Presentation is loading. Please wait.

Presentation is loading. Please wait.

Sven Kreiborg, DDS, DrOdont, PhD

Similar presentations


Presentation on theme: "Sven Kreiborg, DDS, DrOdont, PhD"— Presentation transcript:

1 Disturbances in the Timing of Tooth Eruption in Children with General Diseases
Sven Kreiborg, DDS, DrOdont, PhD Pediatric Dentistry and Clinical Genetics School of Dentistry, Faculty of Health Sciences University of Copenhagen, Copenhagen, Denmark

2 Disturbances in the Timing of Tooth Eruption
Natal/neonatal teeth Premature eruption Delayed eruption

3 Normal Tooth Eruption Timing
In the primary dentition: no significant difference between boys and girls In the permanent dentition: girls have significantly earlier tooth eruption than boys (about 6 months)

4

5

6 Normal Tooth Eruption Timing
There is a weak correlation between tooth eruption and chronological age There is a weak correlation between tooth eruption and skeletal age

7 Normal Tooth Eruption Timing
There is a strong correlation between tooth eruption and dental age

8 Demijian et al. A new system of dental age assessment Hum Biol 1973;45:211-27

9

10

11 Stages of Tooth Eruption
Pre-eruptive Intra-osseous Mucosal penetration Pre-occlusal Post-occlusal

12

13 TOOTH ERUPTION – DURATION Intra-Osseous Movement
2.5 – 6.5 years (shortest for M1; longest for C) No significant sex difference

14 TOOTH ERUPTION – DISTANCE Intra-Osseous Movement
5 – 20 mm (shortest for M1; longest for C)

15 TOOTH ERUPTION – VELOCITY Intra-Osseous Movement
1-10m/day (10m=0.01mm; 100 days=1mm) No significant sex difference

16 TOOTH ERUPTION – VELOCITY Pre-Occlusal Movement
10-75m/day (100m=0.1mm; 100 days=10mm) No significant sex difference

17 TOOTH ERUPTION – VELOCITY Post-Occlusal Movement
Magnitude and velocity of tooth movement depend on magnitude, velocity, and direction of jaw growth Significant sex difference

18 Disturbances in the Timing of Tooth Eruption
Natal/neonatal teeth (1:2,000-3,000 births) Premature eruption Delayed eruption

19 Disturbances of Tooth Eruption POSSUM-Database
Natal/Neonatal Teeth 62 Syndromes (e.g. Ellis-vanCreveld Syndrome and Hallermann-Streiff Syndrome)

20 Disturbances of Tooth Eruption POSSUM-Database
Premature Eruption 51 Syndromes (e.g. Soto syndrome)

21 Soto Syndrome Premature Tooth Eruption
Tall stature Cerebral gigantism Macrocephaly Large mandible Cause of premature tooth eruption: accelerated general growth

22 Klippel-Trenaunay-Weber Syndrome Premature Tooth Eruption
Generalized unilateral hypertrophy Cutaneous angiomatosis Varicose veins Cause of premature tooth eruption: accelerated general growth unilaterally

23 TOOTH ERUPTION - DELAYED
Genetic factors Chronic diseases Chromosomal aberrations Endocrine disorders - Hypopituitarism - Hypothyroidism - Hypoparathyroidism Syndromes

24 TOOTH ERUPTION DELAYING/HINDERING FACTORS Intra-Osseous Movement
Dental follicle Tooth/root formation Alveolar bone Space conditions Obstacles Bone metabolism

25 TOOTH ERUPTION – DELAYED Physical Factors
Crowding Supernumerary teeth Odontomas/osteomas Cysts Gingival fibromatosis Other

26 Disturbances of Tooth Eruption POSSUM-Database
Delayed Eruption 180 Syndromes e.g. Apert syndrome, Cherubism, cleidocranial dysplasia, ectodermal dysplasias, Ellis-vanCreveld syndrome, GAPO syndrome, Hurler syndrome, Incontinentia Pigmenti syndrome, McCune Albright syndrome, Pycnodysostosis, Tricho-Dento-Osseous syndrome, etc. ….

27 Disturbances of Tooth Eruption POSSUM-Database
Delayed eruption in syndromes with: General growth disturbances Maxillary and mandibular hypoplasia Disturbances of tooth formation Gingival fibromatosis Disturbances of bone metabolism

28 Delayed Tooth Eruption
There is a strong correlation between tooth eruption and abnormal tooth development

29 TOOTH ERUPTION – DELAYED Syndromes with Dental Anomalies
Amelogenesis Imperfecta Ectodermal Dysplasia Ekman-Westborg-Julin Syndrome Morquio syndrome

30 Ectodermal Dysplasia (X-Linked) Delayed Tooth Eruption
Sparse scalp hair, eyelashes, eyebrows Inability to sweat High forhead, depressed nasal bridge Decreased anterior face height Dental abnormalities (oligodontia/anodontia) Microdontia, tooth shape abnormalities Cause of delayed tooth eruption: abnormalities of tooth formation

31 Ekman-Westborg-Julin Syndrome Delayed Tooth Eruption
Macrodontia Multituberculism Pulp invaginations Causes of delayed tooth eruption: abnormalities of tooth development and crowding

