Enamel Hypoplasia and Related Developmental Dental Anomalies

Enamel Hypoplasia and Related Developmental Dental Anomalies

Question 1. Classify enamel hypoplasia. Describe in detail about environmental factors causing enamel hypoplasia.

Answer.

Classification of Enamel Hypoplasia

• Mild: Presence of a few small grooves, pits, and fissures on enamel
• Moderate: Presence of rows of deep pits arranged horizontally over the surface.
• Severe: Portion of enamel may be absent

enamel hypoplasia

“Risk factors for developmental dental anomalies”

Question 2. Write a short note on hypodontia.

Answer. It is the developmental alteration in the number of teeth.

• Hypodontia denotes the lack of development of one or more teeth.
• Oligodontia is a type of hypodontia that indicates the lack of development of six or more teeth.

Etiology

• Genetic: Various syndromes are associated, such as hereditary ectodermal dysplasia, craniofacial dysostosis, etc.
• At present scenario is there towards some teeth.
• X­ray radiation causing damage to the developing tooth bud results in the absence of teeth.

“Enamel hypoplasia and prenatal health connection”

Clinical Features

• Hypodontia is very uncommon in deciduous dentition.
• When hypodontia is present, it frequently involves lateral incisors.
• In permanent dentition, third molars are more commonly affected, and after these, the second premolars and lateral incisors are absent.
• Hypodontia is also associated with microdontia.

Treatment

• Fixed prosthesis should be given to patient in the form of bridges.
• Removable partial dentures can also be given.

“Symptoms of enamel hypoplasia in teeth”

Question 3. Discuss in detail about etiology, clinical features, and treatment of cleft lip and palate. Add a note on the syndromes associated.

Answer.

Clinical Features

• It is seen more commonly in females as compared to males.
• A cleft is seen over the hard and soft palates, and it can also be seen in the cleft of the soft palate alone.
• Extension of cleft palate varies, i.e., it involves the uvula or soft palate; at times it extends over the complete palate, it also sometimes involves the alveolar ridge unilaterally or bilaterally.
• The patient feels difficulty in drinking and eating since liquid and food regurgitate through the nose.
• The patient has a problem with speaking.
• Upper lateral incisors of the patient are short or may be absent.
• Crossbite is present.

Treatment Of Cleft Lip And Cleft Palate

• Cleft palate is usually repaired in 12–l8 months. Early repair causes retarded maxillary growth. Late repair causes
  speech defect.
• Both soft and hard palates are repaired.
• Abnormal insertion of the tensor palati is released. Mucoperiosteal flaps are raised in the palate, which is sewn together.
• If maxillary hypoplasia is present, then osteotomy of the maxilla is done. Orthodontic teeth extraction and alignment of dentition are done.
• Regular examination of the ear, nose, and throat during the follow-up period, i.e,. postoperative speech therapy.
• Whenever complicated problems are present, a staged surgical procedure is done.
• Wardil-Kilner push back operation raising mucoperiosteum flaps based on greater palatine vessels.
• Hearing support is given using hearing aids if a defect is present; control of otitis media.
• Speech problems occur due to velopharyngeal incompetence; articulation problems also can occur. Speech therapy is given. It is corrected by pharyngoplasty, veloplasty, and speech devices.
• Dental problems like uneruption, unalignment are common. They should be corrected by a proper dental opinion, and reconstructive surgery.

“Signs of enamel hypoplasia in baby teeth”

Orthodontic management with alveolar bone graft, maxillary osteotomy is done in 8–11 years.

Syndromes Associated With Cleft Lip And Cleft Palate

There are multiple syndromes associated, but the most common syndrome associated is Pierre­Robin syndrome. This syndrome is characterized by cleft palate, micrognathia, and glossoptosis.
Other syndromes associated are as follows:

1. Goldenhar syndrome: Cleft palate, microstomia, hypoplastic zygomatic arch.

developmental dental anomalies

“Tests for diagnosing developmental dental anomalies”

• Marfan’s syndrome: Cleft palate, skeletal defects, ocular lens defect.
• Down syndrome: Cleft palate, tooth anomalies, fissured tongue, malocclusion.
• Patau syndrome: Cleft lip and cleft palate, polydactyly, and heart anomalies.
• Orofacial digital syndrome: Cleft lip, digital malformation, deformed facial features.
• Treacher-Collin syndrome: Cleft lip and cleft palate, facial deformities.
• Median cleft face syndrome: Cleft palate, nasal cleft, and frontonasal dysplasia.
• Otopalatodigital syndrome: Cleft palate, mandibular micrognathia, facial deformity.
• Blepharocheilodontic syndrome: Eye anomalies, cleft lip and palate, microdontia.