KELAINAN TUMBUH

KEMBANG GIGI

DRG IKA ANISYAH SpKGA

• Sejumlah kelainan gigi yang menyebabkan cacat pada
perkembangan gigi dapat disebabkan oleh faktor lokal,
keturunan/herediter, penyakit sistemik atau trauma.
• Steward dan Presscot mengelompokkan kelainan tersebut
dalam:
• Kelainan jumlah
• Hyperdontia
• Hipodontia
• Kelainan ukuran
• Microdontia
• Macrodontia
• Fusion
• Gemination
 • Kelainan bentuk
• Dens Evagenatus
• Dens Invaginatus
• Taurodontism
• Dilaserasi

• Kelainan struktur email

• Enamel hypoplasia
• Enamel hypocalcification
• Amelogenesis imperfecta
• Kelainan struktur dentin
• Dentinogenesis imperfecta
• Dentin dysplasia
• Regional odontodysplasia

• Kelainan struktur cementum

• Kelainan warna
 HYPERDONTIA
(SUPERNUMERARY TEETH)
• Disebut juga supernumerary teeth, yaitu jumlah gigi berlebih
dari yang seharusnya.
• Insidensi hyperdontia:
• Lebih banyak pada laki-laki daripada perempuan
• Lebih sering pada maxilla daripada mandibula.
• Lebih sering terjadi pada periode gigi tetap daripada gigi sulung.

• Beberapa gigi supernumerary adalah:

• Mesiodens: yaitu gigi berlebih yang erupsi pada palatal mid line.
• Paramolar: yaitu gigi berlebih yang terletak di regio molar maxilla
atau mandibula.
• Distomolar: yaitu gigi berlebih yang terletak di belakang molar ketiga.
• Secara morfologi gigi supernumerary
dikelompokkan dalam bentuk supplemental dan
rudimenter.
• Bentuk supplemental menyerupai bentuk gigi
• Bentuk rudimenter mengalami perubahan
bentuk dengan bentuk gigi konus dan tuberkulasi
(multicusp).
• Gigi supernumerary dapat mengganggu erupsi
gigi lain yang berdekatan sehingga
mengakibatkan impaksi atau ectopic.
 HYPODONTIA

• Oligodontia, Partial anodontia, or hypodontia is

the congenital absence of one or more teeth.
• Cause:
• Interferences such as radiation exposure or a
hereditary disturbance like ectodermal displaysia can
result in this rare condition.
• Treatment:
• Treatment for missing teeth depends on their location
in the mouth.
 ABNORMALITIES OF TOOTH SIZE
• CROWN SIZE:
• MACRODONTIA: Teeth which exceeds the normal range
of variations, maxillary incisors, mandibular incisors &
mand second premolar

• MICRODONTIA: Teeth smaller then the normal, may be

either of the usual form, or conical/peg shaped.
 1.PERUBAHAN UKURAN
a.Microdontia
b.Macrodontia

Microdontia

a.Microdontia
Etiologi : autosomal dominant inheritance = sifat kromosome yang diturunkan.
Klinis : ukuran lebih kecil dari normal,oleh karena pituitary dwarfism. Relative lebih
kecil juga bisa karena rahang besar.
Contoh : 1. Gigi I2 (peg lateral)
2. M3
3.supernumery
b.Macrodontia
Klinis : 1. Memang besar karena pituitary gigantism
2. relative besar oleh karena rahang kecil
3. gigi berdesakan
4. pola erupsi yang abnormal oleh karena kurang tepat
Contoh : -mandibula third molar , hemifacial hypertrophy
 2. PERUBAHAN BENTUK
a. Gemination
• Etiologi tidak diketahui diduga karena trauma
• Pathogenesis : fusi dari dua gigi berasal dari satu enamel organ.
• Klinis : dua mahkota satu root canal dilihat dari rontgen foto
b. Fusion
• Etiologi belum diketahui mungkin trauma
• Pathogenesis : bersatunya 2 benih gigi menjadi satu struktur gigi yang besar.
• Klinis : bisa mahkota daja atau mahkota dengan akar
• Catatan : tidak bisa dibedakan dengan germination

