6/24/2011

ULFAT

DEVELOPMENT OF
DENTITION & OCCLUSION
LECTURE III
BY

DR. ULFAT BASHIR

MCPS, FCPS (Orthodontics)

PROFESSOR

1
 6/24/2011

3) First Transitional Period (6 to 8 years)

DETERMINANTS OF UPPER / LOWER 1ST MOLAR

OCCLUSION

Terminal plane of primary 2nd molars

Spacing in primary dentition (type I or II)

Lee – way space of Nance

Cusp – fossa relationship

Muscular forces

ULFAT

3) First Transitional Period (6 to 8 years)

PROBABILITIES OF FIRST MOLAR RELATIONSHIP

IF MESIAL STEP IN DECIDUOUS MOLARS

No further adjustment required

Normal class I

Class III tendency

IF FLUSH TERMINAL PLANE

End – to – end relation

Early mesial shift to get class I in type I dentition

Late mesial shift in Lee way space in type II dentition

The spaces closed by force of erupting 1st molar ULFAT

2
 6/24/2011

3) First Transitional Period (6 to 8 years)

NORMAL SEQUENCE OF ERUPTION AT THIS STAGE

LOWER 1ST MOLAR  UPPER 1ST MOLAR _ LOWER

CENTRAL INCISOR  UPPER CENTRAL INCISIOR
 LOWER LATERAL INCISOR  UPPER
LATERAL INCISOR

AT THE END OF THIS STAGE

Incisors present
Sometime crowded in lower arch and spaced in upper arch
More labial inclination than primary incisors

First permanent molars erupt with end – to – end

relationship
ULFAT


3) First Transitional Period (6 to 8 years)

ULFAT

3
 6/24/2011

4) Second Intertransitional Period (8 to 10 years)

This phase is again a state of pause in which no eruption of
teeth occur, except lower cuspids

GENERAL FEATURES
Increased vertical facial dimensions for
o Heightening of alveolar ridges
o Accommodating continuous root growth of
cuspids and premolars

Maxillary tuberosity and mandibular ramal activity for

permanent 2nd molar eruption

Maxillary cuspids are still under development lateral to nose

and roots of lower cuspids close to inferior border of
mandible
Premolars are nestled in bifurcation of their antecedents /
evidence of distal root resorption of primary molarsULFAT

4) Second Intertransitional Period (8 to 10 years)

UGLY DUCKLING STAGE

In this stage an interesting physiological transient
phenomenon occur in the dentition at 8-9 years of age
exhibited by, median maxillary diastema and spaced
& flared incisors

The reason is the erupting maxillary canine, the crown of

which erupts first mesially pushing the roots of lateral
incisors mesially and crowns distally, creating spaces
in the incisors. But

once the canine completes its distal & occlusal path of

eruption, this phenomenon vanishes and there is no
need of any orthodontic intervention at this stage
ULFAT

4
 6/24/2011

4) Second Intertransitional Period (8 to 10 years)

GABLE EFFECT
The cusps of cuspids and premolars is connected, a gable
effect is noted before their eruptions, where first
premolar is on the peak position

But normally cuspids play a “catch up” role and pass up the
premolar to erupt earlier

MAXILLARY MIDLINE DIASTEMA

Sometimes, the maxillary labial frenum persists to become

a cause of the maxillary permanent median diastema
ULFAT

It is common sense to
take a method and try
it, if it fails, admit it
frankly and try another,
but above all, try
something
(Roosevelt)
ULFAT

5
 6/24/2011

4) Second Transitional Period (10 to 12 years)

Is characterized by
Last exchange of teeth

Primary cuspids and molars shed

Permanent cuspids and premolars erupt

2nd permanent molars erupt

All permanent teeth complete eruption except 3rd molars

ULFAT

4) Second Transitional Period (10 to 12 years)

ARCH LENGTH / CIRCUMFERENCE DECREASE

After primary 2nd molar exfoliation in both arches
Seems to increase after mandibular cuspids and incisors
eruption but shortens more than existed by the late
mesial shift using positive Leeway space

ULFAT

6
 6/24/2011

4) Second Transitional Period (10 to 12 years)

LEEWAY SPACE OF NANCE
It is the extra space acquired by the eruption of the
permanent cuspids and bicuspids after the exfoliation
of their antecedents (primary cuspids & first and
second molars). This may also known as positive
Leeway space compared to the negative Leeway
space in the anteriors. It is 1.8 mm (0.9 mm per side)
in upper arch and 3.4 mm (1.7 mm per side) in the
lower arch.

E SPACE
It is the space given by the lower primary 2nd molar at the
eruption of 2nd premolar (a part of the Leeway
space). It is the maximum amount of space given by
any upper or lower primary molars. It is calculated as
2 mm
ULFAT

4) Second Transitional Period (10 to 12 years)

Leeway space is utilized for

Establishing class I molar relationship

Distal movement of cuspids and premolars compensating
for incisors liability

POSSIBLE SEQUENCE OF ERUPTION

MAXILLA
1ST PREMOLAR  2ND PRE MOLAR  CUSPID

1ST PREMOLAR  CUSPID  2ND PREMOLAR

MANDIBLE
CUSPID > 1ST PREMOLAR > 2ND PREMOLAR

1ST PREMOLAR > CUSPID > 2ND PREMOLAR

ULFAT

7
 6/24/2011

4) Second Transitional Period (10 to 12 years)

SECOND PERMANENT MOLARS ERUPTION
Emerge along with 2nd premolar or after all other teeth
Help in late mesial shift of first molar in Leeway space
Pathway of eruption is same as for first molar

DIFFERENCE BETWEEN EARLY & LATE MEISAL SHIFT OF FIRST

MOLARS
Early mesial shift occurs at the time of permanent first
molar eruption in the first transitional stage where it
tends to close the spaces of primary dentition

while late mesial shift occurs in the second transitional

stage, after the exfoliation of primary 2nd molars
(utilizing the positive Leeway space) to establish class
I molar relationship
ULFAT

6) Adult Dentition Period (12 years onwards)

This stage is exhibited by

Nose and chin become more prominent (bone apposition on

chin)
Reduction in convex profile
Prominent brow area by
 Pneumatization of frontal air sinus
 Apposition at glabella
Growth of jaws continue to make room for 3rd molars
Frequently inadequate growth lead to
 Impacted 3rd molars
 Congenitally small 3rd molar buds or missing
Gradual completion of roots of 2nd and 3rd molars
ULFAT

8
 6/24/2011

AT THE COMPLETION OF THE DEVELOPMENT

OF DENTITION & OCCLUSION
The student be able to know
Features of primary & permanent dentition in occlusion
Estimation of the space for any of the un – erupted tooth
Dental age determination at different ages by
• Which teeth have erupted
• Amount of resorption of the roots of primary teeth
• Amount of development of permanent teeth

TO BE TAUGHT AT THE CLINICS

ULFAT

Email; orthoraja69@hotmail.com