Etiology of malocclusion 2

Part1
Today we are going to talk about the local dental factors .
This slide is very imp., it indicate that the malocclusion is multifactorial.
So local factors are:
1-abnormalities in tooth size, number and form.
2-premature loss of primary teeth.
3-loss of permanent teeth.
4-prelonged retention of primary teeth.
5- abnormal development in position of tooth germs.
6-sucking habit.
7- large persistent labial frenum.
We talked about sucking habit and large persistent labial frenum.
So lets start with :

١- abnormalities of both size, number and form:
small teeth which called microdontia result in spacing , because its small.
Large teeth on the opposite way may result in crowding.
Supernumerary teeth: an extra teeth which account about 1%, have many
complications we will talk about them later.
Missing teeth or congenitally missing teeth, called hypodontia which account for 6%,
it may result in spacing if left missing ,however if the space grow prematurely it will
not result in space.
Abnormal forms: 1-dense in dentin
2-dilaceration
3-gemination
A-supernumerary teeth:
account about 1%, males have supernumerary teeth more than females.
The etiology : extra teeth is excessive dental activity however its organized growth of
the dental lamina.
Types of supernumerary teeth: 1- conical
2-tuberculate
3-supplemental
4-Odontomes
1-conical or mesiodens: usually its inverted and often found in middline, formed early
and may erupt causing displacement.
You will see a radiographs with supernumerary teeth mesiodens erupted.
2-tuberculate: formed late and usually it does prevent the eruption of upper incisors,
usually its in pairs.
3-supplemental: identical and often found at end of the series.
Identical: its similar to the adjacent tooth, to the last teeth in the series, Lateral incisor
is the most common supplemental tooth. Lateral incisor is the end of incisor series,
and you may found a supplemental lateral incisor which identical to lateral incisor,
however its extra so instead of 4 incisors :2 centrals and 2 laterals you may found 5,

Its more unilateral than bilateral.5 slide2). if this guide is no more available then canine eruption may be affected. 6-cystic formation. What is the difference between complex and compound odontom? [Ans: compound odontoma: An odontoma in which the odontogenic tissues are organized and bear a superficial resemblance to teeth . 2-over eruption of opposing tooth So if you need to put prosthesis you may need to protrude this tooth. 2-mandibular 2nd premolar. 5-root resorbtion of central incisors.spacing (like p. why? Because one of the theories behind the palatal impaction of maxillary canine is the guidance theory which states that the distal side of the lateral incisor root will act as a guide of canine eruption. .one extra lateral incisor in one side. if there is no guidance anymore the eruption will be affected. in this case its not so sever. Why supernumerary teeth are considered as etiological factors of malocclusion? Can you see this mesiodense? Its erupting. A)lateral incisor: the case in(p. So the consequences of supernumerary teeth may result in: 1-midline diastema like first 2 photos.5 more times than normal patient without missing lateral incisor . Repeat : one of the theories called maxillary canine impaction is the guidance theory which states that dental aspect of the lateral incisor root acts as a guide for the canine eruption. It can affect the path of eruption of the canine. its 2. at order: 1-3rd molars.on the right. 2-crowding. usually it’s the most common missing tooth. 3-delayed eruption of central incisors. 4-maxillary 2nd premolar. b)missing mandibular 2nd premolar : it may result in 1. it accounts for 6%. usually if lateral incisor is missing there is a great risk that the adjacent canine on that side will be palataly impacted. 4-malposition of central incisors. of course its cause crowding bec there is extra tooth. So missing teeth may result in spacing. in this case the mesiodense prevent central upper incisor from erupting. but there are many cases with severe over eruption of the opposing teeth. In retained deciduous 2nd molar :in this case upper E still retain and it submerge or intra occluded. :tooth form or non tooth form. 4-odontomes: which either complex or compound. 3-lateral incisor. but complex odontoma:in which the various odontogenic tissues appear in a haphazard arrangement that bears no resemblance to teeth. Dr ans. 5-mandibular central incisor.5 slide1). B-hypodontia or congenitally missing teeth.

