6/24/2011

ULFAT

DEVELOPMENT OF DENTITION &

OCCLUSION
LECTURE 1
BY

DR. ULFAT BASHIR

MCPS, FCPS (Orthodontics)

PROFESSOR

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OBJECTIVES
TO UNDERSTAND
Normal development of dentition

Normal & abnormal patterns of dentition

The timings of eruptions of primary & permanent dentition

Establishment of normal occlusion

And co-relate the knowledge with clinical orthodontics

ULFAT

WHAT KNOWLEDGE
REQUIRED
General tooth development
Normal eruption mechanism
Morphology of primary & permanent
dentition

ULFAT

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NOLLA STAGES OF TOOTH

DEVELOPMENT
0) ABSENCE OF CRYPT

1) PRESENCE OF CRYPT

2) INITIAL CALCIFICATION

3) ONE THIRD CROWN COMPLETED

4) TWO THIRD CROWN COMPLETED

5) CROWN ALMOST COMPLETED

6) CROWN COMPLETED

7) ONE THIRD ROOT COMPLETE

8) TWO THIRD ROOT COMPLETED

9) ROOT ALMOST COMPLETED (OPEN)

10) APICAL END OF ROOT COMPLETED

ULFAT

STAGES
of Eruption
1. PRE – ERUPTIVE

2. INTRA – ALVEOLAR

3. INTRA ORAL

4. OCCLUSAL

ULFAT

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ERUPTIVE FORCE
The precise mechanism through which eruption force is generated
remains un-known.

However, following theories exist:

Cross-linking in maturing collagen in PDL provide the eruptive

force

Localized variation in blood pressure or flow

Forces derived from contraction of fibroblasts

Alterations in the extra cellular ground substances of PDL similar

to thixotropic gels

ULFAT

FACTORS DETERMINING TOOTH POSITION

DURING ERUPTION

PRE – ERUPTION STAGE

Tooth germ dependent upon inheritance

INTRA - ALVEOLAR STAGE

Presence / absence of adjacent tooth

Rate of resorption of primary teeth

Early loss of primary teeth

Localized pathology

Or any factor altering alveolar growth

ULFAT

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FACTORS DETERMINING TOOTH POSITION

DURING ERUPTION

INTRA – ORAL STAGE

Mesial drift tendency

Tooth can be moved by lip / cheek / tongue extraneous objects

OCCLUSAL STAGE

Muscles of mastication act upon interdigitated teeth

Upward forces of eruption and alveolar growth are countered by

forces of occlusion

ULFAT

ULFAT

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Development of Dentition & Occlusion

I. BIRTH TO THE COMPLETE PRIMARY DENTITION (Birth to 21/2 yrs)

II. FIRST INTERTRANSITIONAL PERIOD ( 2 ½ to 6 yrs)

III. FIRST TRANSITIONAL PERIOD (6 to 8 yrs)

IV. SECOND INTERTRANSITIONAL PERIOD (8 to 10 yrs)

V. SECOND TRANSITIONAL PERIOD (10 to 12 yrs)

VI. ADULT DENTITION (12 yrs onwards)

ULFAT

I) Birth To The Complete Primary Dentition

(Birth to 21/2 Years)
THE MOUTH OF THE NEONATE
Basic form of arches is defined in intrauterine life

Alveolar processes are covered by gum pads

MAXILLARY GUM PAD

Is horse shoe shaped

The arch is longer and wider than lower

The palatal vault is almost flat

The alveolar process is separated on palatal side by a

horizontal groove called dental/gingival groove

The upper labial frenum is continued with incisive papilla

ULFAT

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I) Birth To The Complete Primary Dentition

(Birth to 21/2 Years)
MANDIBULAR GUM PAD
Is “u” shaped but flattened anteriorly

Labial crest is slightly everted

COMMMON FEATURES OF BOTH ARCHES

Gum pads are divided into segmented elevations by developing
teeth

Segments relating second deciduous molars are defined by five

months of age

“lateral sulcus” a well defined groove distal to crypts of deciduous

canines
ULFAT

I) Birth To The Complete Primary Dentition

(Birth to 21/2 Years)
UPPER / LOWER GUM PADS IN OCCLUSION

Is difficult to define as they are designed for suckling

The lower gum pad is distal to upper to a variable degree and the
position is

judged by relationship of “lateral sulci”

INCREASED INCIDENCE OF ANTERIOR OPEN BITE

Rich in vital neuromuscular functions e.g.; suckling / swallowing

yawning etc

Tongue rests in between jaws until eruption starts ULFAT

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I) Birth To The Complete Primary Dentition

(Birth to 21/2 Years)

PRECOCIOUSLY ERUPTED PRIMARY TEETH

NATAL (AT BIRTH)

NEONATAL (DURING 1st MONTH)

PRE – ERUPTED (DURING 2ND - 3RD MONTH)

RIGA FIDA DISEASE

Natal or neonatal teeth can cause the ulceration of the undersurface of
the tongue, protected by the oral shields. Teeth are not
removed, but if are diseased, are removed

ULFAT

I) Birth To The Complete Primary Dentition

(Birth to 21/2 Years)

INTRA – BONY FEATURES

Tooth buds of all primary teeth at the same common level in infant

Incisors are somewhat crowded due to

 Early attaining mesio-distal width

 Slow inside – out width of posteriors

Succedenous incisors / canines are apical and lingual

Lack of ramal growth so that occlusal plane pass through condyle

ULFAT

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I) Birth To The Complete Primary Dentition

(Birth to 21/2 Years)

SEQUENCE AND TIMING OF ERUPTION OF PRIMARY TEETH

LOWER CENTRAL INCISOR 6 mo

LOWER LATERAL INCISOR 7 mo
UPPER CENTRAL INCISOR 7 ½ mo
UPPER LATERAL INCISOR 9 mo
LOWER FIRST MOLAR 12 mo
UPPER FIRST MOLAR 14 mo
LOWER CANINE 16 mo
UPPER CANINE 19 mo
LOWER SECOND MOLAR 20 mo
UPPER SECOND MOLAR 24 mo

ULFAT

I) Birth To The Complete Primary Dentition

(Birth to 21/2 Years)
AT COMPLETION OF DENTITION / 2 1/2 YEARS

Primary cuspids / molars are in occlusion

All teeth are upright except some labial inclination of upper incisors

The roots of primary cuspids / molars are not completed

Premolar buds are underneath the bifurcations of primary molars

Crowns of permanent incisors / canines / first molars are at various

developmental stages

Entire face has gone to vertical growth so that occlusal plane pass
below condyles ULFAT

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I) Birth To The Complete Primary Dentition

(Birth to 21/2 Years)

FEATURES OF PRIMARY OCCLUSION

Primary incisors are uprighted except upper incisors which are slightly
labially inclined

Generalized spacing is present but more in the anterior region

Primate spaces present mesial to upper deciduous cuspids & distal to

lower deciduous cuspids

Median maxillary diastema due to low attachment of labial frenum

Primary dentition may be type I dentition or classical (spaced dentition)

or

ULFAT

I) Birth To The Complete Primary Dentition

(Birth to 21/2 Years)

type II dentition (closed dentition) also called as Hollywood smile

normally leads to future crowding

Shallow overjet & overbite

Flush terminal plane between upper & lower primary second molars

Ovoid arch forms

ULFAT

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Email; orthoraja69@hotmail.com

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