:

• Site: commonly occurs over the lower lip
• Age and sex: common in adult males
• Features:
  • There may be redness and edema over the area
  • The lips become dry and scaly
  • Tiny bleeding spots are seen
  • Gradually the scales become thick and horny
  • Vertical Assuring and crusting occur
  • There is a blurring of the margins
  • Vesicles are formed which rupture to form superficial erosions
  • Warty nodules may form There is the possibility of malignant transformation

Actinic cheilitis Management:

• Topical fluorouracil
  • Applied in 5% cone. For three times daily for 10 days
• CO₂ snow: used to remove superficial lesions
• Vermillionectomy:
  • Vermillion borders are excised
• Laser ablation- to vaporize Vermillion
• Electrodesiccation- it leads to dehydration by the insertion of electrodes into the tissues.

Oral Medicine Developmental Disorders Viva Voce

1. Micrognathia of the maxilla is due to a deficiency in the pre-maxillary area
2. Ankyloglossia cause difficulty in articulation of 1, r, t, d,n, th, sh and z
3. Ghost teeth is due to defect in mineralization
4. Ghost teeth are seen in regional odontodysplasia
5. Shell teeth are seen in dentinogenesis imperfect
6. Permanent molars are most commonly affected by taurodontism
7. Torus mandibularis is commonly seen on the lingual surface of the mandible opposite to the premolar
8. Mesiodens is the most common supernumerary teeth
9. Deciduous mandibular second molar is the most common ankylosed teeth
10. Commonly missing teeth are
    • Primary – maxillary and mandibular lateral inci¬sors
    • Permanent – third molar
11. Bohn’s nodules are seen at the junction of the hard and soft palate
12. Epstein pearls are seen along the median raphe of the hard palate
13. Dental lamina cysts of new born are seen on alveolar ridges
14. False anodontia is due to multiple extracted teeth
15. Pseudo anodontia is due to multiple unerupted teeth
16. Infusion patient will be having one tooth less than normal
17. In germination, patient has one tooth extra of normal