Jenis Kelainan

By:Zuhria Purnama
1513101010036
Supernumerary teeth
Definisi
Kelainan jumlah tumbuh kembang gigi

adanya satu atau lebih elemen gigi melebihi jumlah gigi yang normal

dapat terjadi pada gigi sulung maupun gigi tetap

terjadi pada tahap inisiasi dan proliferasi.

 Etiologi

1. Proliferasi sel yang berlebihan pada saat pembentukan benih gigi

Gigi yang terbentuk melebihi jumlah yang normal
2. Diturunkan dari orang tua (herediter)
3. Bagian dari sindroma tertentu cleft lip and cleft palate (sumbing
pada bibir dan langit-langit).
 Gambaran klinis
Supernumerary teeth memiliki bentuk yang sama atau berbeda dengan gigi normal
Bila berbeda bentuknya dapat konus (seperti kerucut), tuberculate (memiliki

banyak tonjol gigi), atau odontome (bentuknya tidak beraturan).

Lebih sering terjadi pada rahang atas dibandingkan rahang bawah.
Dapat terbentuk di berbagai bagian rahang:

a. Daerah antara gigi insisif 1 atas kanan dan kiri (mesiodens)

b. Sebelah gigi molar (para-molars)

c. Bagian paling belakang gigi molar terakhir (disto-molars)

d. sebelah gigi premolar (para-premolars).

Lebih sering terjadi pada gigi tetap dibandingkan gigi susu.
Contoh kasus

Gambar kiri : mesiodens pada rahang atas

Gambar kanan : paramolar pada rahang atas

Distomolar pada rahang atas
Dilaserasi
Dilaserasi
Dilaserasi merupakan suatu angulasi akar
yang abnormal terhadap aksis memanjang
dari mahkota gigi.
Umumnya deviasi angulasi terlihat sangat

tajam , hampir tegak lurus.

Etiologi: trauma merupakan salah satu

faktor penyebab sehingga mahkota

bergeser dan akar memutar atau bengkok
setelah terjadinya trauma.
Keadaan ini menimbulkan masalah pada

saat pencabutan gigi.

Midline Diastem
DEFINATION OF DIASTEMA
A space between adjacent teeth is called a
diastema.

DEFINATION OF MIDLINE DIASTEMA

Midline diastema refers to anterior midline
spacing between the two central incisors.

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 ETIOLOGY OF MIDLINE DIASTEMA

1. NORMAL DEVELOPING DENTITION

a) Physiologic median diastema/ ugly duckling
stage
b) Ethnic and familial
c) Imperfect fusion of midline of premaxilla

2. TOOTH MATERIAL DEFICIENCY

d) Microdontia
e) Macrognathia
f) Missing lateral
g) Peg laterals
h) Extracted tooth

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3. PHYSICAL IMPEDIMENT
a) Retained deciduous
b) Mesiodens
c) Abnormal labial frenum
d) Midline pathology
e) Deep bite

4. HABITS
f) Thumb sucking
g) Tongue thrusting
h) Frenum thrusting

5. ARTIFICIAL CAUSES
i) Rapid maxillary expansion
j) Milwaukee braces

6. RACIAL PREDISPOSITION

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1. NORMAL DEVELOPING DENTITION
a) Physiologic median diastema/ ugly duckling stage
It is a transient or self correcting malocclusion which is
seen in the maxillary incisor region between 8-9 years. It is
particularly seen during the eruption of the permanent
canines.
As the permanent canines erupt they displace the roots of
the lateral incisors mesially.
This causes a divergence of the crowns of the two central
incisors causing a midline spacing.
This was described by Broadbent as the ugly duckling stage
as children tend to look ugly during this phase of
development. So it also known as Broadbent phenomenon.
It is a self correcting anomaly.

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b) Ethnic and familial
Certain group of peoples, especially negroid groups
exhibit median diastema as an ethnic norm.
Median diastema is seen in some families also.

c) Imperfect fusion at the midline

Median diastema occurs due to imperfect fusion at
the midline of the premaxilla.
A V-shaped or W shaped osseous septum may be
associated with this condition.

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2. TOOTH MATERIAL DEFICIENCY
a) Microdontia
Microdontia refers to teeth that appear smaller in
size compared to normal.
In this case the jaw size is normal but the size of
the teeth is small which produces diastema
between the teeth.
Microdontia is most frequently seen in Downs
syndrome and ectodermal dysplasia.

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b) macrognathia
It is a developmental anomaly characterized by an
abnormal large jaw. In this case the size of the tooth is
normal but because of the increase in size of jaw, it
results in diastema.
c) Missing lateral.
Due to the missing lateral there will be tooth material-
arch discrepancy as a result there will be drifting of
adjacent teeth.
d) Extracted tooth
This also results in tooth material-arch discrepancy which
causes drifting of adjacent teeth.

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3. PHYSICAL IMPEDIMENT
a) Retained deciduous teeth.
This causes ectopic eruption of tooth and formation of median
diastema.

b) Mesiodens
Presence of an unerupted mesiodens between the two central
incisors also predispose to midline diastema.

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c) Abnormal labial frenum
The presence of a thick and fleshy labial frenum can cause
a midline diastema.This type of fibrous attachment can
prevent the two maxillary central incisors from
approximating each other.
d) Midline pathology
Soft tissues and hard tissue pathologies such as cysts,
tumors and odontomes may cause midline diastema.

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4. HABITS
a) Thumb sucking
Thumb sucking is defined as placement of the thumb or one
or more fingers in various depths into the mouth.
It can cause severe proclination of the maxillary anterior
teeth along with formation of diastema
b) Tongue thrusting
This is a condition in which the tongue makes contact with
any teeth anterior to the molars during swallowing.
It also causes proclination of anterior teeth along with
diastema and open bite.
c) Frenum thrusting
This habit is a self injurious habit.
If the maxillary incisors are slightly spaced apart, the child
may lock his labial frenum between these teeth and permit it
to remain in this position for several hours.

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5. ARTIFICIAL CAUSES/ IATROGENIC CAUSES
a) Rapid maxillary expansion
Originally rapid maxillary expansion at the mid palatal suture
was recommended to help meet this goal.
With rapid expansion at a rate of 0.5 to 1 mm/day 1 cm or
more of expansion is obtained in 2 to 3 weeks.
A space is created at the mid-palatal suture which is filled
initially by tissue fluids and hemorrhage, and the expansion is
highly unstable.
The opening of the mid-palatal suture is fan-shaped or
triangular with maximum opening at the incisor region and
gradually diminishing toward the posterior part of the palate.
As a result there is incisor separation and a midline diastema
is formed.
This diastema closes as a result of the trans-septal fibre
traction.
b) Milwaukee braces
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A, Bilateral constricted maxilla with upper midline shift; B, type
1 RME appliance in mouth;
C, end of expansion; D, correction of upper midline shift at end
of retention period.
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6. RACIAL PREDISPOSITION

The presence of midline spacing also has a racial and

familial background.
The negroid race shows the greatest incidence of midline
diastema.

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