This document discusses self-correcting anomalies that arise during development of the dentition from infancy to adulthood. These anomalies include a retrognathic mandible, anterior open bite, and infantile swallowing in the pre-dental period. In the primary dentition stage, common anomalies are anterior deep bite, spacing, and flush terminal plane. Mixed dentition anomalies include anterior deep bite, mandibular crowding, the ugly duckling stage, and end-on molar relationships. Increased overjet and overbite can occur in the permanent dentition stage. All of these anomalies typically correct themselves without treatment as the jaws and dentition develop through growth and the eruption of permanent teeth.

1. SELF CORRECTING ANOMALIES
MADE BY :
DR. DHARATI PATEL

2. Content
• Introduction
• Classification
▫ Pre-dental period
▫ Primary dentition
▫ Mixed dentition
▫ Permanent dentition
• Summary
• References

3. ALSO CALLED TRANSIENT MALOCCLUSION
• Get corrected themselves
• As they pass through the developmental stages

4. ▫ ANOMALY:
Is defined as marked deviation from normal.
▫ SELF CORRECTING ANOMALIES :
Self-correcting anomalies are the anomalies
which arise in the child’s developing dentition during the
period of transition from that of gum pads stage to the onset
of permanent period and get corrected on their own without
any dental treatment.

5. Classified based on stages of
development of dentition
PREDENTAL PERIOD
PRIMARY DENTITION
MIXED DENTITION
PERMANENT DENTITION

6. PRE-DENTAL PERIOD
(From birth to the eruption of 1st deciduous teeth)
1) Retrognathic mandible :
• Mandibular lateral sulcus lies posterior to maxillary
lateral sulcus
• Upper gum pad protrudes - about 5 mm

7. Causes :
• Growth magnitude and duration – greater for anterior
maxilla then anterior mandible
• Upper anterior gum pad > lower anterior gum pad
(intercuspid width ) (intercuspid width )
• Mandible undergoes the largest amount of growth post-
natally rather than prenatally .

9. Self corrected by :
• within 6-7 months
• By downward and forward growth of the
mandible

11. Clinical consideration :
▫ Remain till 6 months after birth and helps in
suckling
▫ Can not be used as a reliable diagnostic criteria for
predicting subsequent arch relationship
▫ But if the antero-posterior dimension of gum pads
is greater the possibility of the child developing a
malocclusion is greater.

12. 2) Anterior open bite :
▫ When Upper and lower gum pads are
approximated :-
 Contacts only at the molar region
 Space exist in the anterior region
called anterior open bite

14. Self corrected by:
▫ At 6-7 months
▫ Eruption of primary incisors .

15. Clinical consideration
▫ This open bite is considered normal
▫ Helps in suckling

16. 3) Infantile swallowing :
Nipple is drawn into
mouth
Tongue protrudes
between the nipple
and lower lip
Milk is Directed to
the pharynx
Milk passes between
the faucial pillars
and lateral channels
of pharynx
Excess milk dribbles
down the chin
• Different from mature swallowing
• Carried out by stomatognathic system

17. Features of infantile swallowing
outlined by Moyer(1964) :
• The jaws are apart – tongue placed between upper
and lower gum pads.
• The mandible stabilization – by contraction of
muscles of seventh cranial nerve and interposed
tongue
• Swallow is guided and controlled - Sensory
interchange between lips and tongue

18. Self corrected by :
▫ Gradually disappears with eruption of teeth
And
▫ As infant begins to eat solid food (approximately
1st year)
▫ Tongue is contained within the dental arch and
mandible is no longer protrude
▫ Indicate the onset of mature swallowing

19. Clinical consideration
▫ As above two conditions , the anterior region of
the gum pads do not come in contact with each
other
▫ Hence to swallow an infant has to close this space
▫ So tongue is used to close the space by placing it
between the gum pads during swallowing.
▫ During transitional period both swallowing can be
observed

20. PRIMARY DENTITION
(6 months to 2.5 to 3 years )
1) Anterior deep bite :
▫ Excessive vertical overlapping
▫ The lower incisal edge come in contact with the
cingulum of upper incisor

21. Causes :
▫ Primary teeth are more upright than their
successors
▫ Have more vertical inclination - Inter-incisal angel
of (about 1500)
▫ Infra-occlusion of partially erupted molars

23. Self corrected by:
• Complete Eruption of primary molars-Increase
the vertical dimension
• Attrition of incisal edges
• Forward and downward growth of mandible

24. Clinical consideration
• Should not consider as – Malocclusion
• orthodontic treatment for deep bite – not
required

25. 2) Spacing
• Delabarre (1918) – first described interdental
spacing in primary dentition

26. Types of spaces in primary dentition
▫ Primate /anthropoid/simian spaces :
▫ Physiological/developmental spaces :
 4 mm in maxilla
 3 mm in mandible

27. Primate space
Physiologic space

28. Clinical consideration
• Spaced dentition is supposed to be good -
important for normal development
• Spaces can be utilized for adjustment of
permanent successors which are always larger
• Absence of spaces indicates that crowding may
occur in permanent dentition

