This document reviews delayed tooth eruption (DTE), including potential causes, clinical implications, investigations, and treatment approaches. DTE can be caused by local factors like physical obstructions, injuries, or arch length deficiencies, as well as systemic factors such as preterm birth, malnutrition, endocrine disorders, genetic syndromes, and medical treatments. Diagnosing DTE involves examining dental development stages, medical history, and radiographs. Treatment depends on the cause but may include removing obstructions, surgically exposing teeth, applying orthodontic traction, or treating underlying medical conditions.
1. The document describes the development of dentition and occlusion from the embryonic oral cavity to the permanent dentition in adults.
2. Key stages of tooth development include the dental lamina, enamel organ, bud stage, cap stage, and bell stage. The primary teeth erupt around 6-8 months and the permanent dentition begins emerging around age 6 with the first molars.
3. The mixed dentition period involves space management during the transition between primary and permanent teeth. The permanent dentition is usually complete by around 13 years of age.
The document provides guidance on a child's first dental visit. It recommends that the first visit should occur within 6 months of the eruption of the first primary tooth and no later than 12 months of age. The goals of the first visit are to familiarize the child with the dental environment, address parental anxiety, improve oral hygiene, provide preventative care and identify risks. It provides tips for making the dental office child-friendly and establishing trust with the child and parents. A thorough examination is conducted along with developing an individualized treatment plan focusing on prevention and gradual acclimation to care.
This document provides an overview of enamel hypoplasia, including its definition, classification, etiology, clinical features, radiographic features, and management. Enamel hypoplasia is defined as an incomplete or defective formation of the enamel matrix of teeth. It can be hereditary or environmental in origin. Common causes include nutritional deficiencies, infections like syphilis, and dental fluorosis from excess fluoride intake. Clinical features range from mild pitting to severe absence of enamel. Treatment depends on severity and location, and may include desensitizing agents, composite restoration, crowns, or extractions for severely malformed teeth.
This document provides a history of fluorides and their discovery and use in dentistry. It discusses how fluorine was first discovered in the 18th century and early observations of fluorides in teeth and bones in the 19th century. In the early 20th century, Dr. McKay first observed mottled enamel in children in Colorado and suspected it was related to fluoride levels in drinking water. Extensive surveys and studies over decades by McKay, Black, Dean and others confirmed high fluoride levels in endemic areas with mottled enamel. They established fluoride's role in preventing dental caries when consumed in optimal levels in drinking water.
This document provides an overview of early childhood caries (ECC), including definitions, classifications, prevalence, risk factors, management, and prevention. ECC is defined as the presence of one or more decayed, missing, or filled tooth surfaces in any primary tooth in a child under 6 years old. Key risk factors include dental plaque, mutans streptococci bacteria, frequent sugar consumption, and improper feeding practices like prolonged bottle use. Prevention strategies focus on educating parents and caregivers on promoting proper oral hygiene, healthy diets, and reducing transmission of cariogenic bacteria from mother to child.
This document discusses pericoronitis, which is inflammation of the gum tissue surrounding an incompletely erupted tooth, usually the lower wisdom tooth. It can be chronic or acute with intensified symptoms. The space under the gum flap provides an area for food debris and bacteria. Treatment involves pain management, cleaning the area, and antibiotics for severe cases. Surgically, the gum flap may be removed or the tooth extracted depending on its position and stage of eruption, as removal of the problem tooth is often the best approach to prevent future occurrences of pericoronitis.
gingiva and periodontal problems in childrenGarima Singh
This document provides an overview of gingival and periodontal diseases in children. It begins with an introduction stating that many periodontal diseases originate during childhood, so early detection and treatment are important. It then covers topics such as the normal periodontium in children, classifications of gingival diseases including gingivitis, acute gingival diseases like herpetic gingivostomatitis, and gingival enlargement. It also discusses periodontitis, specifically aggressive periodontitis which can occur in adolescents, as well as systemic diseases associated with periodontal problems. The conclusion emphasizes that early detection and treatment of periodontal issues in children can prevent more advanced diseases and also identify underlying systemic conditions.
1. The document describes the development of dentition and occlusion from the embryonic oral cavity to the permanent dentition in adults.
2. Key stages of tooth development include the dental lamina, enamel organ, bud stage, cap stage, and bell stage. The primary teeth erupt around 6-8 months and the permanent dentition begins emerging around age 6 with the first molars.
3. The mixed dentition period involves space management during the transition between primary and permanent teeth. The permanent dentition is usually complete by around 13 years of age.
The document provides guidance on a child's first dental visit. It recommends that the first visit should occur within 6 months of the eruption of the first primary tooth and no later than 12 months of age. The goals of the first visit are to familiarize the child with the dental environment, address parental anxiety, improve oral hygiene, provide preventative care and identify risks. It provides tips for making the dental office child-friendly and establishing trust with the child and parents. A thorough examination is conducted along with developing an individualized treatment plan focusing on prevention and gradual acclimation to care.
This document provides an overview of enamel hypoplasia, including its definition, classification, etiology, clinical features, radiographic features, and management. Enamel hypoplasia is defined as an incomplete or defective formation of the enamel matrix of teeth. It can be hereditary or environmental in origin. Common causes include nutritional deficiencies, infections like syphilis, and dental fluorosis from excess fluoride intake. Clinical features range from mild pitting to severe absence of enamel. Treatment depends on severity and location, and may include desensitizing agents, composite restoration, crowns, or extractions for severely malformed teeth.
This document provides a history of fluorides and their discovery and use in dentistry. It discusses how fluorine was first discovered in the 18th century and early observations of fluorides in teeth and bones in the 19th century. In the early 20th century, Dr. McKay first observed mottled enamel in children in Colorado and suspected it was related to fluoride levels in drinking water. Extensive surveys and studies over decades by McKay, Black, Dean and others confirmed high fluoride levels in endemic areas with mottled enamel. They established fluoride's role in preventing dental caries when consumed in optimal levels in drinking water.
This document provides an overview of early childhood caries (ECC), including definitions, classifications, prevalence, risk factors, management, and prevention. ECC is defined as the presence of one or more decayed, missing, or filled tooth surfaces in any primary tooth in a child under 6 years old. Key risk factors include dental plaque, mutans streptococci bacteria, frequent sugar consumption, and improper feeding practices like prolonged bottle use. Prevention strategies focus on educating parents and caregivers on promoting proper oral hygiene, healthy diets, and reducing transmission of cariogenic bacteria from mother to child.
This document discusses pericoronitis, which is inflammation of the gum tissue surrounding an incompletely erupted tooth, usually the lower wisdom tooth. It can be chronic or acute with intensified symptoms. The space under the gum flap provides an area for food debris and bacteria. Treatment involves pain management, cleaning the area, and antibiotics for severe cases. Surgically, the gum flap may be removed or the tooth extracted depending on its position and stage of eruption, as removal of the problem tooth is often the best approach to prevent future occurrences of pericoronitis.
gingiva and periodontal problems in childrenGarima Singh
This document provides an overview of gingival and periodontal diseases in children. It begins with an introduction stating that many periodontal diseases originate during childhood, so early detection and treatment are important. It then covers topics such as the normal periodontium in children, classifications of gingival diseases including gingivitis, acute gingival diseases like herpetic gingivostomatitis, and gingival enlargement. It also discusses periodontitis, specifically aggressive periodontitis which can occur in adolescents, as well as systemic diseases associated with periodontal problems. The conclusion emphasizes that early detection and treatment of periodontal issues in children can prevent more advanced diseases and also identify underlying systemic conditions.
Natal and neonatal teeth refer to teeth that are present at birth or erupt within 30 days of birth. The incidence is estimated to be 1 in 1000 for natal teeth and 1 in 30,000 for neonatal teeth, with the majority being mandibular incisors. These premature teeth can cause issues with breastfeeding and tongue laceration. Radiographs are needed to assess root development and mobility. Teeth that are excessively mobile or interfering with breastfeeding should be removed to prevent aspiration risk and further trauma.
