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McDonald Chapter 9 174-202 Italicized notes have been questioned on the Dental Decks
Overview
Life cycle: Initiation/Bud; Cap; Bell; Apposition; Calcification, Eruption, Attrition Human Dentition Formulae Average Eruption Chronology Lingual Eruption of Mandibular Incisors Teething Eruption anomalies Neonatal and Natal teeth Anomalies in Newborns Premature loss teeth and space maintenance
Permanent Dentition 2 1 2 3 I --- C --- B --- M ---=16 x2=32 2 1 2 3 Recall that the formula is for the left or right half of the mouth an then needs to be multiplied by 2.
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Pre-eruptive phase
Bud/Cap/Bell/Apposition/C alcification Ends when root development begins
Influences on Eruption:
Root formation 75% Thyroid and growth hormones Parathyroid-hormone-related-protein Proliferation of Hertwigs epithelial root sheath (HERS) Proliferation of the connective tissue of dental papilla Simultaneous growth of the jaw Pressure from muscular action Apposition and resorption of bone Interplay of osteoblasts, osteoclasts, regulatory genes and dental follicles
Attrition Stage
A tooth will continue to erupt as it wears Super-eruptioneither lack of opposing tooth or excessive wear results in continued eruption of a tooth
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Researchers disagree over chronology. We will use McDonalds as our reference. 1st molars begin to calcify at birth; 3rd molars at 8-10 y.
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Desirable and most common sequence for permanent teeth: Mx: 1st molars centrals laterals 1st premolars 2nd premolars (canines) 2nd molars
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Desirable and most common sequence for permanent teeth: Md: 1st molars centrals laterals canines 1st premolars 2nd premolars 2nd molars
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Activity: Create an eruption sequence with the specific tooth number or letter distributed. We will form a simulated mouth as eruption times are called.
McDonald 179 9-2
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Birth-1st molars initiated calcification 4 y--all crowns initiated calcification 8 y--all crowns complete 12 y--all crowns emerge 16 y--all roots complete
Excludes 3rd molars
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First Molars 9-10 y Mandibular Incisors 9-10 y Maxillary Incisors 10-11 y Completion of apex: 2 to 3 y after eruption Can a root canal procedure be done on a first molar or incisor on a child with a dental age of 11 years old? YESroot closure has occurred
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Eruption sequestrum
Small spicule of calcified tissue extruded through the alveolar mucosa over an erupting molar Can be easily removed May not be bone but tooth tissues
McDonald 182 9-6
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At 8, 9, 10, premolar eruption resulting from premature loss of primary teeth is greatly accelerated
Space maintenance may not be needed
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Distal shoe
Directs eruption of the 1st permanent molar when 2nd primary molar is prematurely lost
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Lingual arch
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