summerized tooth eruption_1

Introduction

  • Presented by: Katayoun Saalem, Department of Pediatric Dentistry

Page 1

  • In the name of God

Page 2

Topic Overview

  • Focus on tooth eruption and what to expect in children.

Page 3

Title

  • Tooth Eruption by Katayoun Saalem

Page 4

References

  • McDonald 2021, Chapter 20

  • Nowak 2019, Chapter 3

Page 5

Lesson Plan for First Session

  • Describe eruption mechanisms

  • Familiarity with teething and difficult eruption

  • Understand failure of eruption

Page 6

Definition of Tooth Eruption

  • Movement of teeth from their formation site in the alveolar process to their functional position in the oral cavity.

Page 7

Eruption Mechanism

  • Eruption begins with root formation.

  • Initial thought on eruption stages based on Demerjian's Stage E.

Page 8

Timing of Eruption

  • Permanent teeth eruption timing varies by type of tooth.

Page 9-12

Timing of Permanent Teeth Eruption

  • Central Incisor: 7-8 years

  • Lateral Incisor: 8-9 years

  • Cuspid: 11-12 years

  • First Premolar: 10-11 years

  • Second Premolar: 10-12 years

  • Upper Dental Arch

  • First Molar: 6-7 years

  • Second Molar: 12-13 years

Page 13

Maxillary Eruption Timings

  • First Premolar: 10-11 years

  • Second Premolar: 10-12 years

Page 14

Effect of Premature Loss of Primary Molars on Eruption

  1. Early loss (4-5 yrs) delays eruption of premolars.

  2. Loss after age 5 decreases delay in eruption.

  3. Extraction at ages 8-10 accelerates premolar eruption.

Page 15

Eruption Timing of Primary Teeth

  • New findings indicate earlier initial calcification and later eruption of primary teeth than previously accepted.

  • Eruption timing is now recognized as 2 months later than before.

Page 16

Baby Tooth Development Chart

Teeth Location

Eruption

Shedding

Central Incisor

8-12 months

6-7 years

Lateral Incisor

9-13 months

7-8 years

Canine

16-22 months

10-12 years

First Molar

13-19 months

9-11 years

Second Molar

25-33 months

10-12 years

Page 17

Normal Variations in Eruption

  • Variations of up to 6 months on either side of average eruption date are normal.

Page 18

Eruption Timing Considerations

  • Left-right-side eruption should not deviate by more than 2-4 months.

Page 19

Boys vs. Girls in Lower Permanent Tooth Development

  • Girls advance earlier than boys in crown completion and particularly in root development, notably in mandibular canines.

Page 20-21

Theories of Tooth Eruption

  • Eruption is a complex process regulated by various cells and signals from dental and alveolar structures.

Page 22

Signaling Pathways in Tooth Development

  • Involves the interaction of dental follicle and alveolar bone through various signaling molecules.

Page 23-25

Paracrine Signaling Pathway

  • Interaction between dental follicle and adjacent tissues involving various growth factors for effective eruption.

Page 26

Overview of Tooth Eruption Process

  • Involves recruitment of mononuclear cells into the dental follicle for osteoclastic activity to create an eruption pathway.

Page 27

Theories of Eruption

  1. Root elongation

  2. Vascular tissue forces

  3. Alveolar bone growth

  4. Dentin growth

  5. Periodontal membrane influence

  6. Hormonal factors

  7. Viable dental follicle presence

  8. Muscular action pressure

  9. Alveolar crest resorption

Page 28-30

Eruption Process Stages

  • Pre-emergent Stage: Begins with root formation, requiring a cleared path.

  • Includes resorption of alveolar bone, allowing dental movement.

Page 31

Eruption Canal

  • Offers guidance to the tooth during eruption, facilitates its positioning within the jaw.

Page 32-34

Timing of Tooth Emergence

  • Emerges closer to the root formation stage, with significant root formation occurring by clinical emergence.

Page 35

Tooth Emergence Movement

  • Teeth can reach occlusion before root development is complete, emphasizing intraosseous and supracrestal tooth movements.

Page 36-37

Influencing Eruption Path

  • Determined by genetic and local factors including crowding.

Page 38

Duration from Crown Completion to Full Occlusion

  • Takes approximately 5 years for permanent teeth.

Page 39-41

Resorption Mechanisms

  • Pressure from erupting teeth leads to differentiation and activation of osteoclasts and odontoclasts.

Page 42-43

Eruption Anomalies

  • Blocked Eruption Path: Caused by inadequate space or ankylosis.

  • Ectopic Eruption: Common in specific teeth like molars or incisors.

Page 44-47

Primary Failure of Eruption

  • Genetic Influence: Mutations in relevant genes affect the eruption pathway.

  • Teeth may remain unerupted and lead to open bite conditions.

Page 48-50

Management Strategies

  • Regular monitoring is essential; intervention if ankylosis is evident after careful evaluation.

Page 51-55

Lingual Eruption of Mandibular Permanent Incisors

  • Common and often self-correcting, requiring periodic observation.

Page 56-59

Teething and Difficult Eruption

  • Signs include increased saliva, irritability, and redness of gums.

  • Recommended management includes gentle massage and proper supervision during teething.

Page 60-64

Eruption Hematoma and Sequestrum

  • Occurs shortly before tooth eruption and typically resolves without intervention or may require minor surgical intervention.

Page 65-71

Natal and Neonatal Teeth

  • Rare conditions characterized by teeth present at birth or shortly after.

  • management focuses on maintaining teeth and preventing complications.

Page 72-73

Epstein Pearls, Bohn Nodules, and Dental Lamina Cysts

  • Normal mucosal findings in newborns requiring no treatment.

Page 74-78

Local Factors Affecting Eruption

  • Includes issues like ankylosis and eruption rhythm interruptions.

Page 79-82

Ankylosis Characteristics

  • Clinical and radiographic methods aid in diagnosing ankylosed teeth; may affect normal exfoliation and dental eruption.

Page 83-96

Management of Ankylosed Teeth

  • Early recognition is crucial.

  • Different strategies depend on the individual case, emphasizing monitoring versus active treatment.

Page 97-101

Factors Affecting Eruption in the Permanent Teeth

  • Examination of complications due to primary tooth ankylosis on permanent successors.

Page 102-104

Systemic Factors Related to Delayed Eruption

  • Includes genetic disorders and hormonal issues.

Page 105

Conclusion

  • Thank you for the attention!