Eruption &"Shedding QUESTIONS

Eruption
Complete
-Eruption is defined as...................................................................

Answer: axial or occlusal movement of the tooth or the tooth germ inside its crypt
until it reaches the functional position in the occlusal plane

-Phases of eruption are....................... ,....................&.......................

Answer: preeruptive-eruptive-post eruptive

-The pre-eruptive phase starts in......................& ends when...............

Answer: early bell stage-beginning of root formation

-The eruptive phase starts in.......................& ends when......................

Answer: start of root formation- tooth reach the occlusal plane

-The post eruptive starts in...........................& ends when....................

Answer: beginning of tooth function-end of life span of tooth

-The functional phase is the ...................phase.

Answer: post eruptive phase

-The prefunctional is the ......................phase

Answer: eruptive phase

-the movements that occur in the pre-eruptive phase are...........&........

Answer: bodily movement & eccentric growth

-the movements that occur in the eruptive are.................

,...................,.............................&..........................

Answer: bodily , rotation , axial occlusal , & tilting

-the movements that occur in the post eruptive phase are .........&........

Answer: mesial drifting & axial occlusal

-the pre eruptive phase is characterized by ................... ,....................&..................

-the drifting bodily movement occurs due to.......................

Answer: bone resorption in the side where the tooth is moving to and bone
deposition in the side where the tooth is coming from.

-eccentric growth means .................and it occurs in the .............phase

Answer: growth characterized by one part of the tooth is fixed and the other is
growing leading to shift of centre – pre eruptive phase

-in the pre-eruptive phase, the permanent anterior tooth is

in......................&......................relation to their deciduous predecessors.

Ans: lingual and apical

-in the pre-eruptive phase, the maxillary molars develop with their occlusal
surfaces facing............................while the lower molars develop with their occlusal
surfaces inclined..................

Answer: distally-mesially

-the eruptive phase is characterized by ...................,....................,

......................&.............................

Answer: root formation , attachement apparatus (Cementum +PDL + Bone)

formation , dentogingival junction formation , Rapid active eruption

-the fibro cellular follicle that guides the permanent successor to erupt is
called............................

Ans: gubernacular canal

-the gubernacular canal: function.................?

Answer: guide the eruption of the permanent successor by creating eruption
pathway.

Site (in ant &post)........?

Anterior :lingual to the deciduous tooth ,posterior: in the socket of the deciduous
molars in between the widely diverged roots.

Content................................?

Answer : Gubernacular cord (remnants of Dental lamina+epithelial cells)

-the movements done in the post eruptive phase are.........................&..................

Answer : mesial drift & axial occlusal

-the movements done in the post eruptive phase are done to

compensate..........................&..........................................

Ans: growing jaw + incisal (occlusal ) attrition + interproximal attrition.

-if there is no post eruptive movements, the patient will suffer

from.......................&....................... = ( the movements that occur in the post
eruptive phase are done to prevent .....................&.................)

Ans: injury to TMJ & spacing between teeth

II)GIVE SCIENTIFIC TERM:

-the eruption phase that begins at the early bell stage and ends at the beginning of
root formation

Answer: pre eruptive phase

-the growth that occur when one part of the tooth remain stationary while the
remainder part continue to grow leading to shift in its centre.

Answer: eccentric growth

-the type of movement that occur as a result of osteoclastic activity in the crypt
wall in advance of the moving tooth and bone deposition in the crypt wall behind
it.

Answer: bodily movement

-a canal open in the lingual side of the deciduous anterior tooth and in the bi or tri
furcation of the posterior deciduous tooth and it helps in guiding the eruption.

Answer: gubernacular canal

-the axial or occlusal movement of the tooth from its developmental position inside
the jaw to its functional position in the occlusal plane.

Answer: Eruption

-the gradual appearance of the tooth in the oral cavity due to occlusal movement of
the tooth.

Answer: Active eruption

-the gradual recession of the gingival & attachment epithelium from the tooth.

Answer: passive eruption

II)GIVE REASONS:

-in the bodily movement there are both bone deposition and bone resorption while
in the eccentric growth there is bone resorption only without bone deposition.

Ans: because in the bodily movement there will be bone resorption in the surface
toward which tooth moves and bone deposition occurs on the wall behind it.

While in the eccentric growth , one part of the developing tooth germ remains
stationary and the remainder continues to grow so only bone resorption will occur
facing the growing part.
-when the lower 8 is impacted it is placed with their occlusal surfaces facing
mesially while when the upper 8 is impacted it is placed with their occlusal surface
facing distally.

