Tooth eruption


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Tooth eruption

  1. 1. Tooth EruptionEruption is the movement of the developing teeth through the bone and theoverlying mucosa of the jaws to appear in the oral cavity and reach the occlusalplane.OREruption is the axial movement of the tooth from its developmental position withinthe jaws to the functional position in the occlusion plane.Movements of teeth leading to eruption take place in three phases• Pre-eruptive phase• Eruptive phase• Functional phasePre-eruptive phase• The movements in preeruptive phase are the movements of the developingtooth before the root begins to form.• It consists of movements of the developing tooth within the alveolar process.• The tooth germs move outward and upward/downward with the increasinglength, width and height of the jaws.• Preeruptive movements involve bodily movement and eccentric movementof the developing tooth germ.• Bodily movement is the shift of the entire tooth germ.• Eccentric movement is the relative growth in one part of the tooth, leading toa change in the centre of the tooth germ.5
  2. 2. Eruptive phase (Pre-functional phase)• Eruptive phase begins when the root starts to form and ends when the toothreaches occlusal plane.• After initiation of root formation PDL also starts to develop.• PDL is remodelled continuously to accommodate the eruptive toothmovement.• The end of secretory phase of amelogenesis also coincides with the start ofthe eruptive phase.• During the eruptive phase the tooth germ undergoes intraosseous movementsand supraosseous movements.• The rate of supraosseous movements is a lot faster than the intraosseousmovements.• The tissue in front of an erupting primary tooth is different from that of apermanent tooth.• A strand of fibrous tissue containing the remnants of the dental lamina,know as gobernacular cord forms a pathway in advance of developingpermanent tooth.• During the eruptive stage the crown breaks the double layer epitheliumoverlying it and enters the oral cavity.• The eruption causes the tissue around it form the junctional epithelium andthe gingiva.• This phase is also called as prefunctional phase.Functional phase (Post-eruptive Phase)• The functional phase begins when the tooth reaches the occlusal plane andcontinues as long as the tooth remains in the oral cavity.• Movements in the early stages of this phase accommodates the growth ofroot and the jaws.• This phase is also called the post eruptive phase.Directions and Rates of Tooth Eruption• main direction is axial (i.e. long axis of the tooth)• also movement in other planes – resulting in tilting and drifting• eruption rates are greatest during times of crown emergence• rates will differ based on tooth type – balance between eruptive forces andresistive forceso permanent maxillary incisors – 1mm/montho mandibular second molars – 4.5 mm in 14 weekso permanent third molars – 1 mm in 3 monthso eruption rates can slow to 1 mm/6 months in crowded dentitions6
  3. 3. Mechanism of Tooth EruptionThere are many theories that explain the mechanism of tooth eruption;Vascularity• Vascularity plays an important role in tooth eruption• Sufficient blood supply to the tooth germ has proven to cause eruptive toothmovement• Localized hyperamia has shown to causes increased vascularity of theperiodontal tissue and also increased eruption of adjacent tooth.Pressure• Decreased pressure overlying a tooth and increased pressure around thetooth are major factors in tooth eruption.• When the root formation begins an eruption pathway develops overlying thetooth.• Remodelling of tissue around the developing tooth brings about an increasein pressure tooth which causes the tooth movement.Root Formation• Root formation causes an overall increase in the length of the tooth.• It produces enough force that leads to the resorption of bone.• However, this force in itself does not cause tooth movement.• Rootless teeth also erupt.Bone Remodelling• The selective resorption and formation of bone surrounding the tooth causeits movement.• This theory also explains the tooth movement during preeuptive phase.Dental Follicle• There is signalling between the reduced enamel epithelium and the dentalfollicle.• This signalling regulates the timing of eruption of teeth – known as ‘biologicclock’.Periodontal Ligament• The remodelling of PDL has also been considered as a factor for tootheruption.• The fibroblasts possess traction power that causes tooth movement.7
  4. 4. • The PDL helps lift the tooth to its occlusal plane during the supraosseousphase of eruption.8