Presentation is loading. Please wait.

Presentation is loading. Please wait.

Disturbances in the Timing of Tooth Eruption in Children with General Diseases Sven Kreiborg, DDS, DrOdont, PhD Pediatric Dentistry and Clinical Genetics.

Similar presentations


Presentation on theme: "Disturbances in the Timing of Tooth Eruption in Children with General Diseases Sven Kreiborg, DDS, DrOdont, PhD Pediatric Dentistry and Clinical Genetics."— 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 Natal/neonatal teeth Premature eruption Premature eruption Delayed eruption Delayed eruption

3 Normal Tooth Eruption Timing In the primary dentition: no significant difference between boys and girls 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) 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 chronological age There is a weak correlation between tooth eruption and skeletal 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 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 Pre-eruptive Intra-osseous Intra-osseous Mucosal penetration Mucosal penetration Pre-occlusal Pre-occlusal Post-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 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) Natal/neonatal teeth (1:2,000-3,000 births) Premature eruption Premature eruption Delayed 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 Tall stature Cerebral gigantism Cerebral gigantism Macrocephaly Macrocephaly Large mandible Large mandible Cause of premature tooth eruption: accelerated general growth

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

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

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

25 TOOTH ERUPTION – DELAYED Physical Factors Crowding Crowding Supernumerary teeth Supernumerary teeth Odontomas/osteomas Odontomas/osteomas Cysts Cysts Gingival fibromatosis Gingival fibromatosis Other 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 General growth disturbances Maxillary and mandibular hypoplasia Maxillary and mandibular hypoplasia Disturbances of tooth formation Disturbances of tooth formation Gingival fibromatosis Gingival fibromatosis Disturbances of bone metabolism Disturbances of bone metabolism

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

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

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

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

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

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

34 APERT SYNDROME Delayed Tooth Eruption Premature craniosynostosis Premature craniosynostosis Maxillary hypoplasia Maxillary hypoplasia Shallow orbits Shallow orbits Small nose Small nose Syndactyly of hands and feet 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 Short stature Increased bone density (osteopetrosis) Increased bone density (osteopetrosis) Delayed closure of fontanelles and sutures Delayed closure of fontanelles and sutures Hypoplastic midface Hypoplastic midface Mandibular retrognathia Mandibular retrognathia Aplasia of teeth 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 Osteopetrosis Pycnodysostosis Pycnodysostosis McCune Albright syndrome McCune Albright syndrome Tricho-dento-osseous syndrome Tricho-dento-osseous syndrome Osteopathia striata with cranial sclerosis Osteopathia striata with cranial sclerosis

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

38 Tricho-Dento-Osseous Syndrome Delayed Tooth Eruption Curly/frizzy hair Curly/frizzy hair Increased bone density Increased bone density Aplasia of teeth Aplasia of teeth Amelogenesis imperfecta Amelogenesis imperfecta Taurodontism 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 Increased bone density Hearing loss Hearing loss Linear striations in long bones Linear striations in long bones Aplasia of teeth Aplasia of teeth Taurodontism Taurodontism Cause of delayed tooth eruption: abnormal bone metabolism

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

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

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

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

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

45 Cherubism Delayed Tooth Eruption Cystic, fibrous jaw lesions Cystic, fibrous jaw lesions Bilateral symmetric jaw expansion Bilateral symmetric jaw expansion Exposure of sclera below the iris Exposure of sclera below the iris Aplasia of teeth 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 Gingival fibromatosis Neurofibromatosis Neurofibromatosis Apert syndrome Apert syndrome

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

48 GAPO syndrome Delayed Tooth Eruption Growth retardation Growth retardation Alopecia Alopecia Pseudoanodontia Pseudoanodontia Optic atrophy Optic atrophy Premature craniosynostosis Premature craniosynostosis Thick lips, thick and fibrous gingiva 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) 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/teethExtraction of primary tooth/teeth Removal of obstaclesRemoval of obstacles DenudationDenudation Removal of alveolar bone occlusallyRemoval of alveolar bone occlusally Orthodontic tractionOrthodontic traction Bone distractionBone distraction AutotransplantationAutotransplantation

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


Download ppt "Disturbances in the Timing of Tooth Eruption in Children with General Diseases Sven Kreiborg, DDS, DrOdont, PhD Pediatric Dentistry and Clinical Genetics."

Similar presentations


Ads by Google