This document provides information on infant oral health care. It defines an infant as a child under 12-24 months of age. Maintaining good oral health is important during this period as the foundation for permanent teeth and overall oral health is laid down. Breastfeeding is advantageous for infant oral health as breastmilk does not cause significant acid production, supports moderate bacterial growth and has protective factors. However, prolonged or at-will breastfeeding can increase risk of nursing caries. Bottle feeding increases risk of rapid weight gain compared to breastfeeding due to differences in muscle use and milk flow. Dentists can educate parents on proper feeding practices, fluoride use, and early dental visits to promote infant oral health.
This document provides guidelines for providing anticipatory guidance to parents at different stages of their child's development. It covers topics such as oral development, nutrition, oral hygiene, fluoride use, habits, and injury prevention. Guidelines are provided for prenatal counseling, and ages 6-12 months, 12-24 months, 2-6 years, 6-12 years, and adolescence. The document emphasizes educating parents on establishing good oral health habits and preventing dental injuries at each stage.
This document provides an overview of pulpotomy procedures for primary teeth. It begins with definitions of pulpotomy and discusses the rationale, objectives, indications, contraindications and classification of different pulpotomy techniques. It then describes various medicaments that can be used, including formocresol, glutaraldehyde, calcium hydroxide, and ferric sulfate. The document outlines techniques for formocresol pulpotomy, electrosurgical pulpotomy, and laser pulpotomy. It also discusses recent concepts in pulpotomy including the use of bone morphogenetic protein and enamel matrix derivatives. The document concludes by examining reasons for failure of pulpotomy therapy.
This document provides an overview of dental caries epidemiology. It begins with definitions of epidemiology and dental caries. It then discusses the history of caries in prehistoric man and global and Indian caries scenarios. Several classic epidemiological studies on dental caries are summarized. Theories of caries etiology including Miller's chemico-parasitic theory are explained. Epidemiological factors influencing caries including the host, agents, environment and time are described. Saliva properties and their relationship to caries susceptibility are also summarized.
This document discusses different types of space maintainers used in orthodontics. It defines space maintainers and describes their purpose in maintaining space after premature loss of primary teeth. The document categorizes space maintainers as either removable or fixed, and lists examples of common types, their advantages and disadvantages, ideal requirements, indications and contraindications. Key space maintainers mentioned include acrylic partial dentures, lingual arches, Nance holding arches, and band and loop appliances.
Management & Prevention of early childhood cariesSushma Mohan
This document discusses the management and prevention of early childhood caries (ECC) and rampant caries. It defines ECC as occurring in primary teeth, usually affecting maxillary incisors and molars. Rampant caries can occur at any age and affects both primary and permanent teeth. Treatment for ECC focuses on controlling the carious process, restoring teeth, and educating parents on diet and oral hygiene. Prevention strategies include community education, preventing transmission of cariogenic bacteria, and home-based approaches like fluoride varnish and sealants. Management of rampant caries depends on the extent of decay and involves provisional restorations, diet and hygiene counseling, and fluoride therapy tailored to a patient's
Psychological management of child in dentistry using Jean Piagets Cognitive T...savithasathyaprasad
This power point deals with clinical implication of Jean Piaget's theory of child psychology in paediatric dentistry and application in chair side behavior management of child
Bruxism refers to the involuntary, excessive grinding or clenching of teeth. It can occur during waking hours or sleep. The document discusses the various definitions, types, prevalence, etiology, diagnosis, and treatment of bruxism. Bruxism is a multifactorial condition influenced by morphological, pathophysiological, respiratory, and psychological factors. It is most common in children under 11 years of age. Treatment involves the use of occlusal splints and addressing any underlying causes like stress, sleep disorders, malocclusion, or respiratory conditions.
Periodontal disease in children -pedodonticsRachael Gupta
This document provides an overview of periodontal diseases in children. It begins with definitions of key anatomical structures like the periodontal ligament, cementum, and alveolar bone. There are anatomical differences in these structures between primary and permanent dentition. Periodontal diseases are less common in children due to wider interdental spaces and stronger bone remodeling. Examination of periodontal diseases in children focuses on gingival health, plaque, calculus, and probing depths. Early onset periodontitis is classified into prepubertal, localized, and generalized forms based on extent and age of onset. Treatment involves nonsurgical approaches like dental cleaning and antibiotics.
The document discusses delayed tooth eruption, including its causes and characteristics. It describes the normal phases of tooth eruption and defines delayed eruption. Potential causes of delayed eruption include local conditions like scarring from trauma or tumors, systemic conditions such as nutritional deficiencies, endocrine disorders, and genetic syndromes. Specific local conditions discussed in detail are mucosal barriers, odontogenic tumors, ankylosis of deciduous teeth, radiation damage, and oral clefts. Systemic conditions explored include malnutrition, vitamin D-resistant rickets, hypothyroidism, hypopituitarism, hypoparathyroidism, HIV infection, cerebral palsy, celiac disease, and ichthyosis
Breastfeeding provides optimal nutrition for infants. Colostrum produced in the first few days after birth is higher in protein and electrolytes compared to mature breast milk produced after 3 weeks. Breast milk supports the infant's oral health by protecting against colonization of cariogenic bacteria and reducing the risk of early childhood caries, especially if nocturnal breastfeeding is avoided after teeth erupt. Diet counseling during infant oral health visits focuses on appropriate breastfeeding and weaning practices, use of bottles, and dietary fluoride supplementation based on water fluoride levels.
This document discusses plaque control and various plaque control measures. It begins by explaining that plaque control involves regular removal of plaque to prevent periodontal diseases. Mechanical methods like toothbrushing and interdental cleaning are important, as well as chemical agents like chlorhexidine and essential oils. Different toothbrushing techniques and powered toothbrushes are described. The document also discusses dentifrices, interdental aids, and concludes that proper oral hygiene through plaque control is critical for preventing periodontal disease.
Detection, diagnosis and prevention of dental cariesMasuma Ryzvee
The document discusses the diagnosis and prevention of dental caries. It covers the development and features of caries, methods for detection including examination, radiographs, and devices. It also discusses caries risk in patients, the role of plaque, diet, and fluoride in prevention. Specific fluoride modalities like toothpaste, mouthwashes, and professionally applied treatments are outlined. The use of pit and fissure sealants for caries prevention in teeth pits and grooves is also summarized, along with patient selection and the application method.
This document discusses chemical plaque control agents. It begins by defining terms like antimicrobial agents, antiplaque agents, and antigingivitis agents. It describes ideal properties of antiplaque agents such as eliminating pathogens selectively and exhibiting substantivity. The document then examines various approaches to chemical plaque control like using antiadhesive, antimicrobial, plaque removal, and antipathogenic agents. Specific agents discussed in detail include chlorhexidine, povidone-iodine, triclosan, and delmopinol. The modes of action, effectiveness, and potential side effects of different agents are summarized.
The document discusses the development of occlusion from birth through adulthood. It covers the pre-dentate period from birth to 6 months, the primary dentition period from 6 months to 6 years, the mixed dentition period, and the permanent dentition period. Key points include the segmentation of gum pads at birth, eruption times of primary teeth, factors affecting occlusion development, and clinical significance of understanding occlusion development.
Dental management of children with special health care needsaravindhanarumugam1
hope this will throw a light in understanding special children and dental management of the same particularly for pediatric dentistry PGs .children with genetic diseases and emotionally handicapped ( child abuse and neglect ) are not discussed here as they are separate topics.
dr. aravindhan
Fluoride reduces dental caries through multiple mechanisms including:
1) Incorporation into tooth enamel and dentin during development and after eruption, making the tooth structure less soluble in acid.
2) Interacting with the bacterial enzymes and metabolic processes that produce acid in dental plaque, reducing acid production.
3) Promoting remineralization of enamel and dentin that have been demineralized by acid from plaque bacteria.
We in Chinthamani Laser Dental Clinic & Implant Centre ,cover every speciality and subspeciality in dentistry so that all kind of your dental problems can be treated efficiently and effectively.