Gemination Fusion Fusion

• Fusion 
• Definition:
• Fusion is where two developing teeth merge into one
tooth.
  Cause:
• The phenomenon of tooth fusion arises through union
of two normally separated teeth, and depending upon
the stage of development of the teeth at the time of
union, it may be either complete or incomplete
fusion.  
• Treatment:
• There is a groove that runs
down the back of the tooth
that is prone to decay and
may necessitate a filling.
• Gemination 
• Definition:
• Gemination is where a developing tooth splits into
two separate teeth.
• Cause:
• The phenomenon of gemination arises when two
teeth develop from one tooth and, as a result, the
patient has a larger tooth but a normal number of
teeth overall, in contrast to fusion, where the patient
would appear to be missing one tooth.
• Treatment:       
• There is a groove that runs down
the back of the tooth that is
prone to decay and may
necessitate a filling.
• It can present a problem if they
do not fall out at the right time
and interfere with the eruption
of the permanent teeth.
• Dens Evaginatus
• Definition:
• Dens evaginatus, or DE, is a rare dental anomaly involving
an extra cusp or tubercle that protrudes from the tooth.
• Premolars are more likely to be affected than any other
tooth.
• Cause:
• The exact etiology of this condition is unknown, but is
thought to be a result of genetics or a disruption of the
tooth during formation.
Treatment:
• This condition requires monitoring as the tooth can lose its
blood and nerve supply as a result, and may need root canal
treatment.
• Talon cusp 
• Definition:
• A talon cusp is an extra cusp that resembles an eagle's talon
(a talon is the claw of a bird of prey). A talon cusp appears as
a projection from the cingulum of incisor teeth.
• They are found rarely in primary teeth.
• Cause:
• The exact etiology of this condition is unknown, but is
thought to be a result of   genetics or a disruption of the
tooth during formation.
• Treatment:
• Large talon cusps can interfere with occlusion; however,
grinding them down is a hazardous endeavor. Talon cusps
often contain a prominent pulp horn which is very
susceptible to exposure in the younger patient.
• This condition requires monitoring as the tooth can lose its
blood and nerve supply as a result, and may need root canal
treatment.
• Dens invaginatus/Dens in dente
•   Definition:
• Dens invaginatus or dens in dente, means tooth within
a tooth.  
• Cause:
• A developmental disturbance in tooth formation
resulting from invagination of the epithelium
associated with coronal development into the area
that was to be pulp space.
• Teeth most affected are maxillary lateral incisors.
• The malformation shows a broad spectrum of
morphologic variations and frequently results in early
pulp necrosis (death).
• Treatment:
• Root canal therapy may be difficult due to the complex
anatomy of the teeth.
• Taurodontism
• Definition:
• Taurodontism is a morphoanatomical change in the
shape of a tooth, which usually occurs in multirooted
teeth. An enlarged body and pulp chamber, as well as
apical displacement of the pulpal floor, are
characteristic features.
• The term means "bull like" teeth. On dental
radiograph, the involved tooth looks rectangular in
shape without apical taper. The pulp chamber is
extremely large and the furcation may be only a few
millimeters long at times.
• Cause:
• Conditions associated with
taurodontism:
• Oral-facial-digital Syndrome
• Amelogenesis Imperfecta-Type IV 
• Down Syndrome
• Treatment:
• Endodontic treatment of a taurodont
tooth is challenging, because it
requires special care in handling and
identifying the number of root canals.
 Disturbances in Formation

• Dilaceration 
Definition:
• 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.
 Hereditary Disturbances in
Structure or Formation
• Amelogenesis imperfecta 
• Definition:
• Amelogenesis imperfecta is an abnormal formation of the
enamel or external layer of teeth.  People afflicted with
amelogenesis imperfecta have teeth with abnormal color: yellow,
brown or grey. The teeth have a higher risk for dental cavities and
are hypersensitive to temperature changes. This disorder can afflict
any number of teeth.

