Eruption and Occlusion of the Permanent Dentition Mark

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Eruption and Occlusion of the Permanent Dentition Mark H. Taylor, D. D. S. ,

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

Don’t Fake Knowledge! • Know Nolla's stages of calcification • Know time of eruption

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

Nolla's 10 Stages of Calcification • Stage 2 - initial calcification • Stage 6

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

Time of Eruption (Years)

Time of Eruption (Years)

Why Know Calcification Times? Enamel hypoplasia

Why Know Calcification Times? Enamel hypoplasia

Fluorosis

Fluorosis

Fluorosis and Hypoplasia

Fluorosis and Hypoplasia

Fluorosis and Hypoplasia

Fluorosis and Hypoplasia

Factors Affecting Eruption • Genetics - sequence & timing mostly genetically controlled • Nutrition

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

Eruption Facts • Girls 5 months faster than boys • 6 -1 -2 -4

Eruption Facts • Girls 5 months faster than boys • 6 -1 -2 -4 -3 -5 -7 and 6 -1 -2 -4 -5 -3 -7 most common in maxilla • (6 -1)-2 -3 -4 -5 -7 and (6 -1)-2 -4 -3 -5 -7 most common in mandible

Mesial Drift and Anterior Component of Force • • Mesial drift Ectopic eruption Axial

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

Ectopic Eruption

Ectopic Eruption

Ectopic Eruption

Ectopic Eruption

Ectopic Eruption

Ectopic Eruption

Space Maintenance - PHA

Space Maintenance - PHA

Space Maintenance - LLHA

Space Maintenance - LLHA

Space Maintenance - BLS

Space Maintenance - BLS

Space Maintenance - Distal Shoe

Space Maintenance - Distal Shoe

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

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

Functional Cross Bite

Functional Cross Bite

Functional Cross Bite

Functional Cross Bite

Functional Cross Bite

Functional Cross Bite

Functional Cross Bite

Functional Cross Bite

Quad Helix Appliance

Quad Helix Appliance

Quad Helix Appliance

Quad Helix Appliance

Distalizing Appliance

Distalizing Appliance

Absence of Permanent Teeth • 4 -6% congenital absence • Females more frequently missing

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

Missing Permanent Teeth

Missing Permanent Teeth

Extra Permanent Teeth • Supernumerary teeth found most frequently in the maxillary incisor region

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

Supernumerary Teeth

Supernumerary Teeth

Supernumerary Teeth

Supernumerary Teeth

Supernumerary Teeth

Supernumerary Teeth

Supernumerary Teeth

Supernumerary Teeth

Supernumerary Permanent Tooth

Supernumerary Permanent Tooth

Supernumerary Permanent Tooth

Supernumerary Permanent Tooth

Supernumerary Permanent Tooth

Supernumerary Permanent Tooth

Changes in Arch Width • Intercanine and intermolar growth – significant increases between 6

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

Changes in Arch Length and Overbite • Arch length decreases* – late mesial shift,

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 1997. (20 -55 yoa)

Intercanine Growth

Intercanine Growth

Angle Classification • Class I Molar (65%) • Class II Molar (30%) • Class

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

Class I Molar Distal Mesial

Class I Molar Distal Mesial

Class II Molar Distal Mesial

Class II Molar Distal Mesial

Class III Molar Distal Mesial

Class III Molar Distal Mesial

Cuspid Classification • Neutro (Class I) • Disto (Class II) • Mesio (Class III)

Cuspid Classification • Neutro (Class I) • Disto (Class II) • Mesio (Class III)

Neutro Cuspid (Class I) Distal Mesial

Neutro Cuspid (Class I) Distal Mesial

Disto Cuspid (Class II) Distal Mesial

Disto Cuspid (Class II) Distal Mesial

Mesio Cuspid (Class III) Distal Mesial

Mesio Cuspid (Class III) Distal Mesial

Divisions of Class II • Division I - excess OJ • Division II -

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

Divisions of Class II Division 1

Divisions of Class II Division 1

Divisions of Class II Division 1

Divisions of Class II Division 1

Divisions of Class II Division 1

Divisions of Class II Division 1

Divisions of Class II Division 2

Divisions of Class II Division 2

Divisions of Class II Division 2

Divisions of Class II Division 2

Divisions of Class II Division 2

Divisions of Class II Division 2

Divisions of Class II Division 2

Divisions of Class II Division 2

Six Keys to Occlusion • • • Class I molar relationship Mesial crown angulation

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

Types of Faces • Brachycephalic broad & short • Dolichocephalic long & narrow •

Types of Faces • Brachycephalic broad & short • Dolichocephalic long & narrow • Mesocephalic normal

Brachycephalic

Brachycephalic

Dolichocephalic

Dolichocephalic

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

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

Mesocephalic For the moviegoer….

Mesocephalic For the moviegoer….

Mesocephalic For the intellectual dental student….

Mesocephalic For the intellectual dental student….

You Tell Me.

You Tell Me.

Profile?

Profile?

Overbite - Overjet?

Overbite - Overjet?

Occlusion?

Occlusion?

Huskers!!!!

Huskers!!!!