Contact us:
Chinthamani Laser Dental Clinic & Implant Centre
1/464,Mount Poonamallee High Road,
Iyyapanthangal,
Chennai-56
Phone no.044-43800059 , 92 83 786776
Email:
chinthamanidental@gmail.com,
dr_mrgvl@gmail.com
Website:
www.chinthamanilaserdentalclinic.com
Primary teeth are important for several reasons, including aiding in speech development, chewing and eating, and guiding the eruption of permanent teeth. Tooth eruption is a complex process involving bone resorption and formation, as well as root development over several years before teeth emerge into the mouth. The sequence and timing of primary and permanent tooth eruption follows a generally predictable pattern, though there can be variations in individuals. Factors like genetics and local issues can influence the eruption process and cause problems like delayed, premature, or ectopic eruption.
Eruption problems /certified fixed orthodontic courses by Indian dental academy Indian dental academy
This document discusses dental eruption and problems with eruption from the Indian Dental Academy website. It provides information on the mechanisms, etiology, diagnosis, and treatment of eruption problems. The key points are:
- Tooth eruption is a complex process involving root development, periodontium establishment, and functional occlusion.
- Problems can occur at any phase of eruption due to ectopic tooth position, obstacles in the eruption path, or failures in the eruption mechanisms.
- Common causes of delayed eruption are local factors like scarring, supernumerary teeth, and systemic factors such as nutrition deficiencies, endocrine disorders, cerebral palsy, and genetic syndromes.
- Accurate
Natal and neonatal teeth refer to teeth that are present at birth or erupt within 30 days of birth. The incidence is estimated to be 1 in 1000 for natal teeth and 1 in 30,000 for neonatal teeth, with the majority being mandibular incisors. These premature teeth can cause issues with breastfeeding and tongue laceration. Radiographs are needed to assess root development and mobility. Teeth that are excessively mobile or interfering with breastfeeding should be removed to prevent aspiration risk and further trauma.
This document provides information on infant oral health care. It defines an infant as a child under 12-24 months of age. Maintaining good oral health is important during this period as the foundation for permanent teeth and overall oral health is laid down. Breastfeeding is advantageous for infant oral health as breastmilk does not cause significant acid production, supports moderate bacterial growth and has protective factors. However, prolonged or at-will breastfeeding can increase risk of nursing caries. Bottle feeding increases risk of rapid weight gain compared to breastfeeding due to differences in muscle use and milk flow. Dentists can educate parents on proper feeding practices, fluoride use, and early dental visits to promote infant oral health.
This document provides guidelines for providing anticipatory guidance to parents at different stages of their child's development. It covers topics such as oral development, nutrition, oral hygiene, fluoride use, habits, and injury prevention. Guidelines are provided for prenatal counseling, and ages 6-12 months, 12-24 months, 2-6 years, 6-12 years, and adolescence. The document emphasizes educating parents on establishing good oral health habits and preventing dental injuries at each stage.
This document provides an overview of pulpotomy procedures for primary teeth. It begins with definitions of pulpotomy and discusses the rationale, objectives, indications, contraindications and classification of different pulpotomy techniques. It then describes various medicaments that can be used, including formocresol, glutaraldehyde, calcium hydroxide, and ferric sulfate. The document outlines techniques for formocresol pulpotomy, electrosurgical pulpotomy, and laser pulpotomy. It also discusses recent concepts in pulpotomy including the use of bone morphogenetic protein and enamel matrix derivatives. The document concludes by examining reasons for failure of pulpotomy therapy.
This document provides an overview of dental caries epidemiology. It begins with definitions of epidemiology and dental caries. It then discusses the history of caries in prehistoric man and global and Indian caries scenarios. Several classic epidemiological studies on dental caries are summarized. Theories of caries etiology including Miller's chemico-parasitic theory are explained. Epidemiological factors influencing caries including the host, agents, environment and time are described. Saliva properties and their relationship to caries susceptibility are also summarized.
This document discusses different types of space maintainers used in orthodontics. It defines space maintainers and describes their purpose in maintaining space after premature loss of primary teeth. The document categorizes space maintainers as either removable or fixed, and lists examples of common types, their advantages and disadvantages, ideal requirements, indications and contraindications. Key space maintainers mentioned include acrylic partial dentures, lingual arches, Nance holding arches, and band and loop appliances.
Management & Prevention of early childhood cariesSushma Mohan
This document discusses the management and prevention of early childhood caries (ECC) and rampant caries. It defines ECC as occurring in primary teeth, usually affecting maxillary incisors and molars. Rampant caries can occur at any age and affects both primary and permanent teeth. Treatment for ECC focuses on controlling the carious process, restoring teeth, and educating parents on diet and oral hygiene. Prevention strategies include community education, preventing transmission of cariogenic bacteria, and home-based approaches like fluoride varnish and sealants. Management of rampant caries depends on the extent of decay and involves provisional restorations, diet and hygiene counseling, and fluoride therapy tailored to a patient's
Psychological management of child in dentistry using Jean Piagets Cognitive T...savithasathyaprasad
This power point deals with clinical implication of Jean Piaget's theory of child psychology in paediatric dentistry and application in chair side behavior management of child
Bruxism refers to the involuntary, excessive grinding or clenching of teeth. It can occur during waking hours or sleep. The document discusses the various definitions, types, prevalence, etiology, diagnosis, and treatment of bruxism. Bruxism is a multifactorial condition influenced by morphological, pathophysiological, respiratory, and psychological factors. It is most common in children under 11 years of age. Treatment involves the use of occlusal splints and addressing any underlying causes like stress, sleep disorders, malocclusion, or respiratory conditions.
Periodontal disease in children -pedodonticsRachael Gupta
This document provides an overview of periodontal diseases in children. It begins with definitions of key anatomical structures like the periodontal ligament, cementum, and alveolar bone. There are anatomical differences in these structures between primary and permanent dentition. Periodontal diseases are less common in children due to wider interdental spaces and stronger bone remodeling. Examination of periodontal diseases in children focuses on gingival health, plaque, calculus, and probing depths. Early onset periodontitis is classified into prepubertal, localized, and generalized forms based on extent and age of onset. Treatment involves nonsurgical approaches like dental cleaning and antibiotics.
The document discusses delayed tooth eruption, including its causes and characteristics. It describes the normal phases of tooth eruption and defines delayed eruption. Potential causes of delayed eruption include local conditions like scarring from trauma or tumors, systemic conditions such as nutritional deficiencies, endocrine disorders, and genetic syndromes. Specific local conditions discussed in detail are mucosal barriers, odontogenic tumors, ankylosis of deciduous teeth, radiation damage, and oral clefts. Systemic conditions explored include malnutrition, vitamin D-resistant rickets, hypothyroidism, hypopituitarism, hypoparathyroidism, HIV infection, cerebral palsy, celiac disease, and ichthyosis
Breastfeeding provides optimal nutrition for infants. Colostrum produced in the first few days after birth is higher in protein and electrolytes compared to mature breast milk produced after 3 weeks. Breast milk supports the infant's oral health by protecting against colonization of cariogenic bacteria and reducing the risk of early childhood caries, especially if nocturnal breastfeeding is avoided after teeth erupt. Diet counseling during infant oral health visits focuses on appropriate breastfeeding and weaning practices, use of bottles, and dietary fluoride supplementation based on water fluoride levels.
This document discusses plaque control and various plaque control measures. It begins by explaining that plaque control involves regular removal of plaque to prevent periodontal diseases. Mechanical methods like toothbrushing and interdental cleaning are important, as well as chemical agents like chlorhexidine and essential oils. Different toothbrushing techniques and powered toothbrushes are described. The document also discusses dentifrices, interdental aids, and concludes that proper oral hygiene through plaque control is critical for preventing periodontal disease.
Detection, diagnosis and prevention of dental cariesMasuma Ryzvee
The document discusses the diagnosis and prevention of dental caries. It covers the development and features of caries, methods for detection including examination, radiographs, and devices. It also discusses caries risk in patients, the role of plaque, diet, and fluoride in prevention. Specific fluoride modalities like toothpaste, mouthwashes, and professionally applied treatments are outlined. The use of pit and fissure sealants for caries prevention in teeth pits and grooves is also summarized, along with patient selection and the application method.