• Cause:
• Enamel is composed mostly of mineral that is formed and regulated
by the proteins in it. Amelogenesis Imperfecta is due to the
malfunction of the proteins in the enamel.
• Treatment:
• Crowns are sometimes being
used to compensate for the
soft enamel.  Usually
stainless steel crowns are
used in children, which may
be replaced by porcelain once
they reach adulthood. In the
worst case scenario, the
teeth may have to be
extracted and implants or
dentures are required.
 Amelogenesis Imperfekta
Ada 3 bentuk dasar :
1.Hipoplastik
kerusakan pada pembentukan matriks enamel.
2. Hipokalsifikasi
kerusakan pada mineralisasi deposit matriks
enamel.
3. Hipomaturasi
gangguan perkembangan atau pematangan enamel
 Hipoplasia Enamel

 Gangguan pada enamel yang ditandai dengan tidak lengkap

atau tidak sempurnanya pembentukan enamel
Gambaran klinis :
• Terdapatnya groove, pit dan fisur yang kecil pada permukaan
enamel
• Pada keadaan yang lebih parah dijumpai adanya guratan
guratan pit yang dalam, tersusun secara horizontal pada
permukaan gigi.
• Berwarna putih kekuningan dan coklat, enamel berlubang
dan kasar.
Etiologi Hipoplasia Enamel
Faktor Umum
Faktor Lokal • Lingkungan,
1. Trauma • Prenatal : Sifilis kongenital
2. Infeksi (Hutchinson’s Teeth/Mulberry
Molar) Neonatal : Hipokalsemia
3. Radiasi Postnatal : Defisiensi vitamin
4. idiopatik atau fluor yang berlebihan
(Mottlet enamel).
• Herediter
HipoplasiaEnamel
Hipoplasia Enamel
Hipoplasia Enamel
 Hipokalsifikasi Enamel
Kerusakan pada mineralisasi deposit matriks enamel
secara kualitatif
 Kegagalan email mencapai jumlah yang mencukupi
sehingga gigi menjadi lebih lunak dan berwarna coklat
Gambaran Klinis :
• Terlihat seperti kapur
• Berwarna kuning-coklat
Hipokalsifikasi Enamel
• Dentinogenesis imperfecta (DI)
•  Definition:
• Dentinogenesis imperfecta (hereditary Opalescent
Dentin) is a genetic disorder of tooth development.
This condition causes teeth to be discolored (most
often a blue-gray or yellow-brown color) and
translucent. Teeth are also weaker than normal,
making them prone to rapid wear, breakage, and loss.
These problems can affect both primary (baby) teeth
and permanent teeth.
 Dentinogenesis Imperfekta

 Penyakit autosomal dominan

 Gambaran klinis :
• Pada anomali ini gigi berwarna biru keabu-abuan atau
translusen.
• Enamel cenderung terpisah dari dentin yang relatif lunak
dibanding enamel.
• Dentin tipis, enamel normal dan tanduk pulpa besar.
Dentinogenesis Imperfekta
 Dentin Displasia

Kelainan yang melibatkan sirkum pulpa dentin

dan morfologi akar, sehingga akar terlihat
pendek
 Etiologi: faktor herediter yang diturunkan
secara autosomal dominan.
 Dentin Displasia
Klasifikasi dentin displasia (menurut Shields) :
1. Dentin dysplasia tipe I atau radicular dentin dysplasia :
perkembangan gigi dengan mahkota yang normal baik
dari bentuk, matriks dan konsistennya tapi memiliki akar
yang pendek, konus dan konstriksi pada ujung apikalnya,
bisa mengenai gigi sulung dan permanen.
2.Dentin dysplasia tipe II atau coronal dentin dysplasia :
akar gigi terlihat normal tetapi terjadi perubahan warna
coklat keabu-abuan ditambah dengan terbentuknya
tanduk pulpa yang berbentuk seperti duri pada rongga
pulpa.
Dentin Displasia Tipe 1
Dentin Displasia Tipe 2
TERIMA KASIH