PATTERNS OF TOOTH MOVEMENT

1) Pre- eruptive tooth movement -:

It is a preparatory to eruptive phase. During this phase growing tooth moves in two directions to maintain its position in the jaw viz. bodily movement eccentric movement.

BODILY MOVEMENT:- which occurs continuously as the jaw grows. It is a movement of entire tooth germ causing bone resorption in a direction of tooth movement & bone apposition behind it. ECCENTRIC MOVEMENT :- it is a relative growth in one part of the tooth while the rest of the toth remains constant.

2) Eruptive tooth movement :-

It begins with the initiation of root formation & ends when the teeth reach in occlusal contact.

3) Post- eruptive tooth movement:-

It occurs primarily to maintain the position of erupted tooth while the jaw continues to grow to compensate for occlusal & proximal wear.

THEORIES OF TOOTH ERUPTION Root elongation theory The crowns of the teeth are pushed into oral cavity by virtue of growth & elongation of roots. Pulpal constriction theory The growth of root dentin & subsequent constriction of pulp may cause sufficient pressure to move the tooth occlusaly. Growth of periodontal tissues A] pull by surrounding connective tissue results in eruption of tooth in oral cavity. B] alveolar bone growth squeeze the tooth out of its alveolus & into oral cavity Pressure from muscular action Action of musculature of the cheeks and lips upon the alveolar process causes eruption. Resorption of the alveolar crest Resorption of alveolar crest would serve to exposure of crown. Hormonal theory Hormones secreted by pitutary & thyroid gland might govern eruption. Cellular proliferation theory Osmotic pressure & forces resulting in cellular proliferation in pulp causes eruption.

ERUPTION SEQUESTRUM :

It is a tiny spicule overlying the crown of an erupting first permanent molar.

It appears just before or immediately after the emergence of the tip of cusps through oral mucosa.

Composed of cementum like material.

Developed from osteogenic or odontogenic tissue.

Removed, if it causes irritation under local anaesthesia.

ECTOPIC ERUPTION

Arch length inadequacy or variety of local factors may influence a tooth to erupt in position other than normal

NATAL & NEONATAL TEETH

Eruption of a teeth at or immediately after birth is relatively rare phenomenon. Teeth if present at birth called natal & teeth erupt during first 30 days of life are called as neonatal teeth. Also known as congenital teeth,feotal teeth,dentition praecox.

TEETH AFFECTED:Mandible incisors central incisors 85% Maxillary incisors 11% Mandible canines & molars 3% Maxillary canines & molars 1%

ETIOLOGY:Hypovitaminosis Hormonal stimulation Trauma Febrile status & syphilis Hereditary Superficial position of developing tooth germ predisposes the tooth to erupt early

CLINICAL APPEARANCE:Natal & neonatal teeth may be poorly developed small conical, yellowish with white hypoplastic enamel & dentin & with por or total failure of development of roots. Appearance can be classified as:-

Category 1- a shell like crown structure loosely attached to alveolus by a ream of oral mucosa. No root. Category 2 a solid crown loosely attached to alveolus by oral mucosa . Little or no root. Category 3 incisal edge of a crown just erupted through the oral mucosa Category 4 mucosal swelling with a tooth unerupted but palpable

MANAGEMENT :Radiographs should be made to determine the amount of root development & the relationship of prematurely erupted tooth to its adjacent teeth

King & Lee suggest that inflamed gingival tissue around teeth should be controlled by applying chlorhexidine gluconate gel three times a day.

The sharp incisal edge of the tooth may cause laceration of the lingual surface of the tongue so selective grinding of the tooth should be done in such condition

Prematurely erupted teeth are hypermobile because of limited root development which may lead to danger of aspiration in such cases extraction should be done

After the tooth removal careful curettage of the socket is indicated in attempt to remove any odontogenic cellular remanants.

Such retained remanants may subsequently may develop a typical tooth lik structure that requires additional treatment.

Neonatal teeth may cause difficulty for mother who wishes to breast feed.

Use of breast pump , bottling of milk are recommended.

COMPLICATION:RIGA FEDE DISEASE Traumatic ulcerations on the ventral surface of the tongue , frenum , lip is associated with it. In 1881 & 1890 RIGA & FEDE described this lesion histologically & has subsequently known as RIGA and FEDE disease. Also known as NEONATAL SUBLINGUAL TRAUMATIC ULCERAT