Answer: because mandibular molars develop in the ramus of the mandible with
occlusal surfaces inclined mesially and become upright by the growth of mandible.

While the maxillary molars develop at maxillary tuberosity with occlusal surfaces
facing distally, then move round by the growth of maxilla.

-if there are no post eruptive movements the patient will suffer.

Answer :because post eruptive movements are done to compensate for the occlusal
attrition + proximal attrition + jaw growth , so , if there are no movements done to
compensate these events the patient will suffer from injury to TMJ + spacing
between teeth

III)M.C.Q:

1-which of the following stages of tooth eruption begins with the beginning of
root formation ?

a-pre-eruptive phase b-eruptive phase c- post -eruptive phase

2- Which of the following pairs of movements predominate during the post

eruptive phase :

A -Distal and lingual

B- Axial and mesial.

C- Distal and axial.

D- Axial and rotational.

3- Passive eruption is:

A- Growth in the length of the root.

B - Apical migration of the junctional epithelium

C -Deposition of bone at the fundus.

D- The formation of cellular cementum.

4-The eruptive phase:

A-starts at the late bell stage & end when the tooth reaches the occlusal plane

B-starts at the beginning of root formation & lasts till the end of life span of the tooth

C-starts at the beginning of root formation & ends when the tooth reaches the occlusal
plane

D-starts at the end of root formation & lasts till the end of the life span of the tooth

5-Which of the following movements does NOT occur in the eruptive phase:

A-axioocclusal

B-bodily movement

C-eccentric growth

D-rotation
6- Which of the following does not occur during the eruptive phase?

A-Dentin deposition.

B-Narrowing of apical foramen.

C-Increased thickness of cementum.

D- Enamel formation.

7- During the pre-eruptive phase of tooth eruption:

A-Cementoblasts begin to secrete cementoid.

B-The apical foramen is beginning to close.

C-The developed tooth at the bell stage lies within a crypt of bone.

D-The root is formed.

8- Which of the following occurs during the pre-eruptive stage of eruption of a

tooth:

A- Formation of dentogingival junction.

B- Formation of the root.

C- Formation of stellate reticulum.

9-mesial drift is a major tooth movement that :

A-accommodate the growing jaws

B-compensates interproximal wear

C-compensates occlusal wear

D-is required for pre-eruptive tooth movement

10-occlusal attrition is compensated by :

A-post eruptive movement

B-pre eruptive movement

C-eruptive movement

11-Actual eruptive movements of tooth occur mainly in a :

a) Horizontal direction.

b)Complex pattern.

c) Axial direction.

d) Rotational direction.

12- In the posteruptive phase a tooth undergoes primarily:

a- Rotational movement.

b- Movements in a distal direction.

c- Movements in an apical direction.

d- Movements in an axial & mesial direction.

13- During tooth eruption, the permanent anterior successors move occlusaly
and:

a- Mesially. b- Buccally. c- Lingually d- Distally.

14-Movements of post eruptive phase do NOT accommodate for :

A-Growth of jaws

B-occlusal wear

C-interproximal wear

D-crowding of teeth

15-which of the following movements do NOT occur in the eruptive phase:

A-axio occlusal

B-bodily movement

C-eccentric growth

D-rotation

III)ESSAY:
==give short note on "pre –eruptive phase"?

Answer:

Start at............................

Ends at...............................
Movements are.....................

Deciduous teeth...............??

Permanent teeth:-anterior ??

-premolars??

-molars??

==give short note on "eruptive phase"?

Answer:

Starts at.......................

Ends at........................

Movements are............................(4)

Structures formed are...............................(3)

N.B: Gubernacular canal............." discuss"

==give short note on " post eruptive phase"?

Answer:

Starts at.......................

Ends at........................

3 events: occlusal attrition + proximal attrition + jaw growth

2 movements : axial + mesial drifting

If these movements did not happen ( these movements are done to prevent ):
injury to TMJ + spacing between teeth

GOOD LUCK
 Shedding-
I)COMPLETE:

-shedding is defined as...........................................................................

Answer: natural physiological elimination of the deciduous teeth as a result of their

root resorption then erution of their permanent successors.

-pressure by the growing and erupting tooth germ lead to differentiation of............

Answer: odontoclast

-the permanent anterior tooth germ is

in..............................&.............................relation to the deciduous one

Answer: lingual and apical

-the developing premolar germ is found between.................................

Answer: widely diverged roots of deciduous molars.

-for the permanent anterior tooth to erupt in the same place of their deciduous
predecessors they have to move...................

Answer: occluso vestibular.

-pressure from the permanent anterior tooth will resorb first..........................then

..........................

