牙发育异常-上海交通大学医学院精品课程
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例外？ （exception)
特点：对称发生 (symmetrical)
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2年 （damage occur at age 2)
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)
非龋性疾病
non carious disease
牙发育异常
(developmental abnormality of teeth)
牙外伤
(injury of teeth)
牙体慢性损伤
（chronic injury of teeth)
牙本质过敏症
（dentine hypersensitivity)
牙发育异常
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)
developmental abnormality of teeth
主要内容
Summary
钟状期造釉器 (enamel organ in bell stage)
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
external enamel epithelium
dentine enamel
stellate reticulum
dental papilla
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)
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)
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)
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
釉质发育不良：釉质基质形成障碍(dyspoiesis of
enamel agenesis
enamel matrix)
Hale Waihona Puke Baidu
釉质实质缺损(with enamel loss)
釉质矿化不良：基质形成正常，但矿化不良
enamel hypocalcification
(hypomineralization)
釉质无实质缺损(without enamel loss)
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
病因（Aetiology)
釉质发育不全 （enamel hypoplasia)
✓ 累及754457 提示致病因素在2－3岁以后 754457 (damage occur at age 2-3)
特纳牙 Turner teeth
乳牙的感染、创伤导致恒牙的造釉细胞的损伤 （infection or trauma related to the deciduous predecessor resulting in damage to the ameloblasts of the permanent successor) 釉质呈黄色或棕色（yellowish or brownish pigmentation of the enamel) 表面凹陷、不规则(pits and irregularity of the surface) 牙冠小(the smaller crown than normal)
特点：对称发生 (symmetrical)
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2年 （damage occur at age 2)
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)
非龋性疾病
non carious disease
牙发育异常
(developmental abnormality of teeth)
牙外伤
(injury of teeth)
牙体慢性损伤
（chronic injury of teeth)
牙本质过敏症
（dentine hypersensitivity)
牙发育异常
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)
developmental abnormality of teeth
主要内容
Summary
钟状期造釉器 (enamel organ in bell stage)
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
external enamel epithelium
dentine enamel
stellate reticulum
dental papilla
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)
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)
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)
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
釉质发育不良：釉质基质形成障碍(dyspoiesis of
enamel agenesis
enamel matrix)
Hale Waihona Puke Baidu
釉质实质缺损(with enamel loss)
釉质矿化不良：基质形成正常，但矿化不良
enamel hypocalcification
(hypomineralization)
釉质无实质缺损(without enamel loss)
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
病因（Aetiology)
釉质发育不全 （enamel hypoplasia)
✓ 累及754457 提示致病因素在2－3岁以后 754457 (damage occur at age 2-3)
特纳牙 Turner teeth
乳牙的感染、创伤导致恒牙的造釉细胞的损伤 （infection or trauma related to the deciduous predecessor resulting in damage to the ameloblasts of the permanent successor) 釉质呈黄色或棕色（yellowish or brownish pigmentation of the enamel) 表面凹陷、不规则(pits and irregularity of the surface) 牙冠小(the smaller crown than normal)