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ERUPTION & SHEDDING

OF TEETH

Tooth eruption

Defined as the axial movement of tooth from its


developmental position in the alveolar socket into its
functional position within the oral cavity

Active eruption vertical movement of the tooth due


to actual movement of the teeth

Passive eruption receding of the gingiva leading to


exposure of crown in the oral cavity.

Tooth eruption

Three distinct tooth movements are noticed during


development of dentition.
1. Pre-eruptive these are the movements which begin

before the actual axial movement of teeth

Tooth buds are initially crowded as the jaws (maxilla

and mandible) are small and later as the jaw grows,


these buds move away from each other and align
themselves in their respective crypts.

Permanent tooth buds develop adjacent to deciduous

teeth and later they move apically.

Permanent maxillary molars face distally in the

maxillary tuberosity when they develop, as the maxilla


grows in size they turn mesially and erupt

2. Eruptive movements (pre functional eruptive

phase)
In this phase the actual eruption (axial movement) of
teeth takes place, the mechanism is explained by
various theories

3. Post eruptive- (functional eruptive phase)


To compensate for occlusal and proximal wear of the

teeth
To compensate for the growth of the jaws

Primary Tooth Eruption

Reduced enamel
epithelium fuses with oral
epithelium
Forms a epithelium lined
tunnel
Reduced enamel
epithelium converts into
primary attachment
epithelium

Gubernacular Cord and Canal


Eruption process is the same for
the primary teeth formation of an
epithelium lined tunnel for eruption
Gubernacular cord and
gubernacular canal -

Initially both permanent and decidous


buds are in the same crypt
As the deciduous erupts the permanent
tooth becomes completely enclosed by
bone except for a small canal which is
filled with connective tissue this is
gubernacular cord
The bony canal in which this is present
is known as Gubernacular canal

Helps in guiding the permanent tooth


to erupt

Mechanisms of tooth
eruption: current research
Theories of eruption Bone remodeling theory
Root growth theory : Cushion Hammock ligament
Vascular pressure theory
Periodontal ligament traction theory: most accepted

Bone remodeling theory

This theory states that the tooth erupts because


there is bone resorption above the tooth and bone
deposition below the tooth which pushes the
tooth to its functional position.
Not accepted because bone remodeling occurs as
an effect of tooth movement and not as a cause of
it
Removal of dental follicle stops the bone
remodeling hence the driving force is not within the
bone

Rooth growth theory

As the root grows, it exerts downward pressure on


the bone which pushes the tooth up (like a rocket).
Not accepted because
No fixed base
The tooth moves for a greater distance than the
length of the root
Eruption continues even if the root is sectioned
(cut)
Cushion Hammock theory.

Vascular pressure theory

The pressure exerted by the blood vessels at the


apex of the tooth help in eruption of teeth
Not accepted The pressure exerted is not enough to help in
eruption of teeth
Teeth erupt even when the vascular supply is
cut

Periodontal Ligament Traction


Theory

Most accepted theory


The periodontal ligament fibroblast have
contractile property
The fibroblasts are inter connected to each other
- fibronexus
The contractile forces are transmitted to the
fibres to reorient them to help in eruption of
teeth.
Experimentally proven that the dental follicle is
the most important structure rsponsible for
eruption of teeth

Shedding / Exfoliation of Teeth

The physiologic process resulting in the


elimination of the deciduous dentition is called as
shedding or exfoliation.

It is initiated either by the pressure exerted by the


permanent successor or by increased occlusal
forces.

The cell responsible for removal of hard tissues is


ODONTOCLAST (structure and origin similar to
osteoclast)

Applied aspects

Importance of chronology and sequence


of eruption
Delayed eruption
Impacted teeth
Submerged teeth
Retained deciduous teeth
Remnants of deciduous teeth

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