牙发育异常 - 上海交通大学医学院精品课程.ppt

非龋性疾病 non carious disease 牙发育异常 (developmental abnormality of teeth) 牙发育异常 developmental abnormality of teeth 主要内容 Summary 牙结构异常 Abnormalities of histodifferentiation 牙形态异常 Abnormalities of morphodifferentiation 牙数目异常 Disturbances in number of teeth 牙萌出异常 Disturbances in germination of teeth 牙结构异常 Abnormalities of histodifferentiation 釉质发育不全 enamel hypoplasia 氟牙症 dental fluorosis 四环素牙 tetracycline stained teeth 遗传性牙本质发育不全 hereditary dentinogenesis imperfecta 先天性梅毒牙 congenital syphilitic teeth 釉质发育不全  enamel hypoplasia 定义 definition 牙齿发育期间，由于全身疾患、营养障碍或乳牙的严重的根尖周感染所导致的釉质的结构异常。(enamel abnormalities of histodifferentiation result from systematic disease, nutrition deficiency or severe apical affection of deciduous dentition during teeth formation) 病因 Aetiology 营养障碍 nutrition deficiency 内分泌失调 incretion disorder 婴儿、母体疾病 infant maternal disease 局部因素 localized causes 婴儿、母体疾病 infant maternal disease 出生前 Prenatal 新生儿 Neonatal 婴儿 Postnatal 出生前 Prenatal 感染（infection)——风疹(rubella)、梅毒(syphilis) 母亲的代谢性疾病（maternal systemic disease) 新生儿 Neonatal 新生儿溶血性疾病（haemolytic disease of the newborn) 低钙血症 （hypocalcaemia) 早产儿/晚产儿（premature birth/prolonged labour) 婴儿 Postnatal 感染——尤其是重症病毒感染（severe childhood infections especially the viral exanthemata) 慢性疾病——先天性心脏病、胃肠道疾病、内分泌疾病（chronic diseases in childhood,e.g. congenital heart disease, gastrointestinal and endocrine diseases) 营养不良——维生素D缺乏（nutritional deficiency, e.g. vitamin D) 肿瘤化疗（cancer chemotherapy) 氟中毒（excess fluoride ions) 局部因素 localized causes 感染（Infection) 创伤 （Trauma) 放疗 (Radiotherapy) 临床表现 clinical features 轻症 mild type 重症 severe type 轻症 mild type 釉质形态基本完整（smooth-surface enamel) 仅有色泽和透明度的改变 （white, opaque spots, brown-stained after eruption) 重症 severe type 带状(横沟状)缺陷 (horizontal grooves in the enamel surface) 窝状缺陷 （pits in the enamel surface) 釉质变薄 （general reduction in the thickness of the whole enamel) 对称发生 (symmetrical) 提示 Note 累及 631136 提示致病因素1岁以内 6321 1236（damage occur at age 1) 累及2 2 提示致病因素在出生后第