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Dental Pathology Booklet Bachelor’s Degree in Dentistry Dental Pathology Booklet Queda rigurosamente prohibida, sin la autorización expresa de los titulares del Copyright, bajo las sanciones establecidas en las leyes, la reproducción parcial o total de esta obra por cualquier medio o procedimiento, comprendidos la reprografía y el tratamiento informático, y la distribución de ejemplares de ella mediante alquiler o préstamo públicos. Primera edición: 2020 ®UCAM - Universidad Católica San Antonio Servicio de Publicaciones. Vicerrectorado de Extensión Universitaria. Campus de los Jerónimos Nº 135 30107 Guadalupe - Murcia (España) ISBN: 978-84-18579-99-8 © Universidad Católica San Antonio, 2020 DENTAL PATHOLOGY Dr. José Manuel Granero Marín Dr. Raúl Jiménez Soto Dr. Diego Riera Álvarez Dr. Raúl Melendreras Ruíz Dr. Manuel Maíquez Gosálvez Dra. Carmen Marin Casero Dra. Mª Rosario Sánchez-Carreño López 1 A AUTHORS Dr. José Manuel Granero Marín Vice dean Bachelor´s Degree in Dentistry. Dental Pathology and Therapy I. Coordinating Professor. Dental Pathology and Therapy II. Coordinating Professor. Adhesive Aesthetic Dentistry. Coordinating Professor. Digital Dentistry and New Technologies. Coordinating Professor. UCAM Universidad Católica San Antonio de Murcia. Dr. Raúl Jiménez Soto Dental Pathology and Therapy I Professor (Spanish Degree) Prosthesis II Professor (Spanish Degree) Practicum I Professor (Spanish Degree) UCAM Universidad Católica San Antonio de Murcia. Dr. Diego Riera Álvarez Dental Pathology and Therapy I Professor (Spanish Degree) Practicum I Professor (Spanish Degree) UCAM Universidad Católica San Antonio de Murcia. Dr. Raúl Melendreras Ruiz Dental Pathology and Therapy I Professor (Spanish Degree) Preventive and Community Dentistry (Spanish Degree) UCAM Universidad Católica San Antonio de Murcia. Dr. Manuel Máiquez Gosálvez Dental Pathology and Therapy I Professor (Spanish Degree) Sport Dentistry (Spanish Degree) UCAM Universidad Católica San Antonio de Murcia. 2 Translated and interpreted by: Dra. Carmen Marin Casero Dental Pathology and Therapy I Professor (Bachelor´s Degree) Dental Radiology and Radioprotection Professor (Bachelor´s Degree) Ergonomics, Dental Materials and Instrumentation Professor (Bachelor´s Degree) Preventive and Community Dentistry (Bachelor´s Degree) Preventive and Community Dentistry (Spanish Degree) UCAM Universidad Católica San Antonio de Murcia. Dra. Mª Rosario Sánchez-Carreño López Dental Pathology and Therapy I Professor (Bachelor´s Degree) UCAM Universidad Católica San Antonio de Murcia. Cover photo | Dental Photo RAW © To our alumni 3 4 0 INDEX PART I. DENTAL PATHOLOGY OF EMBRYONIC ORIGIN Chapter 1. Anomalies of dental histodifferentiation. 