32 Morquio Syndrome Delayed Tooth Eruption
Short stature Coarse facies Short neck Joint contractures Prognathism Enamel hypoplasia Cause of delayed tooth eruption: abnormalities of tooth development

33 TOOTH ERUPTION – DELAYED Syndromes with hypoplastic jaws
Apert syndrome Crouzon syndrome Cleft palate Treacher-Collins syndrome Silver-Russell syndrome Pycnodysostosis

34 APERT SYNDROME Delayed Tooth Eruption
Premature craniosynostosis Maxillary hypoplasia Shallow orbits Small nose Syndactyly of hands and feet Causes of delayed tooth eruption: maxillary hypoplasia with severe crowding and gingival hyperplasia

35 Pycnodysostosis Delayed Tooth Eruption
Short stature Increased bone density (osteopetrosis) Delayed closure of fontanelles and sutures Hypoplastic midface Mandibular retrognathia Aplasia of teeth Causes of delayed tooth eruption: hypoplastic jaws with crowding and abnormal bone metabolism

36 TOOTH ERUPTION – DELAYED Syndromes with Bone Disorders
Osteopetrosis Pycnodysostosis McCune Albright syndrome Tricho-dento-osseous syndrome Osteopathia striata with cranial sclerosis

37 McCune-Albright Syndrome Delayed Tooth Eruption
Endocrine abnormalities (precocious puberty) Fibrous dysplasia of bone Scoliosis Patchy/streak-like skin hyperpigmentation Facial asymmetry Sclerotic/dense bone Dental abnormalities Cause of delayed tooth eruption: abnormal bone metabolism

38 Tricho-Dento-Osseous Syndrome Delayed Tooth Eruption
Curly/frizzy hair Increased bone density Aplasia of teeth Amelogenesis imperfecta Taurodontism Causes of delayed tooth eruption: abnormal bone metabolism and abnormalities of tooth development

39 Osteopathia Striata with Cranial Sclerosis Delayed Tooth Eruption
Increased bone density Hearing loss Linear striations in long bones Aplasia of teeth Taurodontism Cause of delayed tooth eruption: abnormal bone metabolism

40 TOOTH ERUPTION – DELAYED Syndromes with Obstacles
Cleidocranial dysplasia Kreiborg-Pakistan syndrome Hurler syndrome Cherubism Gardner syndrome

41 Cleidocranial Dysplasia Delayed Tooth Eruption
Large head with prominent frontal bones Wide sutures and fontanelles Small face Aplasia/hypoplasia of clavicles Supernumerary teeth Causes of delayed tooth eruption: supernumerary teeth and abnormal bone metabolism

42 Kreiborg-Pakistan Syndrome Delayed Tooth Eruption
Premature craniosynostosis Supernumerary teeth Causes of delayed tooth eruption: supernumerary teeth and abnormal bone metabolism

43 Gardner Syndrome Delayed Tooth Eruption
Familial adenomatous polyposis (malignancies) Osteomas of skull/facial bones Epidermoid/sebaceous skin cysts Causes of delayed tooth eruption: osteomas in the jaws

44 Hurler Syndrome Delayed Tooth Eruption
Mucopolysaccharidosis 1H Growth retardation Progressive neurological deterioration Coarse face Corneal clouding Kyphosis and multiple joint contractures Dental cysts Cause of delayed tooth eruption: dental cysts with accumulation of MPS

45 Cherubism Delayed Tooth Eruption
Cystic, fibrous jaw lesions Bilateral symmetric jaw expansion Exposure of sclera below the iris Aplasia of teeth Cause of delayed tooth eruption: cystic jaw lesions (giant-cell granulomas)

46 TOOTH ERUPTION – DELAYED Syndromes with Anomalies of Oral Mucosa
Gingival fibromatosis Neurofibromatosis Apert syndrome

47 TOOTH ERUPTION – DELAYED Syndromes but with Unknown Mechanism
GAPO syndrome Romberg syndrome

48 GAPO syndrome Delayed Tooth Eruption
Growth retardation Alopecia Pseudoanodontia Optic atrophy Premature craniosynostosis Thick lips, thick and fibrous gingiva Cause of delayed tooth eruption: unknown, but ossifications in the gingiva have been seen

49 Romberg Syndrome Delayed Tooth Eruption
Hemifacial atrophy (skin, fat, cartilage, bone, and teeth) Cause of delayed tooth eruption: unknown but related to the atrophy of tissues

50 TOOTH ERUPTION Delay in Intra-Osseous or Mucosal Penetration Stages General Treatment Principle
The tooth should penetrate the mucosa no later than at developmental stage G according to Demirjian et al. (1973)

51

52 TOOTH ERUPTION Delay in Intra-Osseous or Mucosal Penetration Stages Treatment Considerations
Extraction of primary tooth/teeth Removal of obstacles Denudation Removal of alveolar bone occlusally Orthodontic traction Bone distraction Autotransplantation

53 TOOTH ERUPTION Delay in Intra-Osseous or Mucosal Penetration Stages
Be observant and alert and ACT!


Download ppt "Sven Kreiborg, DDS, DrOdont, PhD"

Similar presentations


Ads by Google