the result is one big tooth so this is gemination. So one tooth bud divide into 2 teeth. if you will considered the fused 2 teeth as one tooth its less than one.C) variation or abnormalities of tooth form: Like gemination or fusion. so this is the difference between germination and fusion. What is fusion and what is gemination? The key point is the number. (p. Student asked: what about the roots? Gemination: maybe one root but there is identication indicates that there are 2 roots geminated together. In case of gemination you will find extra tooth geminated with its adjacent tooth. one root ‫ . if you count the tooth adjacent to the tooth you will found that the central is there and lateral is there . in this case its gemination because this is the central and this is the lateral and there are 2 teeth geminated together. In case of fusion you may found that the 2 centrals fused together. however there are 2 centrals geminated together.6 slide 1). In fusion it’s the same number with fused 2 teeth.

the effect is crowding and esthetic complication. Most likely to affect upper or lower incisor. so the movement around that axis in form of rotation. However for the canine the most common cause is: root resorbtion from the adjacent crowded lateral incisors. and again it will result in space loss and crowding. why rotation in the upper and tipping in the lower ? bec of the morphology of the roots: In upper: the upper 6 has big palatal root. If after eruption of 6s there will be a mesial tipping of lower 6s and mesial rotation of upper 6s. . 6s will erupt in amore ant. Position.canine For the primary 2nd molar and primary 1st molar the most common cause for premature loss is : dental caries. because 5 have no space to erupt in.like the crown. B)Premature loss of primary teeth: Why its serious problem to have premature loss of primary teeth? Usually the most commonly loss teeth are the molars: 1-primary 2nd molars 2-primary 1st molars 3. ن آ‬. so either it erupts palataly in a crowded position or it will not erupt and stay impacted tooth. 1.2nd primary molar : if its lost before eruption of 6s. Repeat: mesial tipping of lower 6s and palatal rotation of upper 6s. so there will be a loss of space and this will result in crowding or may result in impaction of the adjacent 5.

post. If this happen and the space lost by the mesial drifting of the post. In the lower arch usually 3s erupt before 4s. Incisors develop palatal.As a treatment either you close the space and extract 5 or regain the space by opening it. So mostly as a result of root resorbtion by crowded lateral incisors may result in canine crowding. Not all lat. space loss and canine crowding or impaction. Why? Because usually lat. Because this is the normal expected movement . teeth the upper canine will be shortage of space so either it will erupt buccally in a crowded position or it will be impacted. Incisors cause root root resorbtion but crowded lateral incisors may cause it. That’s why before a minute in the upper first primary molar I put question mark may have effect on the center line. AIAT KHALILIA ، ‫  آّ أً آ . In the the upper arch usually upper 4s erupt before upper 3s so if the D (1st primary molar ) is lost prematurely this may enhance the upper 4s to erupt. Crowding however 4s will be crowded or impacted. 3-primary canines: we Saied the most common cause for pre mature loss is root resorbtion from the adjacent lateral incisor. The more ant the tooth……the more the effect on the midline. If unilateral may result in centerline shift. if unilateral it will affect the midline or the center line. 2.1st primary molars: again 6s and Es will drift mesially. so if the Ds is lost this may enhance the canine to erupt first and to relieve the ant. Teeth move forward bec of occlusal forces. yes bec if they lost prematurely.

ج إ ات   .

/  0 ‫و‬ !(2. أ  أ‬ !!‫ "!ال‬#$ %&‫ * أن (' إ‬+ ‫ و‬-.

  3 .4( 5‫ آ‬-./  8 ‫ن ../‫ ا‬%6* & .7 ً  -.

ج إ ات و‬9‫ ا‬4 " !!‫ـ" م "!ال‬$  0'(  -./‫   &< أن ا‬4‫ و‬0 !! ‫@د‬A&  ‫ي‬6‫ ا‬+‫اه‬6‫ه@ ا‬ .