patterns of tooth movement

7/30/2019 Patterns of Tooth Movement

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PATTERNS OF TOOTH MOVEMENT

1) Pre- eruptive tooth movement -:

It is a preparatory to eruptive phase.

During this phase growing tooth moves in two directions to maintain its

position in the jaw viz. bodily movement eccentric movement.

BODILY MOVEMENT:- which occurs continuously as the jaw

grows. It is a movement of entire tooth germ causing bone resorption

in a direction of tooth movement & bone apposition behind it.

ECCENTRIC MOVEMENT :- it is a relative growth in one part of

the tooth while the rest of the toth remains constant.

2) Eruptive tooth movement :-

It begins with the initiation of root formation & ends when the teeth reach

in occlusal contact.

3) Post- eruptive tooth movement:-

It occurs primarily to maintain the position of erupted tooth while the jaw

continues to grow to compensate for occlusal & proximal wear.


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THEORIES OF TOOTH ERUPTION

Root elongation theoryThe crowns of the teeth are pushed into

oral cavity by virtue of growth & elongation of roots.

Pulpal constriction theoryThe growth of root dentin & subsequent

constriction of pulp may cause sufficient pressure to move the tooth

occlusaly.

Growth of periodontal tissues A] pull by surrounding connective tissue results in eruption of tooth in oral

cavity.

B] alveolar bone growth squeeze the tooth out of its alveolus & into oral

cavity

Pressure from muscular actionAction of musculature of the cheeks

and lips upon the alveolar process causes eruption.

Resorption of the alveolar crest Resorption of alveolar crest

would serve to exposure of crown.

Hormonal theory -Hormones secreted by pitutary & thyroid gland

might govern eruption.

Cellular proliferation theoryOsmotic pressure & forces resulting

in cellular proliferation in pulp causes eruption.


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ERUPTION SEQUESTRUM :

It is a tiny spicule overlying the crown of an erupting first permanentmolar.

It appears just before or immediately after the emergence of the tip of cuspsthrough oral mucosa.

Composed of cementum like material.

Developed from osteogenic orodontogenic tissue.

Removed, if it causes irritation underlocal anaesthesia.

ECTOPIC ERUPTION

Arch length inadequacy or variety of local factors may influence a

tooth to erupt in position other than normal


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NATAL & NEONATAL TEETH Eruption of a teeth at or

immediately after birth is relatively

rare phenomenon.

Teeth if present at birth called natal & teeth erupt during first 30 days oflife are called as neonatal teeth.

Also known as congenital teeth,feotal teeth,dentition praecox.

TEETH AFFECTED:-

Mandible incisors central incisors 85%

Maxillary incisors 11%

Mandible canines & molars 3%

Maxillary canines & molars 1%

ETIOLOGY:-

Hypovitaminosis

Hormonal stimulation

TraumaFebrile status & syphilis

Hereditary

Superficial position of developing tooth germ predisposes the tooth to

erupt early


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CLINICAL APPEARANCE:-

Natal & neonatal teeth may be poorly developed small conical, yellowish

with white hypoplastic enamel & dentin & with por or total failure of

development of roots.

Appearance can be classified as:-

Category 1- a shell like crown structure loosely attached to alveolus by a ream

of oral mucosa. No root.

Category 2

a solid crown loosely attached to alveolus by oral mucosa .

Little or no root.

Category 3incisal edge of a crown just erupted through the oral mucosa

Category 4mucosal swelling with a tooth unerupted but palpable

MANAGEMENT :-

Radiographs should be made to determine the amount of root

development & the relationship of prematurely erupted tooth to its

adjacent teeth

King & Lee suggest that inflamed gingival tissue around teeth should becontrolled by applying chlorhexidine gluconate gel three times a day.

The sharp incisal edge of the tooth may cause laceration of the lingual

surface of the tongue so selective grinding of the tooth should be done in

such condition


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Prematurely erupted teeth are hypermobile because of limited rootdevelopment which may lead to danger of aspiration in such cases

extraction should be done

After the tooth removal careful curettage of the socket is indicated in

attempt to remove any odontogenic cellular remanants.

Such retained remanants may subsequently may develop a typical tooth

lik structure that requires additional treatment.

Neonatal teeth may cause difficulty for mother who wishes to breast feed.

Use of breast pump , bottling of milk are recommended.

COMPLICATION:-

RIGA FEDE DISEASE

Traumatic ulcerations on the

ventral surface of the tongue ,

frenum , lip is associated with it.

In 1881 & 1890 RIGA & FEDE

described this lesion histologically

& has subsequently known as

RIGA and FEDE disease.

Also known as NEONATAL SUBLINGUAL TRAUMATIC ULCERAT

patterns of tooth movement

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