Developmental disturbances are common congenital malformations that can occur either as isolated findings or as part of a syndrome. Genetic causes have been identified for both isolated tooth malformations and for the dental anomalies seen in patients with craniofacial developmental abnormalities. Developmental disturbances of the teeth may manifest by variations in number, position, size, shape, eruption or structure. Here are descriptions of some of the anomalies:

Amelogenesis Imperfecta – It is a hereditary disorder affecting enamel. Both primary and permanent dentition gets affected, and there is hypomineralization, hypoplasia with discoloration, sensitivity, and fragility of the teeth.

Enamel Pearl – Synonyms include ectopic globules of enamel, droplets, globules, nodules, knots, or exostoses. Most commonly they are seen on root surfaces. It is a risk is a risk for localized deep periodontal pockets since it compromises the attachment of the periodontal ligament. 

Gemination – Condition where a single tooth bud divides into two separate entities. Here, two completely or incompletely separated crowns with a single root and root canal is seen.

Fusion – This anomaly results in the union of two normally separated tooth germs. Fused teeth can have separate or fused pulp spaces. This condition has a high risk for dental caries, periodontal disease, and spacing between teeth.

Concrescence – Rare anomaly where there is confluence of the cementum of two teeth at the root level but not the dentine. 

Taurodontism – Here the teeth is enlarged and the roots are small comparatively. The pulp chamber of this tooth is extremely large with a greater apico-occlusal height. 

Talon Cusp – It is a developmental anomaly in which an accessory cusp-like or tooth-like structure forms from the cingulum area.

Dilaceration - Sharp bend in the roots of the teeth is the characteristic finding in this anomaly. Possible etiologies of dilaceration are related to trauma and to disturbances during root develop. It is seen in both the permanent and deciduous dentitions, and it is more commonly found in the posterior teeth and in the maxilla. 

Dentinogenesis Imperfecta - Most common type of developmental anomaly of dentine. Dentitions are affected by an opalescent brown discoloration. There is reduced support of dentine and enamel is friable. Pulp can get obliterated here.

Palatogingival groove - Anomaly in the maxillary anterior teeth, often with a deep narrow periodontal pocket that communicates with the pulp causing endodontic-periodontal lesions.

Dens Invaginatus - invagination of the enamel organ into the dental papilla during morphodifferentiation, which results in a small tooth within the pulp chamber. Ohlers has classified this condition.

Dens Evaginatus - Most common in the mandibular premolars Clinically, it appears as an anomalous small tubercle or bulge on the occlusal surface.

Dentine Dysplasia - Clinically, the crowns of the affected teeth are normal in shape and color but sometimes slightly opalescent. Radiographically, the pulp chambers are obliterated and the roots are short, often with apical radiolucencies in the absence of caries.

Article by Dr. Siri P. B.