This document discusses chemical plaque control agents. It begins by defining terms like antimicrobial agents, antiplaque agents, and antigingivitis agents. It describes ideal properties of antiplaque agents such as eliminating pathogens selectively and exhibiting substantivity. The document then examines various approaches to chemical plaque control like using antiadhesive, antimicrobial, plaque removal, and antipathogenic agents. Specific agents discussed in detail include chlorhexidine, povidone-iodine, triclosan, and delmopinol. The modes of action, effectiveness, and potential side effects of different agents are summarized.
The document discusses the development of occlusion from birth through adulthood. It covers the pre-dentate period from birth to 6 months, the primary dentition period from 6 months to 6 years, the mixed dentition period, and the permanent dentition period. Key points include the segmentation of gum pads at birth, eruption times of primary teeth, factors affecting occlusion development, and clinical significance of understanding occlusion development.
Dental management of children with special health care needsaravindhanarumugam1
hope this will throw a light in understanding special children and dental management of the same particularly for pediatric dentistry PGs .children with genetic diseases and emotionally handicapped ( child abuse and neglect ) are not discussed here as they are separate topics.
dr. aravindhan
Fluoride reduces dental caries through multiple mechanisms including:
1) Incorporation into tooth enamel and dentin during development and after eruption, making the tooth structure less soluble in acid.
2) Interacting with the bacterial enzymes and metabolic processes that produce acid in dental plaque, reducing acid production.
3) Promoting remineralization of enamel and dentin that have been demineralized by acid from plaque bacteria.
We in Chinthamani Laser Dental Clinic & Implant Centre ,cover every speciality and subspeciality in dentistry so that all kind of your dental problems can be treated efficiently and effectively.
Contact us:
Chinthamani Laser Dental Clinic & Implant Centre
1/464,Mount Poonamallee High Road,
Iyyapanthangal,
Chennai-56
Phone no.044-43800059 , 92 83 786776
Email:
chinthamanidental@gmail.com,
dr_mrgvl@gmail.com
Website:
www.chinthamanilaserdentalclinic.com
Primary teeth are important for several reasons, including aiding in speech development, chewing and eating, and guiding the eruption of permanent teeth. Tooth eruption is a complex process involving bone resorption and formation, as well as root development over several years before teeth emerge into the mouth. The sequence and timing of primary and permanent tooth eruption follows a generally predictable pattern, though there can be variations in individuals. Factors like genetics and local issues can influence the eruption process and cause problems like delayed, premature, or ectopic eruption.
Eruption problems /certified fixed orthodontic courses by Indian dental academy Indian dental academy
This document discusses dental eruption and problems with eruption from the Indian Dental Academy website. It provides information on the mechanisms, etiology, diagnosis, and treatment of eruption problems. The key points are:
- Tooth eruption is a complex process involving root development, periodontium establishment, and functional occlusion.
- Problems can occur at any phase of eruption due to ectopic tooth position, obstacles in the eruption path, or failures in the eruption mechanisms.
- Common causes of delayed eruption are local factors like scarring, supernumerary teeth, and systemic factors such as nutrition deficiencies, endocrine disorders, cerebral palsy, and genetic syndromes.
- Accurate
This document summarizes the process of tooth eruption. It discusses the pre-eruptive, eruptive, and post-eruptive phases of tooth movement. During the pre-eruptive phase, tooth germs move within the jaw before eruption. The eruptive phase involves tooth movement from within the bone to the oral cavity. Post-eruptive movements maintain tooth position as the jaws grow. Theories on the mechanisms controlling eruption and resorption are also presented, along with cellular and molecular factors such as the dental follicle that regulate eruption.
Fluoride helps prevent tooth decay through several mechanisms. It inhibits demineralization, promotes remineralization, alters the action of plaque bacteria, and improves enamel crystallinity and reduces solubility. Both pre-eruptive and post-eruptive exposure to fluoride provides caries prevention benefits, with maximal effects seen from high exposure both before and after tooth eruption. Community water fluoridation was first introduced in the 1940s and has been shown to reduce tooth decay rates by 40-59% in both primary and permanent teeth.
Ankylosis is the fusion of a tooth root to the alveolar bone due to lack of periodontal ligament space. It occurs most commonly in deciduous teeth, especially the mandibular second molar, as a result of root resorption followed by fusion to the bone. This prevents normal exfoliation of deciduous teeth and impaction of the permanent successor. Ankylosis can be caused by local metabolic changes, trauma, infection or abnormal tongue pressure. Clinically, ankylosed teeth appear sunken, lack mobility, and percussion elicits a solid sound. Radiographically, there is partial or complete absence of the periodontal ligament space and lamina dura. Treatment depends on
Supernumerary teeth form in addition to the normal dental formula due to disturbances during tooth development. They can be classified as supplemental if they resemble adjacent teeth or rudimentary if they have abnormal shape/size. Theories for their formation include atavism, tooth germ dichotomy, hyperactivity of the dental lamina, and genetic/environmental factors. Mouse models have provided insights but are limited due to differences from human dentition. Molecular signaling pathways like WNT and BMP play roles in determining tooth number.
Congenitally missing & supernumerary teethBaha'adeen Ali
The document discusses congenitally missing teeth (hypodontia), supernumerary teeth, and their management. It notes that hypodontia affects about 20% of adults and involves missing 1-5 permanent teeth (excluding wisdom teeth). Supernumerary teeth are additional teeth that can occur in any region, with mesiodens being the most common type found in the maxillary midline. Both conditions can cause problems like failure of eruption or displacement. Treatment depends on the specific teeth involved and may include removal, especially if causing issues, or monitoring without removal.
Cleidocranial dysplasia is a genetic condition characterized by defective development of the skull bones and absence or partial absence of the collar bones. It is caused by mutations in the CBFA1 gene. Symptoms include delayed closure of fontanels, protruding jaw, wide nasal bridge, dental abnormalities like delayed tooth eruption and peg-shaped teeth. Diagnosis is confirmed through x-rays showing features like reduced or fragmented clavicles. Treatment focuses on surgical correction of skull defects and dental/orthodontic work to address significant dental problems.
This document provides information about teething and its management in infants and children. It discusses the typical timeline for teeth eruption, common signs and symptoms of teething, and potential complications. It describes conditions like eruption hematoma, eruption sequestrum, ectopic eruption, transposition, infraocclusion, and impacted teeth. Treatment options are outlined for managing teething problems and their associated conditions.
The document discusses several craniofacial anomalies including DiGeorge Syndrome, Treacher-Collins Syndrome, Apert Syndrome, Crouzon Syndrome, Branchiootorenal Syndrome, Down Syndrome, Goldenhar Syndrome, and Pierre-Robin Sequence. It provides the genetic causes, characteristic features, and figures to illustrate each condition. Craniosynostosis and cloverleaf skull syndrome are discussed in more detail, with craniosynostosis defined as the premature fusion of cranial sutures, which can be primary, secondary, or syndromic, and the roles of specific sutures explained.
Achondroplasia is a genetic disorder and the most common cause of dwarfism. It is caused by a mutation in the FGFR3 gene which results in a change of the amino acid guanine being replaced by arginine. This mutation disrupts the bone growth plate resulting in disproportionately short stature with short arms and legs. There is no cure for achondroplasia but treatments can address related conditions and symptoms.
Space regainers /certified fixed orthodontic courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Cleidocranial dysplasia is a congenital disorder of bone formation characterized by abnormalities of the skull, teeth, jaw, and shoulder girdle. It is caused by mutations in the CBFA1 gene and is transmitted as an autosomal dominant trait. Key features include clavicular hypoplasia or agenesis, a narrow thorax, brachycephaly, underdeveloped paranasal sinuses, dental anomalies such as retained primary teeth and supernumerary teeth, and defects of the shoulder girdle ranging from absence of the clavicle to thinning of the clavicles. Radiographic examination typically shows reduced or fragmented clavicles and delayed ossification of bones. Treatment focuses on
Cleidocranial dysplasia is a genetic condition characterized by defective bone development of the skull and absence or partial absence of the collarbone. It causes delayed closure of skull bones and late or unerupted teeth. Symptoms include protruding forehead, wide-set eyes, high-arched palate, and short stature. Dental issues are the most significant complications and require careful orthodontic treatment like dentures or staged tooth removal. The condition is inherited in an autosomal dominant pattern and results from mutations in the RunX2 gene.
