Anomali Gigi

Dental Anomalydrg. Siska yumira1Pengetahuan umum anomali gigiAnomali KetidaknormalanAnomali gigi lebih sering dijumpai pada gigi permanen daripada decidui, RA>>RBDiagnosa anomali Klinis & RadiografisEtiologi :HerediterGangguan pd masa pertumbuhan dan perkembangan gigiGangguan metabolisme tubuh (sistemik)2Dibedakan berdasarkan :JumlahUkuranBentuk : Mahkota & AkarPosisi & ErupsiReaksi jejasDefect enamel, dentin, pulpa, cementumAnomali jumlah

Berkurang jumlahnya

Bertambah jumlahnyaSupernumerary teethSupplemental teethAnodontia oligodontia

hipodonsiaurutan gigi yg sering hilang :M3 RAI2 RAP2 RBI1/i1 RBSupernumerary : gigi yang memiliki bentuk anatomis yang tidak normal; kadang gigi ini berukuran lebih kecil dari normal.Pada gigi sulung dan permanenDpt terjadi px yg menderita syndrome cleidocranial dysplasia dan Gardners syndrome.90% di RAPaling sering I1 RA atau M3 RAMacamnya : Mesiodens, Paramolar, Distomolar / distodens, Peridens with Tuberkel.Mesiodens :Bentuk conus, berada di antara insisive central atau mesial dari kedua insisive 1 (midline mesiodens)

keabnormalan terjadi pd tahap inisiasi, faktor etiloginya herediter.

Erupsi > terlihat, Tidak erupsi > menyebabkan diastemamesiodens

Paramolar

distomolar

Anomali Ukuranmacrodontia

Microdontia*panah birupegshape

Anomali BentukAnomali- bentuk mahkota1. Gemination/skizodontia 1 benih membelah jd 2 decidui >> permanen, Sering pd I & PRo: Sal. Akar 1 gigi, mahkota tmpak trbelah spt 2 gigi2. Fusion / Synodontia / kembar dempet : 2 benih bersatudecidui >>permanen, RA > RBTbentuk tekanan saat pmbentukn akarRo : sal. Akar 2 gigi, mahkotanya menyatuFusion

Fusiongemination

gemination

Anomali - bentuk mahkota3. hutchinson triad a common pattern of presentation for congenital syphilis. It consists of: 1. Hutchinsons teeth : mengenai gigi insisive RA & RB decidui / permanenCiri : servical lebar, insisal sempit dengan notch pd incisal edge screwdriver2. Mulberry molars : gigi molar murbei pada Molar 1 permk. Oklusal dgn cusp spt buah murbei, banyak tuberkel kecil-kecil ganda.3. interstitial keratitisHutchinsons teeth & mulberry molar

Anomali bentuk mahkota4. Taurodontism5. Tubercle / cusp tambahanEnamel pearls (enameloma)Talon CuspDens evaginatusTuberculum intermediumTuberculum sextum

Taurodontism / taurodontiaukuran dan bentuk mahkota normal namun bentuk kamar pulpa memanjang (apico-occlusal), tidak mengecil pd CEJ dan akar memendek>>populasi Eskimo, indian america.Tidak tampak scr klinis harus dental RBisanya berkaitan dgn kondisi :Amelogenesis imperfectaTricho-dento-osseous syndromeKlinefelters syndrometaurodontism

Enamel pearl (enameloma) a condition of teeth where enamel is found on locations where enamel is not supposed to be, such as on a root surface di area furkasiMolar RA >> Molar RB

Talon cusptonjolan kecil enamel pd singulum gigi anterior RA / RB.Sering bertanduk pulpa

Dens evaginatusHasil pertumbuhan enamel organ ke bagian luar gigi.

Tuberculum intermedian : cups tambahan yg letaknya pd area antar cusp lingual (sering pd gigi molar RB)

Tuberculum sextum : cusp tambahan yg letaknya pd marginal ridge antar cusp distal dan cusp distolingual (sering pd M 1 RB - cusp ke-6).

Bukan Anomali SesungguhnyaInsisive atas berbentuk sekop kelainan biologis pada ras anatomi bagian palatal, cingulum dan marginal ridge yang menonjol membentuk seperti sekop. >>> ras Asian, Mongolian, Eskimo dan Indian Amerika. .

Anomali Bentuk AkarDilaceration : sudut 45 - lebih dr 90Flexion : < 90 atau memutarDens in Dente (Dens invaginatus)Concrescence : fusion akar (sementum)Segmented root : akar terpisah jd 2Dwarfed root : akar pendekHypercementosis : jar.sementrum >>>Akar tambahanDilaceration & FlexionDilaceration a severe bend in the long axis of the tooth.it located at the junction between the crown and the rootcan be as much as 90 degrees. usually results from trauma to the unfinished tooth when development is in progress. Flexion a deviation or bend restricted just to the root portion of the tooth the bend is less than 90 degrees. tmay be a result of trauma to the developing tooth.