29. Self corrected by :
▫ Eruption of larger permanent successors
▫ Eruption of first permanent molar
(Early mesial shift )

30. 3)Flush terminal plane :
• Primary molar relationship
A. Flush terminal plane
B. Distal-step terminal plane
C. Mesial-step terminal plane

31. Self corrected by
• Mesial eruptive force of first permanent molar
1. Early mesial shift : By using Primate spaces.
2. Late mesial shift : By using leeway spaces
1.8 mm in maxilla
3.4 mm in mandible

32. Clinical consideration
• The most desirable permanent dentition -
Class-I occlusion
• Relationship of primary terminal plane - key
diagnostic feature regarding future occlusion
status

33. Terminal plane prediction
Class-I 56 %
Class-II 44%
Flush
terminal
<2 mm
80% class-I
2 mm
20% class-III
Mesial
step
Class-II
Highly
predictable
Distal
step

35. Primary terminal
plane (4-5 years )
Initial permanent
first molar
occlusion(6 -7 years )
Final occlusion
(12 years )
1% class-III (< 2mm) 3% class-III
49 % mesial step 27% class- I 59% class- I
17% flush terminal 49% End on
14% distal step 23% class-II 39% class-II
Table: 1 Incidence of Terminal Molar Relationships at Three Stages of
Occlusion Development

36. 4)EDGE TO EDGE BITE :
▫ Due to attrition of primary incisors
▫ By downward growth of mandible over jet
decreased gradually

37. Self corrected by
• Eruption of permanent incisors
• Having more labial inclination-
inter-incisal inclination 1230

38. MIXED DENTITION
(6 years to 12-13 years )
1) Anterior deep bite :
▫ Due to large permanent successor incisors

40. Self corrected by
▫ Complete Eruption of primary molars-
Increase the vertical dimension

41. 2)MANDIBULAR ANTERIOR CROWDING :
• Disproportion between tooth size and arch
length
Cause :
▫ Exchange of larger permanent mandibular
incisors
▫ In narrow lower arch

43. Self corrected by
• Increased inter-canine width - by jaw expansion
• Tongue pressure – cause forward migration of
lower incisors

44. Clinical consideration
• Minor crowding - resolves spontaneously by
development
• Moderate crowding – use of leeway space
▫ Preventing mesial movement of permanent molar

45. 3) Ugly-duckling stage:
• Seen at 8-11 years of age
• First described by – H Broadbent (1937)
• Also called Broadbent phenomenon
• Term Indicates Unaesthetic appearance of child

47. Self corrected by
• Complete eruption of permanent maxillary
canine

49. Clinical consideration
• During this stage children tends to look ugly
• Parents are often apprehensive and do consult
the dentist
• But this condition is corrected by itself -
pressure is transferred from roots to coronal
area
• So no need of any orthodontic treatment

50. 4) End on relationship:
• Buccal cusp tip of permanent maxillary 1st molar
coincide with buccal cusp of permanent
mandibular 1st molar.
• Obtained in mixed dentition period following
the flush terminal relation in deciduous
dentition.

51. Class -1 relationship in
1st permanent molars
End on relationship in
1st permanent molars

52. Self corrected by :
• Eruptive force in mesial direction of
permanent mandibular molars
• Late mesial shift in Non-spaced dentition
▫

53. Clinical consideration :
Initial
occluding end
on relationship
75% shift
towards class-I
relationship
25% shifts into
class-II
relationship

54. PERMANENT DENTITION
1) Increased overjet and overbite:
• Overbite : a vertical distance which the incisal edge of
maxillary incisors overlaps the incisal edge of mandibular
incisors.
• Overjet : a horizontal distance between the lingual
aspect of the maxillary incisors and the labial aspect of the
mandibular incisors.

56. Self corrected by :
▫ By eruption of all permanent molar
▫ Differential growth of mandible
▫ Overbite decreased up to - 0.5 mm by 18 years of age
▫ Overjet decreased up to - o.7 mm between 12 to 20
years of age

57. Summary :
• Therefore self correcting anomalies
 are part of developing dentition
 not to be considered as any developmental or
pathological abnormality
• If there is any apprehension on part of the parents
 it should be removed promptly
 parents should be explained in brief the physiology
behind these transitional changes

58. Reference :
▫ Avery D R, McDonald R E.Dentistry for the child and
Adolescent. Mosby, 9th Edition 2012 , 518-520.
▫ Marwah N. Text book of pediatric dentistry scientific
foundation and clinical practice, Mosby, 3rd Edition 2014,
166-178.
▫ Tandan S. Textbook of pediatric dentistry, Paras
publication , 2nd edition ,2009 ,107-117
▫ Singh G. Text book of orthodontics ,Jaypee , 2nd edition
2007,40-45.
▫ Bhalaji S I. Orthodontics - The Art and Science , Medi , 4th
Edition , 2009 , 44-50.

59. THANK YOU