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Dilaceration
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Dilaceration
Dilaceration is a developmental disturbance in shape of teeth. It refers to an angulation, or a sharp bend or curve, in the root or crown of a formed tooth. This disturbance is more likely to affect the maxillary incisors and occurs in permanent dentition. Although this may seem more of an aesthetics issue, an impacted maxillary incisor will cause issues related to occlusion, phonetics, mastication, and psychology on young patients.
The condition is thought to be due to trauma or possibly a delay in tooth eruption relative to bone remodeling gradients during the period in which tooth is forming. The result is that the position of the calcified portion of the tooth is changed and the remainder of the tooth is formed at an angle.
The curve or bend may occur anywhere along the length of the tooth, sometimes at the cervical portion, at other times midway along the root or even just at the apex of the root, depending upon the amount of root formed when the injury occurred.
Such an injury to a permanent tooth, resulting in dilaceration, often follows traumatic injury to the deciduous predecessor in which that tooth is driven apically into the jaw.
Pressure or pain in the jaw area can be associated with dilaceration. Checking in with a general dentist and an endodontist should be done if a patient feels these symptoms. Signs in radiographic imaging will indicate a bend in the tooth's root as opposed to a straight growth. Dilaceration of the crown, the top part of the teeth that we see when we smile, can be visually seen for diagnosis. Crown dilaceration will present itself as a tooth that is angled to face outward or inward. It will be a non axial displacement and more of a longitudinal displacement.
The etiology of dilaceration is not very commonly known. However, it is thought to be related to:
During the developmental stages, the permanent tooth germ, specifically of the maxillary incisor lies superior to the apex of the primary incisor. If there is damage to the primary incisor, this will cause an impact on the permanent incisor as well as there is only about a 3mm space of thickness between the primary and permanent teeth. In the human mouth, once the permanent teeth begin to develop, they remain underneath the primary teeth. Once they are ready to erupt they push upward eventually causing the primary teeth to fall out. There is essentially a small space between the permanent and primary teeth, roughly less than 3mm of spacing. If a young child is to experience trauma to the mouth, this can cause developmental disorders to the permanent tooth that is still developing and lying direction underneath it. The impact from the primary tooth will be transferred to the permanent tooth that may have its roots formed, thus causing a bend or curvature of the permanent tooth root. It is noted that rather than the force of the impact, the direction in which the impact occurs has a more significant effect on dilaceration formation. Cysts or tumors can cause dilaceration as well. As a tumor or cyst forms it may cause impaction on the growth and development of the permanent teeth as well. This may cause crown or root dilaceration as the tooth tries to grow around the cysts or tumor causing dramatic angulation. Similarly, patients present with supernumerary teeth, may have impacted the growth of underlying permanent teeth causing the abnormal root curvature growth. An ankylosed deciduous tooth will not allow for proper growth the permanent tooth. Thus, the tooth may look for another path to erupt. This may cause dilaceration of root or may potentially impact neighboring teeth causing dilaceration to those teeth.
Dilaceration can be diagnosed with a simple radiograph of the affected teeth. However, if the bends are more lingual or facially present, more advance imaging techniques may be necessary. In some cases a cone-bean CT scan may be useful to create a three dimensional view.
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Dilaceration
Dilaceration is a developmental disturbance in shape of teeth. It refers to an angulation, or a sharp bend or curve, in the root or crown of a formed tooth. This disturbance is more likely to affect the maxillary incisors and occurs in permanent dentition. Although this may seem more of an aesthetics issue, an impacted maxillary incisor will cause issues related to occlusion, phonetics, mastication, and psychology on young patients.
The condition is thought to be due to trauma or possibly a delay in tooth eruption relative to bone remodeling gradients during the period in which tooth is forming. The result is that the position of the calcified portion of the tooth is changed and the remainder of the tooth is formed at an angle.
The curve or bend may occur anywhere along the length of the tooth, sometimes at the cervical portion, at other times midway along the root or even just at the apex of the root, depending upon the amount of root formed when the injury occurred.
Such an injury to a permanent tooth, resulting in dilaceration, often follows traumatic injury to the deciduous predecessor in which that tooth is driven apically into the jaw.
Pressure or pain in the jaw area can be associated with dilaceration. Checking in with a general dentist and an endodontist should be done if a patient feels these symptoms. Signs in radiographic imaging will indicate a bend in the tooth's root as opposed to a straight growth. Dilaceration of the crown, the top part of the teeth that we see when we smile, can be visually seen for diagnosis. Crown dilaceration will present itself as a tooth that is angled to face outward or inward. It will be a non axial displacement and more of a longitudinal displacement.
The etiology of dilaceration is not very commonly known. However, it is thought to be related to:
During the developmental stages, the permanent tooth germ, specifically of the maxillary incisor lies superior to the apex of the primary incisor. If there is damage to the primary incisor, this will cause an impact on the permanent incisor as well as there is only about a 3mm space of thickness between the primary and permanent teeth. In the human mouth, once the permanent teeth begin to develop, they remain underneath the primary teeth. Once they are ready to erupt they push upward eventually causing the primary teeth to fall out. There is essentially a small space between the permanent and primary teeth, roughly less than 3mm of spacing. If a young child is to experience trauma to the mouth, this can cause developmental disorders to the permanent tooth that is still developing and lying direction underneath it. The impact from the primary tooth will be transferred to the permanent tooth that may have its roots formed, thus causing a bend or curvature of the permanent tooth root. It is noted that rather than the force of the impact, the direction in which the impact occurs has a more significant effect on dilaceration formation. Cysts or tumors can cause dilaceration as well. As a tumor or cyst forms it may cause impaction on the growth and development of the permanent teeth as well. This may cause crown or root dilaceration as the tooth tries to grow around the cysts or tumor causing dramatic angulation. Similarly, patients present with supernumerary teeth, may have impacted the growth of underlying permanent teeth causing the abnormal root curvature growth. An ankylosed deciduous tooth will not allow for proper growth the permanent tooth. Thus, the tooth may look for another path to erupt. This may cause dilaceration of root or may potentially impact neighboring teeth causing dilaceration to those teeth.
Dilaceration can be diagnosed with a simple radiograph of the affected teeth. However, if the bends are more lingual or facially present, more advance imaging techniques may be necessary. In some cases a cone-bean CT scan may be useful to create a three dimensional view.