Dilaceration & Flexion

hasil dari invaginasi permukaan enamel ke bagian dalam gigi. Invaginasi area cingulum (dens invaginatus), tepi insisal (dens in dente) mahkota atau pada akar selama perkembangan gigi.mrpkn keabnormalan gigi yg terjadi pada cap stagefaktor etiologiherediter.Sering : I2

Dens invaginatus/dens in dente

Dens in dente ( dens invaginatus)

Concrescenceakar dari dua atau lebih gigi baik gigi permanen maupun gigi desidui berfusi pada sementum.keabnormalan gigi terjadi pada tahap aposisi dan maturasi, etiologinya injuri traumatic atau gigi yang crowded.Biasanya gigi dengan akar concrescence akan kesulitan erupsi atau kadang gagalSering pada M2dan M3 RA juga antara gigi dan supernumeraryR : sulit membedakan concrescence dgn superimposedConcrescence

HypercementosisTerlihat secara radiografi seme ntum menebal di seluruh atau sebagian akar gigiBiasanya terkait dengan inflamasi periapikal, gigi yg tidak berkontakSecara umum, dapat menyertai kondisi :Pagets diseaseAcromegalyPituitary gigantism

Anomali posisi & erupsi Submerged teeth : retained deciduous toothTransposed teeth misplaced : Permanent teethAnkylosed teethRotasiEctopic eruptionEruption cystEruption hematomaImpacted teethANOMALI GIGIVestibular deflectionSupra & infra occlusionDiastemaMesiodistal shift of dentsOral inclinationAnomali karena jejashilangnya / berkurangnya struktur gigiANOMALI GIGIAnomali defect email, dentin, pulpa, cementumEmail : Enamel dysplasia : Environmental enamel hypoplasia, Localized enamel hypoplasia, AIDentin : DI, DD, Odonto DysplasiaPulpa : Resorption, CalsificationCementum : HypophostasiaANOMALI GIGIEnamel dysplasiaPekembangan enamel yg abnormalDisebut Enamel Hypoplasia ggn pd ameloblast ketika pembentukan enamel matrixDisebut Enamel hypocalcification ggn pd saat enamel matrix masakPenyebab enamel dysplasia : herediter, sistemik, ggn lokal (trauma, infeksi)Variasi warna : putih kuning coklatVariasi morfologi : berlubang, kasarEnvironmental enamel hypoplasiaNutritional deficiencies in Vitamin A, C, D, calcium and phosphorusSevere infections such as Rubella, Syphillis, and high feverNeurologic defects such as Cerebral palsy and Sturge-Weber SyndromePrematurity and birth injuriesRadiationFluorosis (excessive ingestion of fluoride)Tetracycline induced hypoplasia and discolorationEnvironmental enamel hypoplasia

Localized enamel hypoplasiaInfection of primary teeth affecting the developing permanent toothTrauma to primary tooth disturbing the permanent tooth budTurners teeth

Amelogenesis ImperfectaGroup of hereditary defects of enamel unassociated with any other generalized effectEntirely an ectodermal disturbanceIncidence = 1 in 14, 000 (Witkop, 1957)Both primary and permanent dentition affectedClassified into four major categories :Tipe I : Hypoplastic AITipe II : Hypomaturation AITipe III : Hypocalcified AITipe IV : Hypomaturation-hypoplastic with taurodontismType I : hypoplastic AIThis defect occurs during the histodifferentiation stage. Enamel is not formed to full thickness because ameloblasts fail to lay down sufficient matrix.

The resulting disorder may include a localized defect, localized pitting, or generalized dimunition of enamel formation.Affected teeth appear small with open contacts due to very thin or nonexistent enamel causing thermal sensitivity.

AI type IType II : Hypomaturation AIThis defect occurs during matrix apposition. Enamel is softer and chips from the underlying dentin. Enamel has a mottled brown-yellow-white color. Contact points present as enamel is of normal thickness. Radiographically enamel approaches the radiodensity of dentin.

AI type IIType III : Hypocalcified AIDefect occurs during the calcification stage. Most common type of amelogenesis imperfecta. Enamel is of normal thickness but soft, friable, and easily lost by attrition.Enamel appears dull, lustrous, honey colored and stains easily.

AI type IIIDentinogenesis imperfectaAn inherited dentin defect originating during the histodifferentiation stageFrequency of occurrence is 1: 8000Defect of predentin resulting in amorphic, disorganized and circumpulpal dentin

Klasifikasi DIShields Type I(associated with Osteogenesis Imperfecta)

Shields Type II (Hereditary Opalescent Dentin)

Shields Type III(Brandywine Type)Klasifikasi DIShields Type I (associated with Osteogenesis Imperfecta) - Inherited defect in collagen formation resulting in osteoporotic brittle bones. Primary teeth more affected than permanent teeth. Other features include periapical radiolucencies, bulbous crowns, obliteration of pulp chambers, root fractures and amber translucent tooth color.Shields Type II (Hereditary Opalescent Dentin) - Primary and permanent dentition are equally affected. Features are same as Shields Type I apart from Osteogenesis Imperfecta.Shields Type III (Brandywine Type) - Teeth have a shell-like appearance with bell-shaped crowns. Occurs exclusively in a isolated group in Maryland called Brandywine population.

DIDentin dysplasiaDentin dysplasia is a genetic disorder of teeth, commonly exhibiting an autosomal dominantinheritance. It is characterized by presence of normal enamel but atypical dentin with abnormal pulpal morphology. Cause: Dentin dysplasia is an inherited disorder.

Types of Dentin dysplasiaThere are two types: Type I is the radicular type, and Type II is the coronal type. With Type I , the roots of teeth are shorter than normal and the pulpchamber may be nearly gone. The pulp chamber is sometimes described as having a "crescent shaped" appearance. With Type II , the pulps are enlarged and are described as having a "thistle tube" appearance, in permanent dentition. In the deciduous dentition, coronal dentin dysplasia bears a resemblance to Dentinogenesis Imperfecta type II.

DD

ODONTODYSPLASIALocalized arrest in tooth development due to regional vascular developmental anomalyGhost-like appearance with short roots and shell-like crownsLarge diffusely calcified pulp chamber

Ghost teeth

Anomalies in cementum : HypophostasiaKadar serum alkaline phosphatase rendahOsteoporosis, bone fragilityGagal membentuk cementum yang mengarah pada premature loss insisive deciduihypophostasia

Unusual dentitionANOMALI GIGI

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