III. DENTAL PROBLEMS

Because the teeth are a special organ, they are discussed separately. They are formed from the ectoderm.

DENTAL CHART = teeth & supporting structures

TOOTH NUMBERS M3 M2 M1 PM2 PM1 C I2 I1 I1 I2 C PM1 PM2 M1 M2 M3

Maxilla Rt. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Lft

Mandible Rt. 32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17 Lft

A. EXAMPLES OF DENTAL DISEASE

VIII. On four teeth in a single person there were dental pearls (enamelomas). These appeared as as round, firmly adherent enamel, located most commonly in or near the bifurcation or trifurcation of tooth roots, or on the root surface near the cemental enamel junction. They are benign and have no secondary complications.

IX. The mandible demonstrates moderately severe dental wear, alveolar resorption, antemortem loss of teeth #1, 16, and quite severe wear on the left mandibular head. The opposite side (not shown) had a normal head.

XV. The right lateral incisor tooth (#7) has come in horizontally, forcing the canine out of place. These is also dental wear of moderate degree and alveolar bone resorption.

XIX. On the mandible teeth there is moderately severe dental wear and attritrition. In addition there is severe wear on the left head of the mandible.

The right head was not available for comparison.

XXX. The mandible is completely edentulous and its bone is highly osteoporotic. The cortex is markedly thin.

XXXIV. On two teeth there were deposits on the roots. This was firmly adherent and resisted attempts at removal.

LVII. Dental wear of moderate degree is present, but no other obvious dental disease. An incidental finding are the cut marks on the mandible indicated by the arrow.

LXI. Malpositioned right central and lateral incisor teeth (#7, 8) has produced crowding of the anterior teeth. The sockets for the remaining teeth appear to be well formed and aligned.

XCIII. Dental disease in this skull includes: severe dental wear and attrition, caries in tooth #4, alveolar resorption, antemortem tooth loss of teeth number #1-3,13-16, abscesses in teeth number #1,2 and 15,16.

XCVI. The left central incisor tooth (#9) is mis-shaped and crowded, but in good alignment.

XCV. There is moderately severe wear on the right mandibular head. The left head is less worn, but is bifid. Dental wear on the teeth visible is moderate but no other dental disease is seen.

XCVI. The posterior mandibular teeth are fused on both sides.

XCVII. In this skull there is dental wear, alveolar resorption, loss of tooth #3, and an abscess involving the roots of teeth #3,2.

CCVIII. In this mandible there is wear and attrition of moderate degree, alveolar resorption, loss of teeth #19,30, abscesses in teeth #19,30, wear on the remaining mandibular head of moderate degree, and marked flaring of the right angle of the mandible.

CXXX. This mandible shows severe dental wear and attrition, alveolar resorption, and antemortem loss of teeth #17-19, 23-25, 30-32. There is quite severe wear on the mandibular heads, moreso on the left.

CXLVIII. In the skull of a young adult there is a malpositioned central incisor tooth (#8) in the maxilla. There is moderate dental wear and a faint palatine torus.

CLI. The right maxillary sinus viewed from the top shows a large antral-oral fistula from the oral cavity into the sinus. It is 7 x 7 mm and has a core of metaplastic bone extended into the sinus for 8 mm. This maxilla had a moderate amount of tooth wear, antemortem tooth loss, alveolar resorption and caries.

CLV. In a maxilla the left central incisor tooth is coming in rotated 90o on its long axis, and is mis-shaped. In addition, the skull base of a young child, with a small paracondyloid process (arrow) is shown. (see congenital and developmental processes)

CLXIII. In this maxilla there is a moderate amount of tooth wear and attrition, and a small torus palatinus.

CXCIV. In a mandible there is severe dental wear and attrition, alveolar resorption, abscesses in teeth #25,26, and severe osteoporosis of the mandible. The osteoporosis comes from loss of teeth.

CCXV. The mandible shows dental wear, alveolar resorption, and an abscess at the root of tooth #18.

CCXXIII. The mandible shows dental plaque of moderate degree.

CCLXXXV. In the left hemimandible there is a large absecess occupying the positions of teeth #17,18. There is also moderate dental wear.

CCVIII. In the maxilla there is severe wear and attrition, caries in tooth #14, and a large torus palatinus.

[15] Bone fragments from the right temporomandibular joint show wear patterns that suggest degenerative change. There is a moderate degree of wear on the tooth surfaces.

[16] The right temporomandibular joint shows wear patterns of moderate degree. There is also a mild degree of tooth wear.

[17] There is moderately severe wear and attrition on the remaining teeth, occlusal surface caries on #30, and wear on the temporomandibular joint surfaces bilaterally, more so on the right.

[73] The maxilla shown demonstrates severe dental wear, attrition, alveolar resorption and a large antral-oral fistula involving tooth #2,3,4,5 roots.

[77] The mandible shown has clefts in the heads and a moderate amount amount of wear. There is also dental wear and attrition of moderate degree (only partially visible in the photo). (see congenital diseases)

[81] In the mandible shown there is marked asymmetry of the ramus such that the left is 20mm shorter than the right. There is also a moderate degree of wear on the head. The teeth show moderate severe wear but no other dental disease. Unfortunately, the remainder of the skeleton was absent. See congenital diseases.

[90] The teeth in the left maxilla are moderately worn and there is a moderate amount of alveolar resorption. Within the maxillary sinus there are three openings for accessory sinuses.

[94] The heads of the mandible are worn, moderate on the right and severely on the left side. The visible teeth show moderately severe wear, but no other dental disease was apparent.

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