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    Eruption

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    Eruption

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    Eruption

    Uploaded by

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    © All Rights Reserved
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    of 5

    ٢٠٢٢٠٠٧٨١ ‫مؤمن احمد محمد سليمان‬

    ٢٠٢٢٠٢٧٥٤ ‫أندرو بشاي منصور‬

    Eruption

    •Normal eruption:-
    When a developing tooth moves from
    it’s initial nonfunctional position within
    the alveolar bone to it’s final functional
    location within the oral cavity.

    The first teeth to erupt are the lower


    and upper central incisors, which
    erupt between the ages of 6 12
    months. The next to erupt are the
    lateral incisors between 9-16
    months, followed by the first molars
    from 13-19 months. Next, the
    cuspids (canines) erupt from 16-23
    months.

    Sometimes there is a disturbance in balance between the rate of jaw


    growth and rate of teeth eruption or teeth sizes which may lead to
    ectopic eruption which is a dislocation of teeth in the jaw.
    Dental eruption is a physiological process at the end of which the
    erupting tooth will occupy its functional place on the dental arch and occlude
    with the opposing tooth. The process of tooth eruption can be negatively
    influenced by a variety of factors [1]. One of the issues that can arise in the
    process of dental eruption is ectopic eruption, a pathological situation in
    which the tooth does not follow its normal eruption path [2]. Among the teeth
    most frequently affected by this anomaly are the maxillary first permanent
    molars and maxillary canines, but the ectopic eruption can affect other teeth
    as well [3].
    The first permanent molars erupt around the age of 6–7, distal to the
    second deciduous molars [4]. The ectopic eruption of the first permanent
    molars represents a local eruption anomaly that causes the first permanent
    molars to remain blocked under the distal surface of the second deciduous
    molar, leading to its inability to erupt up to the level of the occlusal plane and
    to the pathological resorption of the second deciduous molar’s roots [5]. The
    etiology of the ectopic eruption of first permanent molars is multifactorial,
    including local, genetic and inherited factors, and its prevalence is different
    in various populations worldwide [4,6]. Generally, the differences in
    prevalence are related to the size of the sample on which the study was
    carried out, the age range of the patients included in the study, or the dental
    status of the investigated patients [5].

    This case can happen in many ways :


    There is disagreement among various investigators regarding the
    etiology of ectopic eruption. Sweet, in 1939, expressed the view that it
    was related to evolutionary changes, as a result of which a gradual
    reduction is occurring in the number of permanent teeth in the human
    dentition. O’Meara stated that multiple factors were probably involved,
    but that a major factor was insufficient intercanine and
    anterioposterior growth of the jaws. Nikiforuk and others also share
    this view of lack of regional bone growth. Pulver’sinvestigation
    proposes more than one etiologic factor to be responsible for ectopic
    eruption. Following an extensive study of ectopic eruption, he found
    that:

    • The mean size of the maxillary primary and permanent teeth in


    the affected individuals are significantly larger. Further, the
    affected sides showed significantly larger maxillary first
    permanent molars and maxillary second primary molars than their
    counterparts within the sample, which were not affected.
    • The lengths of the maxilla in affected individuals were significantly
    smaller than the known standards. Further, the maxillae were
    positioned in a more posterior relationship to the cranial base.
    • Some of the affected maxillary first permanent molars showed
    delayed calcification.
    • There was an abnormal angulation of eruption of the maxillary
    first permanent molars.

    •How to deal with it


    Several methods of treating ectopically erupting maxillary permanent
    first molars have been suggested like :

    1. Interproximal wedging :-
    After the occlusal surface of the first permanent molar becomes exposed in
    the oral cavity, the eruption path of the impacted tooth can often be
    favorably influenced by inserting a brass ligature wire gingival to the contact
    of the permanent and primary molars.The 0.026 in, brass ligature is
    threaded around the contact area occlusally and tightened with #110 pliers
    to compress the area and wedge the teeth apart. The free end is cut to a 2
    or 3 mm length and is placed in the
    gingival crevice, minimizing irritation to
    the buccal tissue. The wire is tightened
    or a new one placed at three- to seven-
    day intervals to cause distocclusal
    movement of the first permanent molar.
    When the contact opens so that the
    wire can no longer be retained, a larger
    wire is used or the patient is
    reappointed in three or four days, after
    which time the contact will have been
    re-established and the ligature
    treatment can resume.

    2. Distal tipping :-
    Humphrey has described another technique for correcting ectopically
    erupting first permanent molars. A preformed steel orthodontic band is
    adapted to the second primary molar on the affected side. A soft
    Elgiloy*wire is welded and then soldered to the band with a silver bar
    solder. An S-shaped loop is placed in the
    wire. The loop is opened slightly and is flame
    heated prior to cementation. The distal
    extension of the wire is placed in a
    preparation in the central occlusal pit of the
    ectopically erupting molar. It may be
    necessary to reactivate the appliance in
    seven or ten days. An occlusal amalgam or
    preventive resin restoration is later placed in
    the first molar. Bayardo recommends
    soldering two 0.25 Elgiloy wires, one on the buccal and the second on
    the lingual, to an orthodontic band, which has been adapted to the
    primary second molar. Each wire has a helical loop and an extension,
    which engages the ectopic molar. The springs are activated weekly for
    six weeks.

    •References:-

    https://www.mdpi.com/2075-4418/12/11/2731
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3220171/

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