1.1 Anomalies in the development of the enamel 22 1.1.1 Classification of enamel dysplasias 22 1.1.1.1 According to its histopathology 23 1.1.1.2 According to its location 23 1.1.1.3 According to its aetiology 23 1.1.2 Amelogenesis imperfecta 24 1.1.2.1 Etiopathogenesis 24 1.1.2.2 Classification 24 1.1.3 Environmental dysplasias of the enamel 26 1.1.3.1 Prevalence 26 1.1.3.2 Treatment 26 1.1.3.3 Aetiology 27 1.1.3.4 Degrees of involvement 28 1.2 Anomalies in the development of the dentine 29 1.2.1 Classification 29 1.2.2 Dentinogenesis imperfecta 30 1.2.2.1 Histopathology 30 1.2.2.2 Clinical manifestations 30 1.2.3 Dentinal Dysplasia 31 1.2.4 Alterations in the development of dentin associated with syndromes 32 1.3 Anomalies in the development of cement 32 1.3.1 Classification 32 1.3.1.1 According to its histopathology 32 1.3.1.2 According to its aetiology 33 1.4 Anomalies in the development of enamel and dentine 34 1.4.1 Dental dysplasia or odontodysplasia 34 1.4.1.1 Histopathology 34 1.4.1.2 Clinical manifestations 34 1.5 Anomalies in the development of dentine and cement 34 1.5.1 Rhizomelia 34 1.6 Anomalies in the development of enamel, dentine, and cement 34 5 1.6.1 Inherited epidermolysis bullosa 35 1.6.2 Congenital ichthyosis 35 Chapter 2. Anomalies of dental morphodifferentiation. 2.1 Number anomalies 37 2.1.1 Isolated agenesis or hypodontia 37 2.1.2 Oligodontia 37 2.1.2.1 Aetiology 37 2.1.3 Anodontia 38 2.1.4 Hyperdontia 38 2.1.4.1 Aetiology 38 2.1.4.2 Clinical manifestations 38 2.1.4.3 Treatment 39 2.2 Size anomalies 39 2.2.1 Microdontia 40 2.2.2 Macrodontia 40 2.3 Shape anomalies 41 2.3.1 Abnormalities of the complete dental shape 41 2.3.1.1 Conoid teeth 41 2.3.1.2 Taurodontism 41 2.3.1.3 Invaginated tooth “dens in dente” 41 2.3.1.4 Palato radicular groove 42 2.3.2 Anomalies of the crown shape 43 2.3.2.1 Accessory cusps 43 2.3.2.2 Evaginated tooth (dens evaginatus) 43 2.3.2.3 Hutchinson´s tooth and mulberry molar 43 2.3.2.4 Crown anomalies in incisors 44 2.3.3 Anomalies in root shape 44 2.3.3.1 Enamel pearls 44 2.3.3.2 Enamel spurs 44 2.3.3.3 Supernumerary roots 44 2.3.3.4 Reduction of the number of roots 44 2.3.3.5 Excessive angles 44 2.4 Anomalies due to union 44 2.4.1 Fused teeth 44 2.4.2 Gemination 44 2.4.3 Concrescence 45 2.4.3.1 True concrescence 45 2.4.3.2 Acquired concrescence 45 2.4.4 Coalescence 45 6 PART II DENTAL PATHOLOGY OF BIOLOGICAL ORIGIN Chapter 3. Dental discolourations. 3.1 Deposits 48 3.1.1 Dental plaque 49 3.1.2 Materia alba 49 3.1.3 Calculus 49 3.1.3.1 Supragingival calculus 50 3.1.3.2 Subgingival calculus 50 3.1.4 Dental pigments 50 3.1.4.1 Pigmentation caused by bacteria 50 3.1.4.2 Pigmentation caused by ingestion of coloured substances 51 3.2 Stains 52 3.2.1 Fluoride staining 52 3.2.2 Tetracycline staining 53 3.2.3 Staining of pulp origin 53 3.2.4 Iatrogenic staining 53 Chapter 4. Reactive growth of dental hard tissues. 