Space regaining involves moving a displaced permanent tooth into its proper position after premature loss of a deciduous tooth. Methods include fixed appliances like open coil springs and removable appliances like Hawley's retainers. Removable appliances are activated gradually over weeks to exert light distal force on molars and regain up to 2mm of space. Fixed appliances can regain space faster but require proper cementation. Space regaining is best done between ages 7-10 years when tooth roots are still developing.
The document discusses several craniofacial anomalies including craniosynostosis. Craniosynostosis occurs when one or more of the fibrous sutures in the skull fuse prematurely, restricting skull growth. It can be primary, due to a defect in ossification, or secondary, due to inadequate brain growth. Primary craniosynostosis affects a single suture and causes specific head shapes like scaphocephaly or brachycephaly, while secondary craniosynostosis involves multiple sutures fusing. Treatment involves surgery to reshape the skull if increased intracranial pressure develops by age 2-4 months.
Serial extraction is an interceptive orthodontic procedure that involves the planned extraction of certain primary and permanent teeth in a sequence to guide the erupting permanent teeth into a favorable position. It was first described in 1929 as a way to address arch length deficiencies. The most common methods are Dewel's method, Tweed's method, and Nance method, all of which extract primary teeth first, followed by premolars and canines. Potential problems include anterior crossbites from residual spacing or skeletal discrepancies.
This document has been created to run the MBBS students through the basics of dental health, diseases, dental treatments and Oral Manifestations of Systemic Diseases.
This document provides information on plantar fasciitis including its definition, description, epidemiology, anatomy, biomechanics, pathology, signs and symptoms, diagnostic procedures, differential diagnosis, and management. Some key points include:
- Plantar fasciitis is defined as an inflammatory process of the plantar fascia ligament on the sole of the foot.
- It is commonly caused by mechanical overload or repetitive trauma to the plantar fascia.
- Symptoms include heel pain that is worst with first steps after rest.
- Management includes rest, stretches, orthotics, night splints, corticosteroid injections, and surgery in severe cases.
- Studies have found myofascial release and massage
The document discusses the phases of tooth eruption and theories of tooth eruption. It describes three phases of tooth eruption: 1) the preeruptive phase where the tooth germ moves within the jaw bone, 2) the eruptive or prefunctional phase where the root forms and the tooth emerges into the mouth, and 3) the functional or post-eruptive phase where the tooth reaches the bite and the roots continue to develop. Several theories for the mechanism of tooth eruption are mentioned, including the roles of vascularity, pressure changes, root formation, bone remodeling, the dental follicle, and the periodontal ligament.
This document discusses the etiology and classifications of malocclusions. It begins by introducing Graber's classification of etiology, which divides factors into general and local. General factors include hereditary influences on neuromuscular, skeletal, soft tissue and dental structures. Local factors relate to anomalies in tooth number, size, shape, frenums, eruption patterns and loss of primary teeth. The document then examines various classifications in detail, outlining prenatal, postnatal, functional and environmental/acquired etiologies. Specific hereditary, congenital, nutritional and traumatic influences are explored.
the aims of orthodontics is to treat protruded teeth to prevent trauma . crowded teeth help initiation of caries so their treatment is indicated by orthodontics
This document summarizes a literature review on dental erosion. It defines dental erosion as the loss of tooth structure from chemical dissolution by acids not produced by bacteria. The surfaces most commonly affected are the palate and chewing surfaces. Erosion initially appears as dull enamel and progresses to concave lesions lacking ridges. Erosion is often multifactorial, resulting from a combination of attrition, abrasion and erosion. The prevalence of erosion in children ranges from 5-57% according to studies in the UK. Erosion has multiple contributing factors including susceptible teeth, acid exposure time, and intrinsic or extrinsic acid sources.
Radiographic Interpretation of Dental AnomaliesHadi Munib
This document discusses various types of dental abnormalities including developmental, acquired, hyperdontia (extra teeth), hypodontia (missing teeth), macrodontia (large teeth), microdontia (small teeth), transposition (switched positions of teeth), fusion, and concrescence (root fusion). It provides details on the characteristics, causes, prevalence, radiographic features, differential diagnosis, and management of each abnormality.
Developmental disturbances of teeth, such as anodontia, hypodontia, and hyperdontia, can occur due to genetic and environmental factors disrupting the development of teeth. Anodontia is a total lack of teeth development. Hypodontia is an absence of one or more teeth, commonly the third molars, lateral incisors, and second premolars. Hyperdontia is an increased number of teeth, termed supernumerary teeth, which are usually unilateral and occur most commonly in the maxillary anterior region. Early diagnosis and treatment of these conditions can minimize aesthetic and functional problems of adjacent teeth.
This document discusses natal and neonatal teeth. Natal teeth are present at birth, while neonatal teeth erupt within the first month of life. They are uncommon anomalies that can lead to complications like feeding difficulties, trauma to the tongue, and premature eruption of other teeth. Management may involve smoothing sharp edges, protective dressings, or extraction if the tooth is loose or interfering with feeding. The exact causes are unknown but may involve genetic and environmental factors.
Preventive orthodontics aims to preserve normal occlusion and includes patient education, caries control, management of eruption problems, space maintenance, and addressing oral habits. Key aspects are maintaining the deciduous dentition to allow proper eruption of permanent teeth, identifying issues like ankylosed or supernumerary teeth, and using space maintainers like crown-loop or distal shoe appliances as needed. Regular exams are important from an early age to monitor development and catch any issues requiring treatment or referral.
This case report describes an extremely rare case of severe dilaceration (117° palatal inclination) of the root of a maxillary second premolar tooth. Trauma to primary teeth can result in developmental disturbances to permanent successor teeth, including crown and root dilaceration. Dilacerated teeth pose challenges for diagnosis, treatment planning, endodontic access, and extraction. In this case, the maxillary second premolar tooth was severely dilacerated and had to be extracted. Dilaceration is an abnormality that requires a multidisciplinary approach and modified treatment procedures.
Role of Pediatric Dentist - Orthodontic In Cleft Lip and Cleft Palate Patientsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Explore 4 Implications of Genetic Factors on Pediatric Oral Health. Discover how genetic variations contribute to enamel defects, cleft lip and palate, and orthodontic issues. Learn about the impact of genetic syndromes and advances in research, highlighting personalized care and the future potential for improved oral health outcomes.
Natal and neonatal teeth refer to teeth present at birth or within the first 30 days of life. Natal teeth erupt at birth while neonatal teeth erupt within the first month. The most commonly affected teeth are the mandibular incisors. The cause is unknown but may involve the superficial position of the developing tooth germ. Natal and neonatal teeth can resemble normal primary teeth but are often poorly developed with incomplete roots. Radiographs are important to determine root development and whether extraction is necessary to prevent aspiration risk. Most experts recommend leaving the teeth in place if possible to allow stabilization as the permanent arch develops.
This document discusses various types of tooth eruption disorders, including:
1) Premature eruption which includes natal and neonatal teeth. Natal teeth erupt at birth while neonatal teeth erupt within 30 days of birth.
2) Eruption sequestrum which is a small irregular bone fragment overlying an erupting permanent molar.
3) Delayed eruption which occurs when a tooth erupts more than 6 months after the normal eruption time. Local and systemic factors can cause delays.
4) Multiple unerupted teeth which is uncommon and sometimes associated with genetic syndromes.
5) Embedded or impacted teeth which fail to erupt into normal positions and includes lack of erup
The document discusses various abnormalities that can occur during tooth development, including hypodontia, ectodermal dysplasias, and supernumerary teeth. It notes that hypodontia, where there are missing teeth, is the most common dental developmental abnormality. Ectodermal dysplasias are a group of inherited disorders that affect structures derived from ectoderm including teeth, hair, nails, and sweat glands. The most common type is X-linked hypohidrotic ectodermal dysplasia where patients typically have missing teeth, sparse hair, and dry skin. Treatment for hypodontia aims to restore function and aesthetics, often using dentures for young children.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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This case report describes a 9-year-old boy who presented with dental abnormalities characteristic of otodental syndrome. Key findings included large bulbous crowns in both primary and permanent canine and molar teeth. Radiographs showed the abnormal molars appeared to be fused tooth buds with duplicated pulp chambers. The patient was referred for hearing evaluation, though prior testing by parents found normal hearing. Otodental syndrome is characterized by dental anomalies and sensorineural hearing loss inherited in an autosomal dominant pattern with variable expression.
