Altered passive eruption: the undiagnosed entity.
Excessive gingiva can result from delayed or altered tooth eruption. This condition should be considered in restorative dentistry, orthodontic and esthetic treatment.
Epithelial Attachment↗
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Inherited retarded eruption in the permanent dentition.
The term retarded eruption, may be used in cases where eruption is inhibited, causing an interruption in the coordination of tooth formation and tooth eruption. The phenomenon may be local or general, and several etiological factors for retarded eruption have been listed, comprising a lack of space, ankylosis, cysts, supernumerary teeth, hormone and vitamin deficiencies and several developmental disturbances and syndromes. The present paper describes several cases of retarded eruption where no factors other than inheritance have been evident. So far 14 cases have been evaluated, 9 boys and 5 girls. In addition several cases have been registered among parents and grandparents of the probands. Typical features are: retarded eruption, defined as more than 3 SD beyond mean eruption figures, comprises all teeth in the permanent dentition, and in 5 cases also second primary molars. The chronology of tooth formation are within normal limits. Consequently the teeth finish development still laying deeply buried in the jaws, often in aberrant positions and with curves or hooks on the roots. When the teeth finally get the "signal" for eruption, 5-15 years beyond normal eruption time, they move rather quickly into right positions, despite the long eruption paths and the hooked roots. Permanent teeth without, as well as with predecessors, are affected. Extraction of predecessors does not seem to provoke eruption. The main features in management are to take care of the primary teeth, to improve-esthetics, and offer surgery and orthodontics when needed. Analyses of pedigrees indicates that the genetic transmittance may be autosomal dominant as both sexes are affected, about half of the siblings show the trait, and the trait shows continuity through generations.
Adolescent↗
Changes in the shape and orientation of periodontal ligament fibroblasts in the continuously erupting rat incisor following removal of the occlusal load.
One of the main theories which attempts to explain the phenomenon of tooth eruption suggests that periodontal ligament (PDL) fibroblasts move actively and pull the tooth with them out of its socket. To find further support for this theory, we determined the changes in the shape and orientation of PDL fibroblasts induced by a transition from impeded to unimpeded eruption. We measured nuclear area, elongation (length-to-width ratio), and orientation (angulation in relation to the eruption axis) of PDL fibroblasts in impeded (functionally loaded) and unimpeded (hypoloaded) rat incisors. The mean cross-sectional nuclear area did not differ between fibroblasts in the two groups. In contrast, unimpeded eruption resulted in a marked increase in the mean nuclear elongation (from about 2 to 2.56) and a significant increase in the mean nuclear orientation (from 25.6 to 14.0 degrees). Bivariate analysis suggested that these changes occurred in the same cells. Analysis of nuclear elongation and orientation at various distances from the cementum toward the alveolar bone revealed a profile of both parameters, such that cells located 20 to 80 microns away from the cemental surface were more elongated and more frequently oriented toward the eruption axis, while cells at 0 to 20 and 80 to 100 microns were more round/oval and had a greater angulation with the eruption axis. These findings, together with other observations of changes in cell number, number of microtubules, and migration velocity which occur on the shift to unimpeded eruption, support the theory of active movement of PDL fibroblasts as an important component of tooth eruption.
Animals↗
Effect of unilateral superior cervical ganglionectomy on mandibular incisor eruption rate in rats.
To assess the effect of sympathectomy on rat tooth eruption, the effect of a unilateral superior cervical ganglionectomy (SCGx) on eruption rate of ipsi- and contralateral lower incisors was examined. Two experiments were performed. In a first experiment, the eruption rate of ipsilaterally denervated incisors was similar to that of contralaterally innervated incisors, when assessed for up to 28 days after surgery. In a second experiment, under conditions of unilateral unimpeded eruption of incisors performed ipsilaterally or contralaterally to a unilateral SCGx, a significantly lower eruption rate of denervated incisors at the impeded eruption side, and a significantly higher eruption rate of denervated incisors at the unimpeded side were observed, when computed every 2 days. Significant differences in individual Student's t tests at every time interval occurred mainly during the first and the last week of examination. When average daily eruption rate was computed in weekly intervals, a significant interaction between SCGx and the side of impeded or unimpeded eruption was found in a factorial ANOVA, that is, for each of the 4 weeks of examination, sympathetically denervated incisors showed lower eruption rates at the impeded eruption side, and higher eruption rates at the unimpeded side. These results indicate that incisor eruption is not modified by a local sympathetic denervation unless the contralateral lower rat incisor is cut out of occlusion.
