Chapter : Tooth Eruption

Question Bank

Short Notes

1. Define Eruption, Patterns of tooth eruption

2. Stages in tooth eruption
3. Histology of Tooth movement
4. Theories of tooth eruption

Learn to write all the answers with relevant diagrams.

1. Define Eruption, Patterns of tooth eruption/ tooth movement

2. Stages in tooth Eruption
3. Histology of tooth movement

Definition: Eruption is a latin word derived from erumpere to break out refers to the axial
and occlusal movement of the tooth from its developmental position within the jaw to its
functional position in the occlusal plane.

They are physiological movement

pattern of tooth movement

Pre eruptive tooth movement

Eruptive tooth movement

Post eruptive tooth movement

 S No Movement Pattern Histology
1 Pre-Eruptive Tooth  Good space during  Remodelling of the bony wall
Movement primary tooth germ of the crypt
differentiation  Selective bone resorption
 This space becomes (osteoclastic) and formation
used due to growth of (osteoblastic) relative to tooth
tooth germs movement
 Crowding in canine and
incisor region
 Followed by expansion
of jaw in length and
drifting of tooth germs
 Shift- mesial direction
 Permanent teeth with
predecessors also move
before they reach
occlusal plane
 No predecessors for
permanent molars
 Movements of
permanent tooth buds
takes place inside the
crypts in all directions
 All adjustments happen
till jaw is sufficient to
accommodate the teeth
 This phase is
positioning of the tooth
and its crypt within the
growing jaws
preparatory to the tooth
eruption
2 Eruptive Tooth Movement  Tooth moves from its
position within jaw to its
functional position in the
occlusal plane
 Direction of movement is
occlusal or axial
 Pre-functional eruptive
tooth movement: is the
movement used to
describe the tooth after its
appearance in the oral
cavity till it attains the
functional position.
3 Post-Eruptive Tooth  Maintains the position
Movement of the erupted tooth
while the jaw continues
to grow
 Compensates for
occlusal and proximal
wear.
 Physiological mesial
drift happens – The
movements which
compensates the
occlusal and proximal
wear consists of axial
and mesial migration
 Drift- 7mm maximum
 It includes contraction
of the trans-septal
ligament
 Events are associated with
formation of roots, PDL,
Dentogingival junction
 Root formation is initiated by
Hertwig’s root sheath
 This initiates differentiation of
odontoblasts from dental
papilla
 Odontoblasts form root dentin
increasing the length of tooth
 After root formation is
complete, cementum , PDL
and bone lining formations are
completed
 Cytoskeletal formation of
PDL is completed
 Deciduous tooth connects to
the permanent tooth by
gubernacular canal and its
cord which influences the
eruptive forces.
 Reduced enamel epithelium
(REE) causes lysis of
overlying connective tissue
 REE unites with the oral
epithelium, centre part
degenerates and tooth appears
in the oral cavity
 Movement in axial direction
 Age- 14- 18years
 Associated with condylar
growth
 Bone deposition happens at
the alveolar crest and socket
floor.
 The bone formation stabilizes
the tooth during eruption
 Movements are made to
compensate for occlusal and
proximal wear
 No evidence that cementum
formation brings in tooth
movement
 Bone formation- ladder like
pattern seen at the fundus
 Selective deposition and
resorption of the bone by
osteoblast and osteoclast
respectively is noted in Electron
 microscope
 Collage remodelling takes
place at PDL and trans septal
ligaments

4. Theories of Tooth Eruption

 5. Theories of tooth Eruption

Definition: Eruption is a latin word derived from erumpere to break out refers to the axial
and occlusal movement of the tooth from its developmental position within the jaw to its
functional position in the occlusal plane.

They are physiological movement

The 4 proposed theories of tooth eruption are

1. Bone Remodelling Theory

2. Root Formation Theory
3. Vascular Pressure Theory
4. Periodontal Traction Theory

Bone Remodelling Theory

1. Bone remodelling is needed to permit tooth movement

2. Presence of dental follicle is a mandate for remodelling to be carried out as they are
the only source of osteoblasts and osteoclasts (derived from circulating monocytes)
Formulas
a) Dental follicle + tooth germ = bone remodelling happens with tooth eruption
b) Dental follicle – tooth germ = bone remodelling happens
c) Dental follicle +silicon model (replaced in place of tooth germ)= bone
remodelling + silicon model eruption
d) Tooth bud/ silicon model- dental follicle- no movement occurs.
 3. Theory unsure: The remodelling happens around the teeth which causes the tooth
movement
4. Other studies state- control is on the bone lining cells- osteoblasts
Supported theory :

Harmones Produced

Collagenase secreted

Proteolytic enzymes remove the osteoid layer

So cells round up and expiose the newly denuded bone

So stimulus attracts osteoclasts to the site

Root Formation Theory

1. Root formation is a cause of eruptive tooth movement

2. Root formation allows crown formation
3. It permits new cells to proliferate either at the place from where the crown moved or
at the base of the socket.
4. If crown movement is prevented bone resorption occurs at the base. Growth og the
root impinges on a fixed base
5. Postulation: Cushion Hammock ligament theory: Straddling the base of the socket
from one bony wall to another like a sling. This pulp- delineating membrane runs
across the apex of the tooth and has no bony insertions. So, there is no fixed base.
6. No supportive evidence to prove this theory
Vascular Pressure Theory

1. Teeth move in synchrony with arterial pulse

Theory Conclusion: The vascular changes can play an important role in prefunctional
eruption generating eruptive forces

In reasc darte rial

lo dF
B low

Incre asein toal In reasc svolu m e

theovlum othm
e,a oveking aroun dte h
gr50 ound% ic subtare ncei
ap+ calhinre ydrostein atic
pres ure

Increased Hydrostatic Increases the rate in

Hypotensive drugs
pressure tooth eruption
 Stimulation of Decreased Hydrostatic Delay the rate in tooth
sympathetic nerve pressure eruption

Periodontal Ligament Traction Theory & Role of Dental Follicle in tooth Eruption

PDL possess Remodel the Brings in angle

fibroblasts bone for eruption

Orient the
FB has the forces trasmitted
eruptive forces
ability to into collagen
towards the line
contract fibres
of occlusion

Contractile
Exhibit
filaments are in Tooth Erupts
fibronexuses
contact
 Formulas to understand the role of dental follicle
a) Dental follicle + tooth germ = bone remodelling happens with tooth eruption
b) Dental follicle – tooth germ = bone remodelling happens
c) Dental follicle +silicon model (replaced in place of tooth germ)= bone
remodelling + silicon model eruption
d) Tooth bud/ silicon model- dental follicle- no movement occurs.

Notes prepared by Dr Soumya Anandan

Reference: Orban’s 15th edition, chapter 13, Tooth Eruption

Images and diagrams: Google

Flowcharts: Self made