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Eruption and Occlusion of the Permanent Dentition
Mark H. Taylor, D.D.S., F.A.C.D.
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Don’t Fake Knowledge! Know Nolla's stages of calcification
Know time of eruption of permanent teeth
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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
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Time of Eruption (Years)
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Why Know Calcification Times?
Enamel hypoplasia
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Fluorosis
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Fluorosis and Hypoplasia
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Fluorosis and Hypoplasia
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Factors Affecting Eruption
Genetics - sequence & timing mostly genetically controlled Nutrition Premature loss of a primary tooth Eruption… heh heh… get it?
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Eruption Facts Girls 5 months faster than boys
and most common in maxilla (6-1) and (6-1) most common in mandible
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Mesial Drift and Anterior Component of Force
Ectopic eruption Axial inclination produces mesial force Space maintenance
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Ectopic Eruption
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Ectopic Eruption
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Ectopic Eruption
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Space Maintenance - PHA
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Space Maintenance - LLHA
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Space Maintenance - BLS
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Space Maintenance - Distal Shoe
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Crossbites Unilateral vs. bilateral Dental vs. skeletal
Appliance types
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Functional Cross Bite
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Functional Cross Bite
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Functional Cross Bite
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Functional Cross Bite
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Quad Helix Appliance
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Quad Helix Appliance
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Distalizing Appliance
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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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Missing Permanent Teeth
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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
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Supernumerary Teeth
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Supernumerary Teeth
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Supernumerary Teeth
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Supernumerary Teeth
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Supernumerary Permanent Tooth
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Supernumerary Permanent Tooth
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Supernumerary Permanent Tooth
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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
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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)
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Intercanine Growth
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Angle Classification Class I Molar (65%) Class II Molar (30%)
Class III Molar ( 5%)
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Class I Molar Mesial Distal
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Class II Molar Mesial Distal
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Class III Molar Distal Mesial
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Cuspid Classification
Neutro (Class I) Disto (Class II) Mesio (Class III)
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Neutro Cuspid (Class I)
Mesial Distal
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Disto Cuspid (Class II)
Distal Mesial
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Mesio Cuspid (Class III)
Distal Mesial
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Divisions of Class II Division I - excess OJ
Division II - "rabbited" incisors Subdivision - one side
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Divisions of Class II Division 1
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Divisions of Class II Division 1
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Divisions of Class II Division 1
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Divisions of Class II Division 2
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Divisions of Class II Division 2
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Divisions of Class II Division 2
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Divisions of Class II Division 2
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Six Keys to Occlusion Class I molar relationship
Mesial crown angulation Proper crown inclination No rotations Tight contacts Flat occlusal plane
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Types of Faces Brachycephalic - broad & short
Dolichocephalic - long & narrow Mesocephalic - normal
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Brachycephalic
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Dolichocephalic
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Mesocephalic For the gentlemen... For the ladies….
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Mesocephalic For the moviegoer….
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Mesocephalic For the intellectual dental student….
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You Tell Me.
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Profile?
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Overbite - Overjet?
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Occlusion?
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Huskers!!!!
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