Animals↗
[Dysostosis cleidocranialis--a case report].
An 18-year female patient with dysostosis cleidocranialis, treated for dental anomalies characteristic of her basic disease since the age of 12, is described. Delayed resorption of deciduous teeth and eruption of permanent teeth were recorded. At the age of 12, the patient had still had all deciduous teeth, with the exception of lower incisors and right upper mesial incisor. The presence of 11 succedaneous teeth, 7 in the maxilla and 4 in the mandible, had been recorded by X-ray. The treatment performed step by step is presented. Firstly, deciduous teeth were extracted, and a prosthesis for both the maxilla and mandible were constructed to stimulate eruption of permanent teeth. All supernumerary teeth from the jaws were also surgically removed. After the permanent tooth eruption had been accomplished, orthodontic treatment of these teeth was required and it has still been successfully performed. Thus, a conclusion is made that the treatment of dental anomalies should start at the time of normally expected deciduous tooth exfoliation.
Adolescent↗
Dental variables associated with differences in severity of fluorosis within the permanent dentition.
The aim of this study was to assess the influence of age at start, duration, and completion of enamel formation, as well as of tooth-eruption age and enamel thickness on the severity of dental fluorosis within the permanent dentition. The material comprised Ugandan children (n = 219), aged 10-14 years, with 28 teeth and at least 1 tooth with fluorosis. The children were permanent residents in districts with either 0.5 mg or 2.5 mg fluoride/l in the drinking water. Fluorosis was assessed on the vestibular surfaces of all teeth using the modified Thylstrup and Fejerskov (TF) index. In order to relate fluorosis to the dental variables, the material was divided into a test group (n = 103), with fluorosis on all teeth, and a reference group (n = 116), with fluorosis on up to 27 teeth. The reference group was used to confirm or refute the findings in the test group. Paired comparisons showed significantly higher median TF scores for the late than for the early mineralizing and erupting teeth. In multiple regression analyses, the age at start, duration, and completion of enamel formation as well as tooth eruption was significantly related to the severity of fluorosis after controlling for enamel thickness (P < 0.05, n = 14). The effect (R2change) of the dental variables on the variation in severity of fluorosis within the dentition was in decreasing order: the duration of enamel formation, age at completion of enamel formation, tooth-eruption age, and the start of enamel formation.
Adolescent↗
Australian longitudinal study of time and order of eruption of primary teeth.
Timing and sequence of eruption of primary teeth were studied longitudinally in 164 healthy Australian children. Eruption of primary teeth typically began between 7 and 8 months and was completed by 28 months. Tooth eruption was not significantly related to growth rate or to psychomotor maturity. Comparison of the eruption ages in this study with those from longitudinal studies in other countries suggests that no real changes in these have occurred over 40 yr despite increased affluence in industrialised countries over that period.
Age Factors↗
Immediate loading of an implant following implant site development using forced eruption: a case report.
In restoring periodontally involved hopeless teeth, implant treatment has been widely used with combinations of various grafting techniques or guided bone regeneration. Instead of traditional surgical procedures, forced tooth eruption may be used successfully for implant site development. In this case, the authors orthodontically erupted a hopeless central incisor with an angular bony defect. Subsequently, they placed an implant immediately after tooth extraction and immediately loaded it with a temporary resin restoration.
Adult↗
Long-wave cycles in the position of erupting human premolars.
