Chapter 10 Dental Anomalies
In this section you will find one or more examples of the conditions listed in the learning objectives. When answering the questions, try first to identify the condition from memory. Most of these conditions are common. Because they can impact on patient management, these disorders are an important group. Of course, the order in which these entities are presented here will be scrambled. Okay, here we go!
CASE 10-4 Take a look at the lower 2nd molar.
CASE 10-9 The lower right lateral incisor of this hockey player was avulsed last year during practice. The tooth was cleaned and sealed with a retrograde amalgam and then reimplanted and splinted with 009 wire and composite for several months.
CASE 10-10 Take a look at the lateral incisor.
CASE 10-11 Several permanent teeth of this 23-year-old man “exfoliated” spontaneously. All of his remaining teeth look like this. Notice the relative lack of root formation, the pulp is completely obliterated, and the apical radiolucencies may develop as a result of periodontal inflammation.
CASE 10-14 This middle-aged man has a habit that causes a factitial injury to one of his teeth. Clinically the area on the distal of the 1st molar was hard and shiny and has been a definite “meat catch” for many years.
CASE 10-15 Study this radiograph carefully.
CASE 10-18 Gina is the youngest sibling among three others. Mom was a dental assistant before she married the boss (don’t laugh, Denyse was my dental assistant!). The appearance of this tiny spiked tooth provoked Mom to take the brood to the dental office to get a radiograph taken.
CASE 10-19 This patient is a healthy teenager.
CASE 10-20 This patient is a 6-year-old girl.
CASE 10-22 Believe it or not, this gentleman was 80 years old and had never been to the dentist. He was currently having a little discomfort because of the class 1 furcal involvement and a “meat catch” in the area. He would probably have ignored this but his favorite granddaughter was now a hygienist and insisted upon his dental visit.
CASE 10-26 This 26-year-old man has a couple of unesthetic lower anterior restorations. Note the periapical radiolucencies in the area and the shape of the pulp chambers of the incisors. Right there you have the unique features of this anomaly.
CASE 10-27 This 7-year-old boy is in for a check up.
CASE 10-28 This is a 20-year-old man. He complains he does not like the looks of one of his bottom front teeth. He has never had an extraction. Starting at the patient’s posterior right side (left side of the figure) we see the canine, a very wide incisor, the left central and lateral incisors, and the left canine.
CASE 10-29 This middle-aged white man has periodontal disease. The 1st premolar is restored with an older radiolucent composite for esthetics. The right lateral incisor is a dark yellowish brown color, and he wants something done about it.
CASE 10-30 This patient came in with a broken lower partial denture. He wears a complete upper denture, which he was very satisfied with. Because of this, he was wondering if he should get a complete lower denture. If so, this tooth would need to be extracted.
CASE 10-31 Just after the big Thanksgiving turkey meal, the mother of 6-year-old Julie noticed that Julie had not lost her 2nd front baby tooth. The tooth was not even loose at this point. “All she wants for Christmas is her two front teeth” quoted Julie’s mom to her hygienist several days later.
CASE 10-33 This patient is a 58-year-old man.
CASE 10-38 Here’s an interesting phenomenon. Follow these instructions carefully: Look at the posterior bitewing (A) and note the round, radiopaque structure (lower 1st molar). Before looking anywhere else, think about what this might be. Now look at the anterior bitewing (B) taken the same day. Presto! The thing you thought you saw has disappeared!