This document discusses preventive orthodontics and measures taken to prevent malocclusion in children. It focuses on caries control, periodontal health, and preventing malocclusion. Key aspects include periodic oral examinations of children to detect early problems, preservation of arch length, replacement of lost primary teeth with space maintainers, and intercepting potential irregularities to facilitate future treatment. Conditions that can cause orthodontic problems include crowding, mismatch of tooth and jaw size, breathing issues, and thumb sucking. The general factors influencing malocclusion with premature tooth loss include abnormal oral muscles, oral habits, existing malocclusion, and erupting teeth adjacent to space left by loss.
etiology of malocclusion for general practitioners.docxDr.Mohammed Alruby
Etiology of Malocclusion
For general practitioners
Prepared by
Dr. M Alruby
Etiology in orthodontics is the study of actual causes of dento – facial abnormalities.
Malocclusion is the condition where there is a deviation from the usual or accepted relationship, dental malocclusion exists when the individual teeth within one or both jaws are abnormally related to each other, this condition may be limited to a couple of teeth or involving the majority of teeth present.
Development of normal dentition and occlusion depends on a number of interrelated factors that include the dento alveolar, skeletal and the neuromuscular factors. Thus localization of the possible etiology may be a very difficult task.
A- Extrinsic factors:
1- Evolution:
With evolution, the jaws become smaller, reduction in the number and size of teeth and diminution of jaw projection together with increased in vertical height of the face and there is retrognathic tendency in man as he ascends the evolutionary scale.
2- Heredity:
Transmission of dento facial characteristic through generation by genes. The child is a product of parents who have dissimilar genetic material. Thus the child may inherit conflicting traits from both the parents resulting in abnormalities of the dentofacial region. Another reason attributed for genetically determined malocclusion is the racial, ethnic and regional intermixer, which might have led to uncoordinated inheritance of teeth and jaws.
There are three types of transmission of malocclusion from the stand point of genetics:
1- Repetitive: the recurrence of single dentofacial deviation within the immediate family.
2- Discontinuous: a tendency for a malocclusion trait to reappear within the family over several generations.
3- Variable: the occurrence of different but related types of malocclusion within several generation of the same family.
Dental defect of genetic origin include the following:
= Crowding and spacing of teeth.
= Size and characteristic of soft tissue including muscles and frenum.
= Macrognathia and micrognathia.
= Macrodontia and microdontia.
= Oligodontia.
= Tooth shape variations.
= Median diastemas.
= upper face height, nose height, and bigonial width.
= Bimaxillary protrusion.
4- Congenital:
Those are deformities of hereditary or non-hereditary origin but exciting at birth.
The congenital abnormalities that cause malocclusion:
= Cleft lip and palate:
lack of fusion between the two palatal processes to each other. From one third to one half of all cleft palate children have familial history of this deformity.
As with the non-cleft child, palatal, pharyngeal and perioral musculature is well developed at birth to meet the demand of suckling, deglutition and mastication. While the complete unilateral or complete bilateral cleft break the continuity of the upper lip and disturbs the functional pattern and significantly reduce the restraining effect of the buccinators mechanism that pro
Role of pediatric dentist orthodontic in cleft lip and cleft palate patients Abu-Hussein Muhamad
Cleft Lip and Palate is severe birth defect occurring one in 700-1000 newborn infants. Cleft lip and palate together account for 50% of all cases whereas isolated cleft lip and palate occur in about 25% of cases. Management of Cleft Lip and Palate is carried out by multi disciplinary team approach. When ever a child is born with cleft lip and palate or one of them, it interferes with feeding and speech and hampers esthetic severely. Consequently it is psychologically traumatic to both patients as well as for their family members. Patients with cleft lip and palate are also are at high risk for dental diseases. So in such situation proper education, guidance, motivation and encouragement are required. Pre and post surgically pediatric dentist and orthodontics helps the patient by providing functionally and esthetically acceptable occlusion, good oral hygiene and preventive dental care. This paper describes the treatment protocol of pediatric dentistry and orthodontic with cleft lip and palate.
- Traumatic injuries to primary and permanent teeth are common, with maxillary central incisors most frequently affected. Injuries range from enamel fractures to luxations and avulsions.
- Epidemiological studies show that approximately 1/3 of children experience dental trauma to primary teeth and 1/5 experience trauma to permanent teeth. Injuries most often occur from falls at home for young children and from sports for adolescents.
- Proper classification and diagnosis of dental injuries is important to determine appropriate treatment and management. Conditions range from concussion with no displacement to intrusive luxation with tooth displacement into bone.
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DELAYEDTOOTHERUPTION
Faizal C Peedikayil Professor, Department of Pedodontics Kannur Dental College and Hospital.
Correspondence: Faizal C Peedikayil Professor, Department of Pedodontics Kannur Dental College and Hospital Anjarakandy, Kannur,
Kerala, India. Email: drfaizalcp@gmail.com
Received Nov 3,2011; Revised Nov 27, 2011; Accepted Dec 19, 2011
ABSTRACT
Eruption is a complex process that can be influenced bynumber of factors. Significant deviation from the established
norms should alert the clinician to make investigations for the evaluating the cause of delayed tooth eruption. This
review presents etiology, clinical implications, investigations, and a methodology for diagnosis and treatment of
delayed tooth eruption.
Key words: eruption of teeth, chronology of eruption
INTRODUCTION
Eruption of deciduous teeth, their exfoliation
followed by eruption of permanent dentition is an orderly
sequential and age specific event 1
. But most parents are
anxious about the variation in the timing of the eruption,
which is considered as an important milestone during childs
development. Racial, ethnic, sexual, and individual factors
can influence eruption and are usually considered in
determining the standards of normal eruption2,3
.Tooth
eruption is a complex and tightlyregulated process which
is divided into five stages namely preeruptive movements,
intraosseous stage, mucosal penetration, preocclusal and
postocclusal stages3
.
Significant deviations from accepted norms of
eruption time are often observed in clinical practice.
Premature eruption has been noted, but delayed tooth
eruption (DTE) isthe most commonlyencountered deviation
from normal eruption time.The importance of DTE as a
clinical problem is well reflected bythe number ofpublished
reports on the subject. DTE might be the primary or sole
manifestation of local or systemic pathology.4
General considerations
Gender
Studies on teeth emergence shows that permanent
teeth erupt earlier in girls than in boys5
. The difference
between eruption times on average is from 4 to 6 months,
largest difference being for permanent canines. Earlier
eruption ofpermanent teeth in females is attributed toearlier
onset of maturation.6
Preterm birth
World Health Organization (WHO) defines
preterm birth as birth occuring before 37 weeks ofgestation
or if the birth weight is below 2500g7
. Influence of preterm
birth on teeth development and eruption has been
investigated. Most of the studies reported that preterm
babies children have delayed primaryand permanent teeth
eruption. Some researches reported that the greatest delay
was found in children younger than 6 years of age, whereas
for those aged 9 years or older, there was no difference,
indicating that a “catch- up” had occurred 8,9
.
Local factors
Physical obstruction is a common local cause of
DTE. These obstructions can be because of mucosal barrier,
supernumeraryteeth, scar tissue, and tumors etc (Table 1).
Mucosal barrier has also been suggested as an important
etiologic factor in DTE. Any failure of the follicle of an
erupting tooth to unite with the mucosa will entail a delay
in the breakdown of the mucosa and constitute a barrier to
emergence. Gingival hyperplasia resulting from various
causes (hormonal or hereditary causes, drugs such as
phenytoin) might cause an abundance of dense connective
tissue or acellular collagen that can be an impediment to
tooth eruption1,5,6,10
.
Supernumerary teeth can cause crowding,
displacement, rotation, impaction, or delayed eruption of
the associated teeth. The most common supernumerary
tooth is the mesiodens, followed by a fourth molar in the
maxillary arch. Odontomas and other have also been
occasionally reported to be responsible for DTE. Regional
odontodysplasia, (ghost teeth) is an un-usual dental
anomalythat might exhibit a delayor total failure in eruption.