OBJECTIVE: Unusual long-wave cycles in the position of an erupting human premolar were first noted by Trentini et al. [Trentini CJ, Brown WH, Paterson RL, Proffit WR. The application of Moire magnification to high precision studies of human premolar eruption. Arch Oral Biol 1995;40:623-9]. This report characterises them in detail and evaluates their significance relative to human tooth eruption. DESIGN: The magnitude and frequency of Trentini cycles were examined in high-resolution recordings of premolar eruption in patients without and with periapical infiltration of a vasoconstrictor or vasodilator, and the possibility of artifact due to the natural frequency of vibration of a tooth-PDL system or to building vibration was evaluated. RESULTS: The cycles are characterised by a magnitude of 1.3 +/- 0.5 microm and a frequency of 1.8 +/- 0.5 cycles per minute, with greater variation between than among subjects. They cannot be explained as a natural frequency phenomenon, and vibration from microseism is highly unlikely. The cycles disappear when blood flow to the periapical area of the tooth is interrupted and reappear when blood flow resumes. CONCLUSIONS: The cycles appear to reflect a physiologic rhythm, probably related to blood flow in the periodontal ligament. Because they are similar whether or not a tooth is erupting at a particular time, however, it appears that they are not a direct reflection of a blood flow-related eruption mechanism.
Artifacts↗
Aberrant root formation: review of root genesis and three case reports.
The mechanism of root formation and tooth eruption is a complex process which is not fully understood. Prior to a tooth emerging into the oral cavity, root genesis is initiated by derivatives of the enamel organ. The dental follicle mediates an eruption pathway allowing for movement of the developing tooth in a coronal direction. As the tooth moves towards the oral cavity, root formation occurs passively in the resulting space. Failure of the enamel organ and dental follicle to properly coordinate may result in complications in the eruption process. This clinical report presents 3 cases of isolated, unerupted teeth with dysmorphology of the roots. The process of root development and tooth eruption is also briefly reviewed.
Adolescent↗
Primary failure of eruption: a case report.
The long-term effect of extracting infra-occluded (submerged) first permanent molars on the subsequent movement of the second permanent molars was studied in a member of a family with previously noted primary failure of tooth eruption. The case is described with the use of radiographs and diagrams and the conclusion reached that in some pathological conditions tooth movement takes place in an apical direction, an observation that may be termed 'paradoxical' tooth movement.
Adolescent↗
Ectopic eruption of a maxillary canine following trauma.
Traumatic events at an early age may lead to developmental dental anomalies and ectopic tooth eruption. A case is reported in which a traumatic injury at two months of age resulted in the development of supernumerary teeth in the upper right premaxillary region. The maxillary canine ectopically erupted or transposed into the space left by the missing central incisor and eliminated the need for a prosthesis in this region.
Child↗
Relationship between enamel formation and eruption rate in rat mandibular incisors.
The relationship between the formation of dental enamel and tooth eruption was investigated. Rat mandibular incisor eruption rate was accelerated by maintaining incisors out of occlusion. Rate of eruption, enamel thickness, secretory zone length and matrix breakdown were measured. Eruption rate increased by 120% in experimental teeth but enamel secretion increased by only 90%. There were no obvious differences between control and experimental teeth in final enamel thickness or in the molecular weight distribution of the enamel matrix proteins.
Animals↗
[ON THE RELATION BETWEEN PHYSICAL DEVELOPMENT AND THE ERUPTION TIME OF THE 1ST MILK TOOTH].
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Child↗
Expression of tumour necrosis factor-alpha in the rat dental follicle.