Answer: bone separating the socket of deciduous tooth and crypt of permanent
tooth - deciduous root lingually

-pressure from the permanent premolar tooth will resorb ..................

Answer: the surface of the root facing the inter-radicular septum. ( furcation side of
the root

-the early resorption occurring in the roots of deciduous molars is usually repaired
by deposition of ………………………

Answer: cementum

-the odontoclast rests on the tooth surface to be resorbed in a concavity

called.............................

Ans: howship's lacunae

-the origin of odontoclast is.............................

Ans: monocyte or U.M.C

-the methods of formation of odontoclast are......................or.................................

Ans: fusion of many mononuclear cells

Or division of nucleus without division of cytoplasm

-the odontoclast contains...........................enzyme

Ans: acid phosphatase

- the clear zone of odontoclast contain...........................&........................which are

important in......................................

Answer: actin and myosin filaments - attachement of the cell to the structure being
resorbed

-the site of odontoclasts is ......................in anterior teeth , while .......................in

posterior teeth.

Ans: root canal – pulp chamber

-the function of mitochondria inside the odontoclast is:

..............................................,.......................................,.................................

Ans: produce citric acid

 Temporary storage of released ca & P

Provide energy

-during shedding of deciduous teeth, the pulp is........................, and

plays........................role

Ans: vital-passive

-during shedding of deciduous teeth , the PDL had an abrupt loss due to : (4)

........................................................................................................

Ans:- resorbtion of roots

-Active & passive eruption of deciduous teeth during sheeding→ leading to

decrease in the clinical root

-The growth of masticatory muscles of the child during this period

-The fibroblast undergo "apoptotic cell death" (programmed cell death)

-the PDL fibroblast undergoes cell death during shedding called........................

Ans: apoptotic cell death ( programmed cell death)

-apoptotic cell death is defined as.....................................

-the remnants of deciduous teeth

They are due to................................

- the lower E have widely diverged roots greater than the mesiodistal measurement
of the erupting lower 5 so parts of the roots escape from the path of eruption

and their fate are.............................

-ankylosed to bone or resorbed or exfoliated or surrounded by cementum

-the retained deciduous teeth

Defined as:..........................

-it is the deciduous tooth that remains in the oral cavity after its shedding time

They are due to....................................

-missing permanent teeth or impacted permanent teeth or tumor (supernumerary

tooth) preventing the eruption of the permanent successo.

and their fate are................................

- the tooth may persist for some years but finally LOST due to

1-Active and passive eruption of the tooth leading to shortening of its attachment
apparatus.

2- small sized tooth and narrow roots leading to occlusal trauma (specially with the
increase of masticatory force)

-the submerged deciduous teeth :

Defined as :...................

-The tooth active in which its eruption stops, and later appears shortened because
of continued eruption of its neighbors and continued growth of the alveolar bone

They are due to.......................

-mild trauma or excessive repair of cementum leading to direct union between

cementum and bone (ankylosis)

and their fate is that they prevent...............

. -eruption of the permanent successor

-if excessive repair occurs between cementum and bone ,...............will result
Answer:

-ankylosis ( submerged tooth).

-retained deciduous teeth is defined as..................................

II)GIVE SCIENTIFIC TERM

-the natural physiological elimination of the deciduous teeth as a result of

resorbtion of their roots.

Ans: shedding

-cell that resorb the hard dental tissues including enamel during shedding.

Ans: odontoclast

-the tooth that remains in the oral cavity beyond the age at which it is supposed to
be shed.

Ans: retained deciduous teeth

-the tooth that appears shortened because of continued eruption of its neighbours
and continued growth of the alveolar bone

Ans: submerged tooth

-the deciduous tooth that is ankylosed and its active eruption is stopped ,so it can't
reach the normal occlusal plane.

Ans: submerged tooth

-the concavity where the odontoclasts are resting.

Ans: Howship's lacunae

-the process by which the PDL fibroblast undergo programmed cell death during
the process of shedding.
Ans: apoptotic cell death

II)GIVE REASONS:

-the anterior deciduous tooth root is resorbed first from the lingual aspect not from
the labial aspect.

Answer: because the permanent anteriors tooth germs are in lingual and apical
relation to their deciduous predecessors , so pressure from the erupting successor
will cause resorption in the lingual surface of the deciduous root

-the posterior deciduous tooth roots is resorbed first from the furcation side.

Answer : because the premolar germ is found between the deciduous molar roots
and its growth will lead to root resorption on the surface of the root facing the
inter-radicular septum ( furcation side of the root)

-the odontoclast is present in the pulp chamber of the posterior shedded tooth
while in the root canal in the anterior shedded tooth.