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Central incisors, lateral incisors, and canines are the most
frequently affected teeth10,11
Injuries to deciduous teeth have also been
implicated as a cause of DTE of the permanent teeth.
Traumatic injuries can lead to disruption in normal
odontogenesis in the form of dilacerations or physical
displacement of the permanent germ12
. Cystic
transformation of a nonvital deciduous incisors might also
cause delay in the eruption of the permanent successor. In
some instances, the traumatized deciduous incisor might
become ankylosed or delayed in its root resorption .This
also leads to the overretention of the deciduous tooth and
disruption in the eruption of its successor. The eruption of
the succedaneous teeth is often delayed after the premature
loss of deciduous teeth before the beginning of their root
resorption. This can be explained bythe abnormal changes
that might occur in the connective tissue overlying the
permanent tooth and the formation ofthick, fibrous gingiva.
Ankylosis occurs commonly in the deciduous dentition,
usuallyaffecting the molars, and has been reported in all 4
quadrants, although the mandible is more commonly
affected than the maxilla.10,12
Arch-length deficiency is often mentioned as an
etiologic factor for crowding and impactions. Arch-length
deficiency might lead to DTE, although more frequently
the tooth erupts ectopically.13
X-radiation has also been shown to impair tooth
eruption. Ankylosis of bone to tooth was the most relevant
finding in irradiated animals. Root formation impairment,
periodontal cell damage, andinsufficient mandibular growth
also seem to be linked to tooth eruption disturbances due
tox-radiation.14
Systemic conditions
The high metabolic demand on the growing
tissues might influence the eruptive process. delayed
eruption is often reported in patients who are deficient in
some essential nutrient.Agarwal et al15
had reported delayed
deciduous dental eruption in malnourished Indian children.
Chronic malnutrition extending beyond the earlychildhood
is correlated with delayed teeth eruption. Most of the teeth
showed a one to four month variation around the mean
eruption time16
Table 2 shows various systemic condition which
can lead to DTE. Disturbance of the endocrine glands
usually has a profound effect on the entire body, including
the dentition10
. Hypothyroidism, Hypopituitarism,
Hypoparathyroidism, and Pseudohypoparathyroidism are
the most common endocrine disorders associated with DTE.
in hypopituitarism or pituitarydwarfism, the eruption and
shedding of the teeth are delayed, as is the growth of the
body in general. The dental arch has been reported to be
smaller than normal; thus it cannot accommodate all the
teeth, so a malocclusion develops. The roots of the teeth
are shorter than normal in dwarfism, and the supporting
structures are retarded in growth.17
Other systemic conditions associated with
impairment of growth, such as anemia (hypoxic hypoxia,
histotoxic hypoxia, and anemic hypoxia) and renal failure,
have also been correlated with DTE and other abnormalities
in dentofacial development.10
Genetic disorders
Genetics has an important role in development. A
generalized developmental delay is seen in patients with
syndromes. Table 3 shows various genetic conditions
assosiated with DTE. Various mechanisms have been
suggested to explain DTE in relation to genetic disorders.
Supernumerary teeth have been found to be responsible
for DTE in Apert syndrome, Cleidocranial dysostosis, and
Gardner syndrome. There is considerable evidence to
implicate the periodontal tissues’ development and
assosiated structures of the tooth in DTE. Lack of cellular
cementum has been found in cleidocranial dysplasia,
cementum-likeproliferations and obliteration ofperiodontal-
ligament space with resultant ankylosis have been noted
in Gardner syndrome. In osteopetrosis, sclerosteosis,
Carpenter syndrome, Apert syndrome, cleidocranial
dysplasia, Pyknodysostosis, and others, underlying defects
in bone resorption might be responsible for DTE.10,18,19,20,21
Occasionally, some syndromes or genetic
disorders are associated with multiple tumors or cysts in
the jaws, and these might lead to generalized DTE. Gorlin
syndrome, cherubism, and Gardner syndrome are such
disorders, in which DTE might be the result ofinterference
to eruption by these lesions20,21,22,23,24.
Generalized delay in
the eruption of teeth is noted in some families . Patient
medical historymight be totallyunremarkable, with DTE as
the only finding. The presence of a gene for tooth eruption
has also been suggested, and its “delayed onset” might be
responsible for DTE in “inherited retarded eruption”.10, 19
CLINICALIMPLICATIONS (table4)
Diagnosis of DTE is an important but complicated
process. When teeth do not erupt at the expected age (mean
+_ 2 SD), a careful evaluation should be performed to
establish the etiologyand the treatment plan accordingly10
.
Various tables and diagrammatic charts of the stages of
tooth development, starting from the initiation of the
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calcification process to the completion of the root apex of
each tooth are part of dental education. Norms with the
average chronologic ages at which each stage occurs should
be compared3
Medical history, family information and
information from affected patients about unusual variations
in eruption patterns should be investigated. Clinical
examination must begin with the overall physical evaluation
of the patient. Significant right-left variations in eruption
timings might be associated with tumors and should alert
the clinician to perform further investigation.10
Intraoral examination should include inspection,
palpation, percussion, and radiographic examination. The
clinician should inspect for gross soft tissue pathology,
scars, swellings, and fibrous or dense frenal attachments.
Careful observation and palpation of the alveolar ridges
buccally and lingually usually shows the characteristics
bulge of a tooth in the process of eruption. Palpation
producing pain, crackling, or other symptoms should be
further evaluated for pathology. Overretained deciduous
tooth and the supporting structures should be thoroughly
examined. Ankylosed teeth also interfere with the vertical
development of the alveolus.10
INVESTIGATIONS
A panoramic radiograph is ideal for evaluating the
position of teeth and the extent of tooth development,
estimating the time of emergence of the tooth into the oral
cavity, and screening for pathology. IOPAwith the image/
tube shift method, Clark’s rule, buccal object rule are
suggested for radiographic localization of tumors,
supernumerary teeth, and displaced teeth, which require
surgical correction. Computed tomography can be used as
the most precise method of radiographic localization 25,26,27
TREATMENTCONSIDERATIONS
The treatment of DTE depends on the etiology. A
number of techniques have been suggested for treating
DTE. The treatment plan should also consider10
(1) The decision to remove or retain the tooth or teeth
affected by DTE
(2) The use of surgery to remove obstructions,
(3) Surgical exposure of teeth affected by DTE,
(4) The application of orthodontic traction,
(5) The need for space creation and maintenance, and
(6) Diagnosis and treatment of systemic disease that
causes DTE.
The treatment flowchart (table 5) can serve as a
guideline for addressing the most important treatment
options in DTE. Once the clinical determination of
chronologicDTE (>2 SD) hasbeen established, a panoramic
radiograph should be obtained. The screening radiograph
can be used to rule out tooth agenesis and assess the
developmental state of the tooth25,28
If there is defective tooth formation, the first step
should be to assess whether the defect is localized or
generalized. Unerupted deciduous teeth with serious
defects should be extracted, but the time ofextraction should
be defined carefully by considering the development of
the succedaneous teeth and the space relationships in the
permanent dentition. In the permanent dentition, unerupted
teeth are normallycloselyobserved until the skeletal growth
period necessary for appropriate development and
preservation of the surrounding alveolar ridge has been
attained.In DTE with no obvious developmental defect in
the affected tooth or teeth on the radiograph, root
development (biologic eruption status), tooth position and
physical obstruction should be evaluated. For a
succedaneous tooth if root formation is inadequate,
extraction ofthe deciduous tooth or exposure toapplyactive
orthodontic treatment is not justified. If the tooth is lagging
in its eruption status, active treatment is recommended
when more than 2/3 of the root has developed25
.
Radiographic examination might also show an ectopic
position of the developing tooth. Often, some deviations
self-correct, but significant migration of the tooth usually
requires extraction. If self-correction is not observed over
time, active treatment should begin. Exposure accompanied
by orthodontic traction has been shown to be successful.