Tooth eruption requires the presence of the dental follicle, a loose connective tissue sac that surrounds each unerupted tooth. The follicle appears to regulate many of the cellular and molecular events of eruption, including the formation of osteoclasts needed to resorb alveolar bone to form an eruption pathway. To that end, the expression of the tumour necrosis factor-alpha (TNF-alpha) gene was examined in the dental follicle as a possible regulator of osteoclastogenesis. TNF-alpha was expressed slightly in the dental follicle of the first mandibular molar of the rat beginning at day 3 postnatally, but maximal expression was seen at day 9, a time that correlates with a slight burst of osteoclast formation seen at day 10 postnatally. In vitro, TNF-alpha was not expressed constitutively in the follicle cells but incubating them with interleukin 1alpha resulted in a strong expression of TNF-alpha after only 0.5h. TNF-alpha itself enhanced monocyte chemotactic protein 1 (MCP-1) and vascular endothelial growth factor (VEGF) gene expression. It also slightly decreased the expression of osteoprotegerin after 3-h incubation but this returned to the control level at 6h. MCP-1 and VEGF could aid in recruiting mononuclear cells (osteoclast precursors) to the dental follicle. In addition to the potential role of TNF-alpha in tooth eruption, this study suggests that the periodontal ligament derived from the dental follicle might have the capacity to synthesize TNF-alpha, and thereby contribute to the destructive events of periodontitis.
Animals↗
Expression of vascular endothelial growth factor in the dental follicle.
Tooth eruption requires the presence of the dental follicle to recruit mononuclear cells, which fuse to form osteoclasts that resorb the alveolar bone such that the tooth can erupt. In the rat first mandibular molar, there is a major burst of osteoclastogenesis at day 3 postnatally and a lesser burst at day 10. Eruption molecules, such as CSF-1, are maximally expressed at day 3 in the dental follicle to promote this maximal osteoclast formation, but by the time of the secondary burst of osteoclastogenesis their expression is dramatically reduced. Because vascular endothelial growth factor (VEGF) can substitute for CSF-1 to promote osteoclastogenesis, we examined its gene expression in vivo in the dental follicle and found that it and its two major isoforms (VEGF 120 and 164) were all maximally expressed at days 9-11, the time of the secondary burst. Treatment of the cells with phorbolmyristate acetate (PMA), a protein kinase C (PKC) activator, enhanced expression of the 2 major VEGF isoforms in the cultured dental follicle cells, whereas adding a specific PKC inhibitor prevented this. Treatment with PMA also increased the protein level of VEGF. Thus, VEGF may be involved in promoting the secondary burst of osteoclastogenesis, and activation of PKC may upregulate its expression.
Animals↗
Age estimation in small children: reference values based on counts of deciduous teeth in Finns.
The eruption of teeth in the mouth is suitable for age estimations during the period when teeth are actively emerging, in the deciduous dentition phase approximately from the age of 6 months to 2.5 years. Estimations of age can be performed simply by counting the number of teeth in the mouth. Reliability of the estimates depends on the reference data available and each population group should preferably have its own standards. In the present study timing of eruption of successive deciduous teeth was studied longitudinally in 129 Finns. The dates of clinical eruption of deciduous teeth were recorded by mothers and checked by dentists. In 40 of the 129 children emergence ages of at the most the four last teeth were based only on semiannual registrations performed by dentists. The main purpose was to provide normal timetables of tooth eruption in small children in forms that are practical in estimations of dental age. No sexual dimorphism existed in the timing of clinical eruption of successive deciduous teeth. The mean age corresponding to the presence of one tooth in the mouth was 7.1 months (S.D.=1.78) and that corresponding to tooth count 19 was 27.8 months (S.D.=3.99). If the chronological age is known, the presented distributions and means with variations make it possible to estimate the degree of advancement or delay in a child's dental development. If the age of the child is not known, the mean and median ages can be used for estimations of chronological age. However, estimations of age should not be based only on tooth counts because of marked variation also within this homogeneous group.
Adult↗
Reliability of eruption rate measurements of the rat incisor.
The reliability of the easy method to measure rat tooth eruption proposed by Schour and Van Dyke has frequently been challenged. To assess its true trustworthiness an experiment was set up using three different groups of rats and two different methods for eruption assessment. One group was used for 'control'. The second group received a potent lathyrogen, while the third group was used as pair-fed+ for the second group. Measurements were made clinically and radiographically. Comparison between the three groups led to the conclusion that the much easier and less expensive method, using the clinical manual measuring method is reliable and may be used in future calculations of eruption rate of rat incisors. It furthermore provides an excellent method to assess the lathyrogenic condition of these animals.
Aminoacetonitrile↗