4.1 Reactive processes of the dentine-pulp complex 56 4.1.1 Sclerotic dentine 57 4.1.1.1 Aetiology 57 4.1.1.2 Histopathology 58 4.1.1.3 Clinical manifestations 58 4.1.2 Tertiary dentine 59 4.1.2.1 Aetiology 60 4.1.2.2 Histopathology 60 4.1.2.3 Clinical manifestations 61 4.1.3 Osteoid tissue 61 4.1.4 Pulp calcifications, pulp stones or denticles 61 4.1.5 False pulp stones 62 4.1.5.1 Aetiology 62 4.1.5.2 Etiopathogenesis 62 4.1.5.3 Histopathology 62 4.1.5.4 Clinical manifestations 62 4.1.6 Diffuse pulp calcifications 62 4.1.6.1 Histopathology 63 4.1.6.2 Clinical manifestations 63 4.1.7 Calcific metamorphosis 63 4.1.7.1 Aetiology 63 4.1.7.2 Histopathology 63 4.1.7.3 Clinical manifestations 63 4.2 Reactive cementum processes 64 4.2.1 Cement growth by age: passive eruption 64 4.2.2 Hypercementosis 64 4.2.2.1 Clinical manifestations 64 4.2.2.2 Aetiology 65 4.2.2.3 Etiopathogenesis 65 4.2.2.4 Histopathology 65 7 4.2.2.5 Clinical manifestations 65 4.2.2.6 Treatment 66 4.2.3 Cementicles 66 4.2.3.1 Etiopathogenesis 66 4.2.3.2 Histopathology 66 4.2.3.3 Clinical manifestations 67 Chapter 5. Teeth consumption processes with physical and chemical origin. 5.1 Attrition 69 5.1.1 Etiopathogenesis 69 5.1.2 Clinical manifestations 70 5.1.3 Prevention and Treatment 71 5.2 Abfraction 71 5.2.1 Etiopathogenesis 71 5.2.2 Clinical manifestations 71 5.2.3 Treatment 72 5.3 Abrasion 72 5.3.1 Aetiology 72 5.3.2 Clinical manifestations 73 5.3.3 Histopathology 73 5.3.4 Prevention and Treatment 73 5.4 Erosion 74 5.4.1 Aetiology 74 5.4.2 Clinical manifestations 75 5.4.3 Prevention and treatment 76 Chapter 6. Cellular tooth consumptive processes with a cellular origin. 6.1 Internal root reabsorption 78 6.1.1 Aetiology 78 6.1.2 Histopathology 78 6.1.3 Clinical manifestations 79 6.1.4 Treatment 79 6.2 External root reabsorption 80 6.2.1 Aetiology 80 6.2.2 Histopathology 81 6.2.3 Clinical manifestations 81 6.2.4 Treatment 81 6.2.4.1 Treatment of pressure reabsorption 81 6.2.4.2 Treatment of inflammatory reabsorption 81 6.2.4.3 Replacement reabsorption treatment 82 6.2.4.4 Treatment of invasive cervical reabsorption 82 6.2.4.5 Treatment of idiopathic reabsorptions 82 6.3 Differential diagnosis between external and internal root reabsorption 82 8 PART III. DENTAL PATHOLOGY OF INFECTIOUS ORIGIN Chapter 7. Introduction to cariology. 7.1 History 86 7.2 Current concept and definition 87 7.3 Epidemiology 88 7.4 Aetiological factors 89 7.4.1 Microbiological factors 89 7.4.2 Diet related factors 90 7.4.3 Host related factors 90 7.4.4 Saliva related factors 91 7.4.5 Socio-demographic factors 91 7.4.6 Fisher-Owens diagram 91 7.5 Pathogenesis 92 7.6 Prevention and treatment 92 Chapter 8. Biofilms related to the aetiology of caries. 8.1 Biofilm 95 8.1.1 Biofilm formation 96 8.2 Dental plaque 97 8.3 Dental plaque microbiology 97 8.3.1 Streptococci 97 8.3.2 Lactobacillus 99 8.3.3 Actinomyces 99 8.3.4 Bifidobacterium 100 8.3.5 Prevotella 100 8.3.6 Veillonella 100 8.3.7 Plaque considerations 100 8.4 Dental plaque formation 100 8.5 Ecological determinants in the formation of dental plaque 102 8.5.1 Nutrients available for dental plaque 102 8.5.2 Oral hygiene 102 8.5.3 Shelter factor 103 9 Chapter 9.
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