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1023 View 4 Comment In discuss Comments enabled In the category: Undefined

I have made a change to a morphologic abnormality 804000009|External hypertosis (morphologic abnormality), I added a new parent of "Neoplasm, benign (morphologic abnormality)". While looking through the impacts of this change I came across "Enamel spur" which has been modeled with "Osteophyte (morphologic abnormality)" which is a subtype of "804000009|External hypertosis (morphologic abnormality)".

My question is, what is the correct morphology for "Enamel spur"? Osteophyte doesn't seem correct, but maybe it is.

Contributors (4)

4 Comments

  1. Hi Penny,

    I am not sure I would consider an enamel spur a disorder.  Morphologic abnormality seems more accurate.  An enamel spur can be a contributing factor to a disorder such as periodontal disease but, in and of itself, it may pose no problem beyond the different shape.  AT least that has been my experience.

    At the same time, I do not think it belongs as an exostosis or an osteophyte, as it is enamel and not bone.  I do like the first three parents in your first clip from the browser and all of those are also disorders, so maybe that is where it needs to best be classified.

    Can I do anything further to assist you in this?  Benoit might want to weigh in on this one and I will lean on a couple of my oral pathology colleagues to see if they identify it differently than what I have presented to you.

     

  2. Having complete a priority task faster than expected, I ended up with a couple hours available to go over recent discussions of the Dentistry SIG on Confluence. Sadly this mostly served to convinced me I don't understand hierarchies in general and disorder and morphologic abnormality in particular. The good news it that probably means I should stay clear of the discussion of caries representation, for now.

    In relation to enamel spur my understanding is that is it a variation of the normal and that in plain English it would not be considered a disorder and that morphologic abnormality would be a better fit. The problem is I am not sure if that matters for SNOMED CT since as pointed out by Mark, all the parents of enamel spurs are in the disorder hierarchy.

    I agree with Mark that enamel spur should not be the child of exostosis of jaw. It is not made of bone and is not located on the jaw but on a structure that happens to be in the jaw. I am less definite on the associated morphology of osteophyte as I am as uncertain about SNOMED "attribute" as I am with hierarchies.

  3. Hi Penni,

     

    I would also say that enamel spur is not a disorder, more a clinical finding. However, as the parents Congenital anomaly of tooth (disorder), Developmental abnormality of tooth size and form (disorder) and Disorders of hard tissues of teeth (disorder) are all disorders I guess this is the logical place in the hierarchy. I think Exostosis of jaw (disorder) is incorrect as this relates to bony outgrowths of which an enamel spur is not.

     

    The following paper defines enamel pearls/enamel spurs quite nicely: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3981278/. I can’t see any morphological abnormality that would cover the developmental anomaly of enamel formation on the root surface and Osteophyte (morphologic abnormality) refers to bone so I believe is incorrect for this concept.

     

    The closest match would possibly be Developmental anomaly (morphologic abnormality) inferred from its parents Congenital anomaly of tooth (disorder) and Developmental abnormality of tooth size and form (disorder).

     

    Best wishes, Sarah