RADIOGRAPHIC

INTERPRETATION
OF DENTAL ANOMALIES
DRG. SHANTY CHAIRANI

CHANGES IN NUMBER OF TEETH

ANODONTIA
Total anodontia: congenital absence of all
teeth
Partial anodontia (hypodontia,
oligodontia): congenital absence of one or
more teeth, usually a maxillary lateral
incisor or mandibular bicuspid or a third
molar tooth.

Total anodontia

Partial anodontia

SUPERNUMERARY TEETH

Teeth in excess of the normal number

Clinical Features:
90% in maxilla
Single or multiple, impacted or erupted
Mesiodens most common, paramolar,
distomolar
Numerous supernumerary teeth are found
in such developmental disturbances as
cleidocranial dysplasia, craniofacial
dysostosis, mandibulofacial dysostosis.

Supernumerary Teeth

Supernumerary Teeth

SUPERNUMERARY ROOTS
Extra roots; more than the expected
number.
Clinical Features: more common in
mandibular bicuspids and permanent
molars from either arch
Radiographic Features: not always
visible on a radiograph

Supernumerary Roots

CHANGES IN SIZE OF TEETH

MACRODONTIA

One or more teeth that are larger than normal.

Clinical Features:
Generalized - all of the teeth are affected
True generalized - all teeth in both arches larger
(pituitary gigantism)
Relative generalized - small jaw size relative to
the teeth makes teeth seem larger crowding of
teeth)
Localized - isolated teeth affected
Only occasionally found and is often associated
with hemifacial hypertrophy
Radiographic Feature: large tooth

Macrodontia

MICRODONTIA

One or more teeth that are smaller than normal.

Clinical Features:
Generalized - all of the teeth are affected
True generalized - all teeth in both arches
smaller (pituitary dwarfism)
Relative generalized - large jaw size relative
to the teeth makes teeth seem smaller;
space between teeth)
Localized - one or two teeth affected,
usually :maxillary lateral incisors (peg
laterals), maxillary third molars
Often conically shaped
Radiographic Feature: small tooth

Microdontia

CHANGES IN SHAPE OF TEETH

GEMINATION

Abnormally shaped crown that is extra wide due to the

development of two crowns from one tooth germ.
Radiographic Feature : a tooth with a single root canal
and either a large crown or two crown.

FUSION

An abnormally shaped tooth that may appear as an

extra wide crown, a normal crown with an extra root, or
other combinations resulting from the union of two
adjacent tooth germs by dentin during development.
Radiographic Feature : a tooth with two root canals and
either a large crown or two crowns.

Gemination

Fusion

CONCRESCENCE

Union of the roots of two or more normal teeth

caused by confluence of their cemental
surfaces.

DILACERATION

A sharp bend or angulation of the root portion

of a tooth.
Radiographic Features : abnormal angulation
anwhere along the length of the tooth

Concrescence

Dilaceration

ENAMEL PEALR (ENAMELOMA)

Ectopic nodular deposits of enamel that
primarily occur in the bifurcation or
trifurcation areas on the roots of molars.
Radiographic Feature : usually found near
the root furcations of single or multirooted
teetH

Enamel Pearl (Enameloma)

DENS INVAGINATUS (DENS IN DENTE)

Developmental anomaly in which a focal area of the crown

is folded inward (invaginated) for various distances.
When severe, this results in a conically shaped tooth with a
small surface opening (dens in dente) that quickly becomes
subject to caries, pulpitis, and periapical inflammation.
Clinical Features:
Rare in primary teeth
Most often permanent maxillary lateral incisors, central
incisors, proemolars, canines and molars
Lingual surface may have pits
Radiographic Features:
May resemble a tooth within a tooth
Enlargement of the root
Dilated invagination lined by enamel with the opening of
the invagination situated along the lateral aspect of the
root

Dens in Dente (Dens Invaginatus)

DENS EVAGINATUS
A developmental anomaly in which a focal
area of the crown projects outward and
produces what appears as an extra cusp or
an abnormal shape to existing cuspal
arrangements.
Radiographic Feature : an extension of a
dentin tubercle on the occlusal surface

TALON CUSP

A form of supernumerary cusp which arises

from the cingulum portion of the tooth and
extends to the incisal edge as a prominent
projection of enamel that imparts a T shape
Clinical Features:

Lingual of maxillary central incisors

Arises from the cingulum portion of the tooth and
imparts a T shape

Radiographic Feature: cusp contains a pulp

horn

Talon Cusp

TAURODONTIA

An anomalous form of teeth that is

characterized by a clinical and anatomic
crown of normal shape and size, an
elongated body, and short roots with a
longitudinally enlarged pulp chamber.

Radiographic

features :

The extension of the rectangular pulp

chamber into the elongated body of the
tooth.
The shortened roots and root canals.

Taurodontia

CHANGES IN STRUCTURE OF TEETH

AMELOGENESIS IMPERFECTA

A spectrum of hereditary defects in the function of

ameloblasts and the mineralization of enamel matrix
that results in teeth with multiple generalized
abnormalities affecting the enamel layer only.
Clinical Features:
Teeth vary in color from white opaque to yellow to
brown
All teeth are affected, smaller and pitted
Normal pulps and dentin but reduced enamel
Radiographic Features:
The squarish shape of the crown, the relatively
thin layer of enamel, the low or absent cusps, and
in some cases advanced abrasion.