In patients in whom the ectopic teeth deviate more than 90°
from the normal eruptive path, autotransplantation might
be an effective alternative.10,23,24,25
An obstruction causing delayed eruption might
or might not be obvious on the radiographic survey. A soft
tissue barrier to eruption is not seen on the radiograph, but
the obstruction should be treated with an uncovering
procedure that includes enamel exposure. Supernumerary
teeth, tumors, cysts, and bony sequestra are physical
obstructions visible on the radiographic survey. Their
removal usually will permit the affected tooth to erupt29
In the deciduous dentition, DTE due to
obstruction is uncommon, but scar tissue (due to trauma)
and pericoronal odontogenic cysts or neoplasms are the
usual culprits in cases of obstruction. Trauma is more
Delayed Tooth Eruption
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common in the anterior region, but cysts or neoplasms are
more likelytoresult in DTE in the canineand molar regions.
Odontomas are reported to be the most common of the
odontogenic lesions associated with DTE30
. Treatment
options for deciduous DTE range from observation,
removal of physical obstruction with and without exposure
of the affected tooth, orthodontic traction on rare
occasions, and extraction of the involved tooth28,31
.
In the permanent dentition, removal of the physical
obstruction from the path of eruption is recommended.
When neoplasms (odontogenic or nonodontogenic) cause
obstruction, the surgical approach is dictated by the
biologic behavior of the lesion. If the affected tooth is deep
in the bone, the follicle around it should be left intact. When
the affected tooth is in a superficial position, exposure of
the enamel is done at tumor removal. Occasionally, the
affected tooth must be removed. McDonald and Avery32
recommend exposure of the tooth delayed in eruption at
the surgical removal of the barrier, but Houston and Tulley
33
advocate removing the obstruction and providing
sufficient space for the unerupted tooth to erupt
spontaneously. If the tooth is exposed at the time ofsurgery,
it might or might not be subjected to orthodontic traction
to accelerate and guide its eruption into the arch. The
decision to use orthodontic traction in most case reports
seems to be a judgment call for the clinician. Occasionally,
a deciduous tooth can be a physical barrier to the eruption
of the succedaneous tooth. In most cases, removing the
deciduous tooth will allow for spontaneous eruption of the
successor4.
When arch length deficiencycreates a physical
obstruction, either expansion of the dental arches or
extraction might be necessaryto obtain the required space.
10,13
Whenever DTE is generalized, the patient should
be examined for systemic diseases affecting eruption, such
as endocrine disorders, organ failures, metabolic disorders,
drugs, and inherited and genetic disorders. Various methods
have been suggested for treating eruption disorders in
these conditions. These include no treatment (observation),
elimination of obstacles to eruption (eg, cysts, soft tissue
overgrowths), exposure of affected teeth with and without
orthodontic traction, autotransplantation, and control of
the systemic disease.1,4,10,11,12,17,19
Faizal C Peedikayil
Table 1: Local Conditions associated with DTE *(10,11,12)
Mucosal barriers-scar tissue: trauma/surgery
Supernumerary teeth
Odontogenic tumors (eg, adenomatoid odontogenic Tumors, odontomas)
Nonodontogenic tumors
Enamel pearls
Injuries to primary teeth
Ankylosis of deciduous teeth
Premature loss of primary tooth
Lack of resorption of deciduous tooth
Apical periodontitis of deciduous teeth
Regional odontodysplasia
Drugs -Phenytoin
Ectopic eruption
Arch-length deficiency and skeletal pattern
Radiation damage
Oral clefts Segmental odontomaxillary dysplasia
Table 2: Systemic Conditions associated with DTE * (10,
15,16,17)
Nutrition
Vitamin D-resistant rickets
Endocrine disorders (Hypothyroidism ,Hypopitutarism, hypoparathyroidism,
pseudohypoparathyroidism)
Long-term chemotherapy
HIV infection
Cerebral palsy
Dysosteosclerosis
Anemia
Celiac disease
Prematurity/low birth weight
Ichthyosis
renal failure
Table 3: Genetic conditions associated with DTE*(10,18-24)
Am elogenesis imperfect and associated disorders
Enamel agenesis and nephrocalcinosis
Am elo-onychohypohydrotic dysplasia dento-osseous
syndrom e (types I and II)
Apert syndrom e
C arpenter syndrom e
C herubism
C hondroectoderm al dysplasia (Ellis-van C reveld
syndrom e
C leidocranial dysplasia
C ongenital hypertrichosis lanuginosa
D entin dysplasia
Mucopolysaccharidosis
D eLange syndrom e
H urler syndrome
H unter syndrom e
Pyknodysostosis (Maroteaux-Lam y syndrom e) (M PS IV)
D ow n syndrome
Ectoderm al dysplasia
Epiderm olysis bullosa
G ardner syndrom e
G aucher disease
R utherford syndrom e
C ross syndrom e
R am on syndrom e
Gingival fibromatoses with sensorineural hearing loss
Gingival fibromatoses with growth hormone deificiency
G orlin syndrom e
N eurofibromatoses
O steopetrosis (marble bone disease)
O steogenesis im perfecta
O todental dysplasia
Parry-Rom berg syndrom e
Prog eria (H utchinson-Gilford syndrome)
R othm und-Thompson syndrome
VonRecklinghausen neurofibrom atosis
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Table 4: Etiology and Diagnosis of Chronological
delayedtooth eruption(>2SD)
Normal biologic
eruption: root length<
2/3
Physical obstruction
Normal tooth development
Abnormal tooth development( defect in shape , size,
structure, colour)
Delayed biologic eruption: root
length>2/3
-Amelogenisis imperfecta
- Dentinogenesis imperfecta
- Regional odontodysplasia
-Dilacerations
- Dentin dysplasia
- preterm birth/ low birth
weight
- nutrition
- vit D resistant rickets
- down’s syndrome
- Hypopitutarism
Radiographycally evident Not evident
radiographically
-supernumerary tooth
- tumor
- cyst
-eruption sequestrum
-ectopic eruption
-Scar from trauma
-Scar from surgery
-Ankylosis
-Gingival hyperplasia
-Premature loss of
primary teeth
OTHERS
-Nutritional deficiency
-Radiation damage
-traumatic displacement of tooth germ
-cleidocranial dysplasia
-arch length deficiency
-Scleroosteosis
-HIV infection
-Genetic predisposition
Delayed Tooth Eruption
CONCLUSION
The sequential and timely eruption of teeth is
critical in overall development of the child. Variations can
occur due to various reasons, but eruption delay of more
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Table 5:Chart of treatmentoptionsof DTE affecting
permanentteeth
Chronological delayed tooth eruption
Radiographic examination
Evaluate for tooth agenesis tooth missing
Tooth present
Evaluate systemic influences Yes Is DTE generalized?
observation No
diagnosis Yes Root development ? 2/3 ? No
Yes
No Observation Physical obstruction
yes No
Evaluate tooth position
if ectopic
Observation
Diagnosis &control of
systemic disease
Observation
Exposure+orthodontic
traction
Extraction +replacement
(implant, fixed removable
prosthesis,
Autotransplantation )
Tooth development
normal on
radiographic survey
Observation
Extraction of affected teeth+
replacement (implant,fixed,
removable prosthesis,
autotransplantation ofhealthy
tooth bud ) .
Exposure of affected tooth
exposure +orthodontic
traction
-Removal of obstruction ,
Removal of obstuction + exposure of
affected teeth ,
Removal of obstruction+ exposure +
orthodontic traction ,
Removal of obstruction + removal of
affected teeth +replacement of
tooth (implant, removable or fixed
prosthesis,autotransplantation),
Removal of obstruction+ removal of
affected tooth +orthodontic space
closure ,
Extraction of neighboring tooth to
create space ,
Expansion of arches
Space closure,
Restorative options
than two years should be investigated. eventhough
genetics has an important role in the eruptuin process other
factors such as gender, body composition, local
disturbances,nutritional factors, systemic diseases etc can
influence the process. But significant cause may be due to
systemic conditions and syndromes associated with
orofacial structures. Timely diagnosis of DTE is necessary
for selecting the right treatment modality.
6. www.ejournalofdentistry.com
86
Faizal C Peedikayil
Source of Support : Nil, Conflict of Interest : Nil
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