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TOOTH MOVEMENT AND ERUPTION

Tooth eruption
eruption takes place in chronological order involves active eruption vertical movement of the tooth as opposed to passive eruption receding of the gingiva how it occurs is not understood
root growth, hormonal action, contractile collagen, vascular pressure?? no requirement for the root

three distinct phases to the development of the dentition


1. pre-eruptive initiation of tooth development 2. tooth eruption prefunctional phase
begins as the roots begin to form

3. development and maintenance of occlusion functional phase


after the teeth have emerged into the oral cavity

Tooth eruption
defined as the axial movement of tooth from its developmental position in the alveolar socket into its functional position within the oral cavity no evidence to suggest that eruption entirely ceases once the tooth meets ints antagonist
outward axial movements experienced during the functional phase may also be a type of eruptive movement also seen after tooth extraction

eruptive forces also experience in adolescents growth spurts preeruptive forces and those generated during the prefunctional and functional stages may be different mechanisms not proven accompanying eruptive forces are resistive forces which prevent eruption soft tissues and alveolar bone, PDL and occlusal forces

Directions and rates of tooth eruption


main direction is axial (i.e. long axis of the tooth) also movement in other planes resulting in tilting and drifting eruption rates are greatest during times of crown emergence rates will differ based on tooth type balance between eruptive forces and resistive forces
permanent maxillary incisors 1mm/month mandibular second molars 4.5 mm in 14 weeks permanent third molars 1 mm in 3 months eruption rates can slow to 1 mm/6 months in crowded dentitions

Primary tooth eruption


several stages
after apposition of the enamel into the crown area of the tooth stops, the ABs create an acellular dental cuticle on the new enamels surface
cuticle protection of emerging enamel two thin layers degraded with mastication

as the tooth erupts it is still covered with a layer of amelobasts and the remaining layers of the enamel organ these layers become compressed as the tooth moves forming a reduced enamel epithelium (REE) or reduced dental epithelium the REE is required for eruption the REE fuses with the oral epithelium lining the oral cavity (see figure 6-28) the REE produces enzymes which disintegrates the central portion of this fused tissue results in an epithelial tunnel through which the tooth erupts collagenases and acid hydrolases this disintegration results in an inflammatory response interpreted as the teething response

-as the tooth erupts, the portion of the epithelium

covering the crown pulls back and exposes the crown -the cervical portion of the epithelium is still attached to the neck of the tooth (figure 6-28) -this fused tissue serves as the initial junctional epithelium (thin dotted line) and creates a seal between the tooth and the surrounding tissue
-i.e. as the tooth pierces the oral epithelium, the cells of the reduced dental epithelium and the oral epithelium form the initial junctional epithelium (thin dotted line) -the REE portion of this junctional epithelium becomes replaced by oral epithelium -later replaced by the definitive dentogingival junction

Permanent tooth eruption


as the succedaneous permanent teeth develop below the primary teeth, the primary tooth is exfoliated eruption is lingual to the roots of the primary teeth
exception is the maxillary incisors which move to a more facial position as they erupt

loss of primary teeth should occur first


involves the differentiation of osteoclasts which absorb the alveolar bone between the primary and permanent teeth development of odontoclasts which resorb portions of the primary tooths root dentin and cementum

eruption process is the same for the primary teeth formation of an epithelium lined tunnel for eruption the process is also similar for the nonsuccedaneous teeth except no primary tooth is shed

Mechanisms of tooth eruption: current research


not well understood bone deposition at the base of the underlying root may initiate eruption and move the tooth axially role for growth factors
initiation of eruption role for EGF and TGF alpha also can be induced by macrophage colony-stimulating factor (MCSF) production of TGF beta1, interleukin 1a by the stellate reticulum enhances the production of monocyte chemotactic protein/MCP1 and colony stimulating factor/CSF1 by dental follicle CSF1 induces the dental follicle to make MCSF MCSF and MCP induce the recruitment of monocytes into the dental follicle monocytes transform into osteoclasts resorb the overlying alveolar bone