Etiology of Various Dental Developmental Anomalies -Review of Literature

Clinical Group Journal of Dental Problems and Solutions ISSN: 2394-8418 DOI CC By Monika Rohilla* Review Article PG Demonstrator, Department of Pedodontics, PGIDS Rohtak, India Etiology of Various Dental Dates: Received: 04 March, 2017; Accepted: 20 March, 2017; Published: 22 March, 2017 Developmental Anomalies -Review of *Corresponding author: Monika Rohilla, PG Demonstrator, Department of Pedodontics, Literature PGIDS Rohtak, India, Tel: 9466187868; E-mail: https://www.peertechz.com age of the patient, type of dentition, associated abnormalities etc. must be taken into consideration. Introduction Discussion The development of the tooth involves many complex The primitive oral cavity or stomodaeum is lined by biological processes, including epithelial- mesenchymal stratifi ed squamous epithelium called the oral ectoderm. The interactions, differentiation, morphogenesis, fi brillogenesis oral ectoderm contacts the endoderm of the foregut to form and mineralization. After 37 days of development, a continuous the buccopharyngeal membrane. At about the 27th day of band of thickened epithelium forms around the mouth in gestation this membrane ruptures and the primitive oral cavity presumptive upper and lower jaws from the fusion of separate establishes a connection with the foregut [5]. The primitive oral plates of thickened epithelium–primary epithelial band and band gives rise to two subdivisions, the vestibular lamina and gives rise to vestibular lamina and dental lamina [1]. dental lamina. The vestibule forms as a result of proliferation of the vestibular lamina into the ectomesenchyme (Figure 1). A series of factors infl uence the normal development of Within the dental lamina, continued and localized proliferative the occlusion, interfering with the correct alignment of teeth activity leads to the formation of a series of epithelial ingrowths and harmonic relationship with the adjacent and antagonistic into the ectomesenchyme at sites corresponding to the position elements [2]. The most spectacular period of development of the human body takes place in utero and during this period various disturbances may occur, producing changes which are congenital but not always inherited. The explanation for the tendency of the person to inherit certain features or characteristics from his parents is based upon the monumental principle observations of Mendel, who gave two principles on which the transmission of characteristics was based [3]. • Principle of dominance • Principle of segregation Developmental disturbances of the teeth may manifest by variations in number, position, size, shape, eruption or structure. Such disturbances may occur in association with some more generalized disorder or may occur independently [4]. General as well as local factors may operate to affect the form and structure of the teeth. It may be that only the form is altered or perhaps only the structure. In other instances both are disturbed. Such infl uences may begin either before or after birth, so that either deciduous or permanent teeth are involved. The treatment plan for the various congenital and hereditary disturbances depends upon the structural, functional and Figure 1: Outline of devolpment of tooth. Broken lines, known or suspected aesthetic requirements and the infl uencing factors such as the interactions that occur Between tissues. 019 Citation: Rohilla M (2017) Etiology of Various Dental Developmental Anomalies -Review of Literature. J Dent Probl Solut 4(2): 019-025. DOI: http://doi.org/10.17352/2394-8418.000042 of future deciduous teeth [5]. The dental lamina serves as the has a polygenetic inheritance pattern and the risk of relatives primordium for the ectodermal portion of the deciduous teeth. having hypodontia will depend upon a combination of numerous Later during the development of the jaws, the permanent genetic and environmental factors, each with a small effect [11]. molars arise directly from a distal extension of the dental lamina [1]. Table 1: Experimental and Clinical Causes of Congenital Development Anomalies. Genetic factors... Inherited Mutagenetic Polyfunctional alkalating agents Because of the complex nature of odontogenesis wherein 1. Infections - Rubella NH2, ThioTEPA cells undergo morphodifferentiation and histodifferentiation Infl uenza A CB1348, TEM Traizene and where the changes in one group of cells are dependent 2. Physical Quinine Injuries..... Pressure Pilocarpine upon another group of cells, there are many possibilities for Temperature changes Thallium disturbances in the development of teeth [5]. Both systemic Radiation Selenium and local conditions may affect the form and structure of the 3. Hormones ... Diabetes mellitus Nicotine Sulfonamides developing teeth (Table 1). In some instances only the gross Hyperthyroidism Hypothyroidism Tetracyclines appearance of the tooth is affected, the structure remaining ACTH Chloroquine normal; in others the structure itself is changed, or both form Cortisone Thalidomide Salicylates and structure may be involved [6,7]. Androgenes Estrogen Malachite green Abnormalities of anatomical form and histological structure 4. Nutrition........ Defi ciencies of – Vitamin A 7. Maternal diseases & include multiple teeth, hyperplasia or overdevelopment, Vitamin B complex Defects and hypoplasia or underdevelopment of the entire tooth and Vitamin D Uterine tumors Vitamin E Uterine infl ammation hypoplasia of part of the tooth, the crown or root. Dysplasia Vitamin K Defects in implantation of the dental structures includes colour changes, hypo plastic Proteins Age defects which result from defi ciencies, traumatic injury, Unsaturated fatty Emotional disturbances acids Stress pyogenic or specifi c infection of the developing teeth. The Potassium Multiple prgenancies deciduous teeth which develop in utero and not as frequently Excess of Vitamin A affected as are the permanent ones. However, heredity, 5. Respiration. Hypoxia congenitally transmitted diseases, malnutrition, and diseases Carbon dioxide excess affecting the mother during gestation may have their effects Carbon monoxide 8. Embryonic defects on the deciduous teeth [7]. The dental anomalies have been Anesthesia with Abnormalities of the ovum classifi ed according to the stage of development of tooth ether gas-oxygen Abnormalities of semen 6. Miscellaneous drugs and chemicals ... Antigen – antibody reactions germ and according to the number, morphology and size and Antimetabolites structure (Table 2) [8]. Aminopterin Amethopterin Disturbances during initiation of tooth germ Table 2: Classifi cation of developmental dental anomalies. Hypodontia: Hypodontia is the term used to describe the 1. According to number, 2. According to the stage of development of morophology and size and developmental absence of one or more primary or secondary tooth germ structure teeth, excluding the third molars (Figure 2). It is the most A) Disturbances during initiation of tooth germ A) Anomalies of tooth number i) Hypodontia common developmental dental anomaly and can be challenging i) Hypodontia ii) Hyperdontia ii) Hyperdontia to manage clinically. The term oligodontia is used to defi ne B) Disturbances during histodifferentation developmental absence of multiple teeth, usually associated and morophodifferentation of tooth B) Anomalies of tooth size and germ with systemic manifestations [9]. Total anodontia denotes morphology i. Microdontia i) Microdontia complete developmental absence of teeth in both dentitions ii. Macrodontia ii) Macrodontia [10]. The prevalence varies from 2.6% to 11.3% [9]. Hypodontia iii. Dens invaginatus iii) Dens invaginatus iv. Dens evaginatus in the primary dentition is less common with reported iv) Dens evaginatus v. Talon's cusp v) Talon's cusp prevalence rates varying between 0.5% to 2.4% [11]. vi. Taurodontism vi) Taurodontism vii. Fusion vii) Fusion Etiology: The etiology of hypodontia may arise as a familial viii. Gemination viii) Gemination ix. Concrescence condition; a high proportion of affected individuals are members ix) Conscrescence x. Dilaceration x) Dilacertioin of families with a previoushistory of the condition. The nature xi. Supernumerary Cusps and roots xi) Enamel Pearls of the inheritance is complex and not well understood [9]. It xii) Supernumerary Cusps C) Disturbances during apposition of hard has been regarded as a multifactorial condition with genetic and rotos tissues and environmental infl uences playing a role. Hypodontia is i) Amelogenesis imperfecta C) Anomalies of tooth structure also a common presenting feature in a number of systemic ii) Enamel hypoplasia i) Amelogenesis imperfecta iii) Dentinogenesis imperfecta conditions, such as ectodermal dysplasia, cleft lip and palate, ii) Enamel Hypopalasia iv) Dentin Dysplasia iii) Dentinogenesis vander wounde syndrome, down syndrome, incontinentia v) Regional Odontodysplasia imperfecta pigmenti, hyalinosis cutis et mucosae, mandibulo-oculo-facial vi) Cemental hypoplasia iv) Dentin Dysplasia vii) Hypercementoses dyscephaly [8,10,12,13]. v) Regional Odontodysplasia viii) Interglobular dentin vi) Cemental hypoplasia ix) Enamel Pearls Brook suggested that in the majority of cases hypodontia vii) Hypercementoses viii) Interglobular dentin 020 Citation: Rohilla M (2017) Etiology of Various Dental Developmental Anomalies -Review of Literature. J Dent Probl Solut 4(2): 019-025. DOI: http://doi.org/10.17352/2394-8418.000042 Recent advances in the fi elds of human genetics and molecular than normal teeth are present in jaws that are somewhat larger biology are providing

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