Amelogenesis Imperfecta

ENAMEL HYPOPLASIA

A defect in tooth enamel that results in less

quantity of enamel than normal.
Etiology : local, systemic or genetic factors
Clinical Features:

Pits, grooves, lines or larger areas of missing enamel

surface
Reduction in enamel thickness
Possible occlusal distortion, aesthetic problems,
sensitivvity
Yelllowish or brownish discoloration
May be localized or present on numerous teeth and all
or part of the surfaces of each affected tooth may be
involved

Radiographic Feature : thin enamel

Enamel Hypoplasia

TURNERS TOOTH
Enamel hypoplasia of a single tooth, most
commonly one of the permanent maxillary
incisors or a maxillary or mandibular
premolar, resulting from local infection or
trauma.

DENTINOGENESIS IMPERFECTA

A hereditary defect consisting of opalescent

teeth composed of irregularly formed and
undermineralized dentin that obliterates the
coronal and root pulpal chambers.
Clinical Features:

Opalescent teeth, undermineralized dentin

Tooth fractures and chips away easily leads to
exposed dentin and functional attrition

Radiographic Features:

Bulb-shaped crowns with constricted CEJ and

thin roots
Multilocular
May exhibit extremely large pulpal chambers;
obliterated

Dentinogenesis Imperfecta

DENTIN DYSPLASIA (ROOTLESS TOOTH)

A hereditary defect in dentin formation in which

the coronal dentin and tooth color is normal; the
root dentin is abnormal with a gnarled pattern
and associated shortened and tapered roots.
Clinical Features:
Normal eruption pattern
Bluish in cervical region
Types

Type I radicular dysplasia

Normal crowns of regular or slightly amber
translucency
Tendency toward complete obliteration of pulp
cavities
Abnormal spaces between the teeth,
malignment, malpositon and severe mobility

Type II coronal dysplasia

Semi-transparent opalescent primary teeth
Normal appearance in the permanent teeth
Incomplete obliteration of pulp cavities
Pulp stones

Radiographic Features:

Type I radicular dysplasia

Extremely short roots

Obliterated pulp chambers and root canals before
eruption
Periapical radiolucencies around the defective roots

Type II coronal dysplasia

Complete obliteration of pulp chambers and root

canals after eruption
Pulp stones
Absence of periapical radiolucencies

Dentin Dysplasia (Rootless Tooth)

REGIONAL ODONTODYSPLASIA (GHOST TEETH)

A developmental disturbance of several adjacent teeth

in which the enamel and dentin are thin and irregular
and fail to adequately mineralize; surrounding soft
tissue is hyperplastic and contains focal accumulations
of spherical calcifications and odontogenic rests.

Clinical Features:

Not adequately mineralized; enamel and dentin are

soft, thin and irregular
Associated with vascular nevi
Usually unilateral
Irregular surface contour with pitting and grooves on
small teeth, yellowish leathery brown in color
Affects teeth sequentially in one or two quadrants,
affects both the primary and permanent dentitions,
any tooth, maxilla anterior most common

 Radiographic

Features:

Much less radiodensity

Thin layers of enamel and dentin
Indistinguishable CEJ
Faint, fuzzy outline
Ghost Teeth appearance
Enlarged pulp chamber, enlarged canals
and wide open apices
Short and stubby roots
Periapical abscess often present
Widened PDL

Regional Odontodysplasia (Ghost Teeth)

ANOMALIES OF ERUPTION TEETH

PREMATURE ERUPTION

Teeth present at birth (natal teeth) or shortly after

(neonatal teeth) ; eruption of permanent teeth
after premature loss of preceding deciduous
teeth.

DELAYED ERUPTION

Appearance of deciduous or permanent teeth

relative to the normal age range.
Radiographic Features:

Unerupted tooth
Usually severe dental crowding in the affected area

Delayed Eruption

IMPACTED TEETH

Teeth continue to form within bone but fail to

erupt into the oral cavity because of a physical
obstruction.
Radiographic Features:

Completely impacted are totally surrounded by

bone
Partially impacted tooth is partly in bone, partly in
soft tissue
Embedded teeth are individual teeth that fail to
erupt for no apparent reason (term not used
much)
Most common are mandibular and maxillary third
molars, maxillary cuspids and supernumerary
teeth.

Partial impaction

Complete impaction

REGRESSIVE CHANGES OF THE

DENTITION

ATRITION
Loss of tooth structure due to mechanical action
of mastication.
Clinical Features:

Older adults
Flattening of occlusal, incisal and proximal surfaces of
teeth

ABRASION
Abnormal loss of tooth structure due to nonmasticatory physical friction.
Clinical Features:

Loss of tooth structure at site of wear

Sensitivity possible

ABRASION
ATRITION

ROOT RESORPTION

Breakdown or destruction of root structure; loss

of root structure.
The apex of the tooth appears shortened or
blunted and irregularly shaped.

EXTERNAL RESORPTION

A loss of tooth structure that begins on the outer

surface and extends inward toward the pulp.
Radiographic Features :

An irregularity in the normal contour of the root.

May be uniform and may produce gradual blunting of
the root apex, or it may begin on the sides of the root

External Resorption

INTERNAL RESORPTION

A form of tooth loss that begins within the pulpal

chambers of intact teeth, destroying dentin as it
extends outward in a uniform pattern toward the
tooth surfaces.
Clinical Features:
Most are within the crown of the anterior incisors
and are idiopathic.
Usually asymptomatic, lesion first detected by
appearance of a pink spot beneath the enamel
surface
Radiographic Features : Fusiform enlargement of the
pulpal chamber of one or more teeth that appears in
either the crown or root pulpal chambers

Internal Resorption

PULP STONE

Sperical calcification within the dental pulp lying

free or attached to the pulpal surface of the
tooth.
Radiographic Features : radiopaque
enlargements within the pulp chamber or canal

HYPERCEMENTOSIS

Excessive deposit of cementum on root surface.

Clinical Features:

Clinically undetectable
Predonimantly adults

Radiographic Features:

Root may have a larger circumference

than the upper portion,
bulbous or pear-shaped
Most frequently premolar teeth