ERUPTIO AND SHEDDING

8/7/2019 ERUPTIO AND SHEDDING

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DENTAL EVOLUTIONARYHISTORY


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ERUPTION

Eruption is the process whereby a toothmoves from its developmental position in

the jaw into its functional position in theoral cavity. Main direction of the eruptive force is axial. Eruption rates of teeth are greatest at thetime of crown emergence.


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Eruption can be regarded as a lifelongprocess since a tooth will often move

axially in response to changing functionalsituations As a tooth approaches the oral cavity, theoverlying bone is resorbed and there aremarked changes in the overlying softtissues.


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Pattern of tooth movement1) Pre-eruptive tooth movement:

Pre-eruptive phase, which starts with theinitiation of tooth development.

2) Eruption tooth movementTooth eruption (prefunctional phase) whichbegins once the roots begin to form.

3 ) Post-eruptive tooth movement:

After the teeth have emerged into the oral cavity,there is a protracted phase concerned with thedevelopment and maintenance of occlusion (thefunctional phase).


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Pattern of tooth movement


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Pre-eruptive tooth movement

Pre-eruptive tooth movement of deciduous teeth : When deciduous tooth germs first differentiate, there is a

good deal of space between them.Because of their rapidgrowth this available space is utilized and the developingteeth become crowded together, especially in the incisor and canine region.

This crowding is relieved by growth in the length of theinfant jaws which provides room for the seconddeciduous molars to drift backward and anterior teeth todrift forward.

At the same time the tooth germs also move outward asthe jaws increase in width and upward( downward in theupper jaw) as the jaws increase in height.


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Pre-eruptive tooth movement of

permanent teeth The permanent incisors and canines first develop

lingual to the deciduous tooth germs at the level of

their occlusal surfaces and in the same bony crypt. Astheir deciduous predecessors erupt, they move tomore apical position and occupy their own bony crypts.

Permanent molars also move considerably from the

site of their initial differentiation. All these movements are linked to jaw growth and may

be considered as movements positioning the tooth andits crypt within the jaws preparatory to tooth eruption.


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Eruptive tooth movement

During the phase of eruptive tooth

movement the tooth moves from itsposition within the bone of the jaw to itsfunctional position in occlusion and theprincipal direction of movement is occlualor axial .


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Post-eruptive tooth movement

maintain the position of the erupted toothwhile the jaw continues to grow

compensate for occlusal and proximal wear.


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H istology of tooth movement

Pre eruptive phase: Total bodily movement of the germ

There is its eccentric growth:eccentric growth: one part of the

developing tooth germ remains stationary

while the remainder continues to grow,leading to a shift in its center.


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Eruptive phase

Significant developmental changes occur Formation of root

Formation of periodontal ligament,Formation of dentogingival junctionAnother specialized feature associated

with the erupting permanent tooth is thepresence of a gubernacular canal or cord.


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M echanism of tooth movement

1 . Root growth2. Vascular pressure Root growth

3. Bone Remodelling4. Ligament traction


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G enes and enzymes responsible

for eruption C-fos gene CSF

EG F


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ROLE OF VITAMIN K INERUPTION

Increase in the rate of growth and eruption.

Incidence of newcarious lesions isreduced.


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Conditions Affecting Tooth Eruption

Mechanical interference by supernumeraryteeth.

Crowding Odontogenic cysts and tumors. Eruption Sequestrum.

Local Causes-Fibromatosis G ingivae. Systemic causes-Rickets & CleidocranialDysplasia.


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Problems during the eruption of deciduous teeth


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T eething

T eething is the process by which aninfant's teeth sequentially appear bybreaking through the gums


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Clinical features

Appears to be linked with: Daytime restlessness Thumb-sucking

G um-rubbing Drooling Loss of appetite Slight fever

Facial rash Sleep disturbance Ear rubbing


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Treatment

Teething rings andteethers

Acetaminophen andibuprofen (should notbe administered tobabies under sixmonths of age).

Sugar-freeparacetamol


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Early and delayed eruption

Condition found toaccelerate the eruptionof teeth

hyperthyroidismneurofibromatosis

Delay in eruption of primary teeth has beennoted in

HypopituitarismhypothyroidismDown's syndrome

Cleidocranial dysostosisG ardener's syndromeCerebral palsy


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Eruption cysts

Eruption cysts are atype of fluid filled sacthat forms on the top

of a tooth that iscoming through.

The cysts are oftenblue, raised and ovalshaped.


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TREATMENT The type of treatment

provided for eruptioncysts ranges from notreatment to extraction of

the tooth and removal of the cyst. The best form of

treatment is to leave italone as eruption cystsare often of noconsequence and resolvewhen the tooth comesthrough.


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N eonatal and natal teeth Natal teeth are those which

come through around the timeof birth.

Usually occur in around 1 in2,000 to 1 in 3,500 births.

Can be considered assupernumerary teeth.

If the natal or neonatal tooth isan extra tooth, then it is usuallyremoved by the dentist.

Extraction is also best for verymobile teeth due to the risk of the tooth falling out andsubsequent swallowing or inhalation.


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Riga-Fedes syndrome Occurs in approximately 6-

1 0% of cases of neonatal or natal teeth.

Ulceration and infantdiscomfort that occur whenprimary teeth come through.

Ulceration in Riga Fededisease may remain for a longtime, resulting in insufficientfood intake, dehydration andretarded growth.


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M anagement

Extraction of the offendingtooth.G rinding to remove the

roughness, bumps and anysharp edges associated withany given tooth.

Coverage of the tooth/teethwith a filling material(composite resin) to provide a

smooth rounded surface. Stomahesive wafers to cover

the teeth and provide a smoothsurface for the tongue to passover during suckling.


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Problems during the eruption of permanent teeth


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PericoronitisPericoronitis is a commonproblem in young adults withpartial tooth impactions.

occurs within 17 to 24 years of age as it is when the thirdmolars start erupting

tissue around the wisdom toothhas become inflamed

Poor oral hygiene andmechanical trauma on nearby

tissue can cause thisinflammation


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Treatment

Treatment for minor symptoms of pericoronitis(spontaneous pain, localized swelling,purulence/drainage, foul taste) is irrigation.

Major symptoms of pericoronitis (difficultyswallowing, enlarged lymph nodes, fever, limitedmouth opening, facial cellulitis/infection) areusually treated with antibiotics.

In most instances the symptoms will recur andthe only definitive treatment is extraction.


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ERUPTIO AND SHEDDING

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