1. Eruption and Occlusion of the Permanent Dentition
Mark H. Taylor, D.D.S., F.A.C.D.

2. Don’t Fake Knowledge! Know Nolla's stages of calcification
Know time of eruption of permanent teeth

3. Nolla's 10 Stages of Calcification
Stage 2 - initial calcification
Stage 6 - eruptive movement begins (crown formation complete)
Stage 8 - alveolar crest pierced (2/3 root development)
Stage 9 - gingival margin pierced (3/4 root development)
Interval between Stage 6 and full interdigitation is about 5 years

4. Time of Eruption (Years)

5. Why Know Calcification Times?
Enamel hypoplasia

6. Fluorosis

7. Fluorosis and Hypoplasia

8. Fluorosis and Hypoplasia

9. Factors Affecting Eruption
Genetics - sequence & timing mostly genetically controlled
Nutrition
Premature loss of a primary tooth
Eruption… heh heh…
get it?

10. Eruption Facts Girls 5 months faster than boys
and most common in maxilla
(6-1) and (6-1) most common in mandible

11. Mesial Drift and Anterior Component of Force
Ectopic eruption
Axial inclination produces mesial force
Space maintenance

12. Ectopic Eruption

13. Ectopic Eruption

14. Ectopic Eruption

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19. Space Maintenance - PHA

20. Space Maintenance - LLHA

21. Space Maintenance - BLS

22. Space Maintenance - Distal Shoe

23. Crossbites Unilateral vs. bilateral Dental vs. skeletal
Appliance types

24. Functional Cross Bite

25. Functional Cross Bite

26. Functional Cross Bite

27. Functional Cross Bite

28. Quad Helix Appliance

29. Quad Helix Appliance

30. Distalizing Appliance

31. Absence of Permanent Teeth
4-6% congenital absence
Females more frequently missing teeth
Most common congenitally absent teeth:
mandibular 2nd premolar
maxillary lateral incisor
maxillary 2nd premolar

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34. Missing Permanent Teeth

35. Extra Permanent Teeth
Supernumerary teeth found most frequently in the maxillary incisor region (mesiodens), and occasionally in the premolar area
2-3% supernumerary teeth, males more common

36. Supernumerary Teeth

37. Supernumerary Teeth

38. Supernumerary Teeth

39. Supernumerary Teeth

40. Supernumerary Permanent Tooth

41. Supernumerary Permanent Tooth

42. Supernumerary Permanent Tooth

43. Changes in Arch Width Intercanine and intermolar growth
significant increases between 6 weeks and 2 years of age
significant increases between 3 and 13 years
mandibular intercanine width established by 8 years of age
after permanent teeth erupted, slight decrease in arch width in the intercanine area
Bishara, et al; “Arch width changes from 6 weeks to 45 years of age” AJO, April 1997

44. Changes in Arch Length and Overbite
Arch length decreases*
late mesial shift, mesial drift, interproximal wear
do not affect interach relationships
Overbite
decreases in primary dentition
increases in mixed dentition
OB/OJ relatively stable in adult*
*Harris, “A longitudinal study or arch size and form in untreated adults” AJO, April (20-55 yoa)

45. Intercanine Growth

46. Angle Classification Class I Molar (65%) Class II Molar (30%)
Class III Molar ( 5%)

47. Class I Molar
Mesial
Distal

48. Class II Molar
Mesial
Distal

49. Class III Molar
Distal
Mesial

50. Cuspid Classification
Neutro (Class I)
Disto (Class II)
Mesio (Class III)

51. Neutro Cuspid (Class I)
Mesial
Distal

52. Disto Cuspid (Class II)
Distal
Mesial

53. Mesio Cuspid (Class III)
Distal
Mesial

54. Divisions of Class II Division I - excess OJ
Division II - "rabbited" incisors
Subdivision - one side

55. Divisions of Class II Division 1

56. Divisions of Class II Division 1

57. Divisions of Class II Division 1

58. Divisions of Class II Division 2

59. Divisions of Class II Division 2

60. Divisions of Class II Division 2

61. Divisions of Class II Division 2

62. Six Keys to Occlusion Class I molar relationship
Mesial crown angulation
Proper crown inclination
No rotations
Tight contacts
Flat occlusal plane

63. Types of Faces Brachycephalic - broad & short
Dolichocephalic - long & narrow
Mesocephalic - normal

64. Brachycephalic

65. Dolichocephalic

66. Mesocephalic
For the gentlemen...
For the ladies….

67. Mesocephalic
For the moviegoer….

68. Mesocephalic
For the intellectual dental student….

69. You Tell Me.

70. Profile?

71. Overbite - Overjet?

72. Occlusion?

73. Huskers!!!!