Answer: because during shedding of the deciduous anterior tooth ( single rooted ) ,
the tooth got loose and fall off only after resorption of a part of the root

While during shedding of the deciduous molar ( 2 or 3 roots) , the tooth got loose
and fall off after complete resorption of their roots and beginning of resorption in
the crown area.

- the PDL of the deciduous tooth during shedding undergoes abrupt loss.

- resorbtion of roots of the deciduous tooth → so they become short

 -Active & passive eruption of deciduous teeth during sheeding → leading to
increase in the clinical crown and decrease in the clinical root with its PDL.

-The growth of masticatory muscles of the child during this period → increase in
masticatory forces applied.

-The fibroblast undergo "apoptotic cell death" = programmed cell death

-remnants of deciduous tooth may remain during shedding .

Answer: look in the complete ( due to.....)

-retained deciduous tooth may remain after its shedding time.

Answer: look in the complete ( due to.....)

-the retained deciduous tooth may persist for years but finally lost

Answer:

1-Active and passive eruption of the tooth leading to shortening of its attachment
apparatus.

2- small sized tooth and narrow roots leading to occlusal trauma (specially with the
increase of masticatory force) and finally loss of the tooth.

-submerged deciduous tooth may appear in a patient mouth.

Answer: look in the complete ( due to.....)

III)MCQ:

1-Remnants of deciduous teeth :

a- Escape resorption during shedding

b- Are poorly developed deciduous teeth

 c- Are incomplete developed deciduous teeth

d- Are abnormally developed deciduous teeth

2- During shedding of deciduous teeth, the pulp

A- Plays an active role in the process.

B- Show sings of degeneration

C- Contain pulp stones.

D- plays a passive role and remains vital.

3-the resorption in lower deciduous molars is primarily initiated

a- at the lingual surface of roots

b- at the labial surface of roots

c- along the transverse diameter of roots

d- at the area of bifurcation of roots

4- Shedding is predominantly the:

A- Physiologic loss of impacted teeth.

B- Pathologic loss of non-vital primary teeth.

C- Physiologic loss of permanent teeth.

D- Physiologic loss of primary teeth.

5-the submerged deciduous tooth is prevented from active eruption by:

a- cyst

b- tumour

c- supernumerary tooth

d- ankylosis to the bone

6- During the shedding of deciduous teeth:

A- Dentinogenesis and cementogenesis stop completely.

B- Pressure from underlying successors is not an important factor.

C- The pulp of the deciduous tooth becomes necrotic.

D- Resorption is intermittent and repair of resorbed hard tissues is

possible.
III)ESSAY:

-Give short note on : Histology of shedding (odontoclast)?? "Nicolas

Cage ☺"

Answer: look in the complete:

Origin......................................
Methods of formation...............................
Site...............................................(ant & post)
E.M.............................................(3 zones)
Contain enzyme...................................
Contain mitochondria that have the following functions.......(3)
Function........................(resorption)

-Give short note on : pattern of shedding??

Answer:

PRESSURE → odontoclast

Anterior : permanent is in lingual and apical relation → moves occluso

vestibular → resorption first to ......then.......

Posterior : premolar between diverged roots of deciduous molars →

early resorption before the shedding time on the furcation side of the
root → repair by cementum like material → at shedding time resorption
of all the roots and sometimes a part of the crown
N.B : Resorption of bone and the deciduous root is not steady &
continuous, but may stop briefly, when some repair of resorbed
cementum & dentine can occur (by cementum).

-Give short note on :

remnants of deciduous teeth

Retained deciduous teeth

Submerged deciduous teeth?

Answer: Look in the complete

define........

Due to...........

Fate.............

-Give short note on : mechanism of shedding? With refer to the

status of both the " pulp & PDL " of the deciduous teeth during
shedding

1-Pressure from the erupting successor lead to odontoclasts ◼

differentiation.

2-Odontoblast and cementoblast secretes collagenase and other ◼

proteolytic enzymes to degrade cementoid tissue or predentine.

3-Then odontoclasts attach to the exposed mineralized cementum or ◼

dentine by its clear zone.

4-Dissolution of minerals( by the citric acid). ◼

5-Disintegration of the organic matrix by lysosomal enzymes (e.g. ◼

collagenase and protease).

6-Transport of the soluble product to the extracellular fluid or the ◼

vascular system.

Pulp is vital and has passive role ◼

PDL subjected to abrupt loss due to ......(4 reasons) ◼

N.B : Resorption of bone and the deciduous root is not steady &
continuous, but may stop briefly, when some repair of resorbed
cementum & dentine can occur

GOOD LUCK