occlusal features in normal development

Question 1

what symptoms are experienced before eruption of the deciduous dentition?

what is the management for this?

Answer 1

• teething
  
  • erythema of surrounding gingiva
  • increased salivation and dribbling
  • can cause systemic problems
    
    • irritability
    • mild fever
• management
  
  • teething toys / gels

Question 2

in what order do the permanent teeth erupt?

Answer 2

Question 3

what is an ‘abnormal’ eruption sequence?

Answer 3

• if there is a change in sequence
• asymmetrical eruption

Question 4

why should you palpate upper canines and when should you?

Answer 4

start palpating upper canines from 9 years old

• should feel bump in buccal sulcus
• if there is a concavity - canine may be in ectopic position
  
  • can cause damage to the roots of the lateral and central incisors

Question 5

describe the eruption of the first permanent molars

when does this happen?

Answer 5

at 6 years

• The first molars usually erupt into 1/2 unit class II relationship guided by the Es
  
  • have a flush terminal plane position
• The Es are exfoliated
• As the leeway space is large in the mandible and there is growth in the mandible
  
  • it leads to transition into a class I molar relationship

Question 6

When is there eruption of the lower incisors?

what characteristics are common?

Answer 6

ages 7-8

• Lower incisors tend to be crowded when they first erupt
  
  • May improve following exfoliation of lower Cs and with further growth

Question 7

When is there eruption of the upper incisors?

describe

what characteristics are common?

Answer 7

ages 7-8

• permanant incisors are larger than the deciduous predeceddors
• incisors develop palatally and erupt labial to the deciduous teeth
  
  • into a wider arc
• delayed eruption can lead to space loss
  
  • class 3 incisors relationship when there is eruption
• majority of children will have mildly crowded upper 2-2 on initial eruption
• reassure - improved with subsequent alveolar growth

Question 8

what teeth have erupted by ages 8-9

what is common

Answer 8

• Upper centrals and laterals have erupted
• Lower centrals laterals and canines have erupted
• Midline diastema

Question 9

how does midline diastema occur and when usually?

how does it resolve?

Answer 9

usually between ages 8-9

• upper anteriors are proclined
  
  • their roots are convergent prior to eruption of the 3s
• majority close spontaneously when upper 3s erupt
  
  • upper canines put pressure on the roots of the laterals and causes the anteriors to be pushed together and close the diastema

Question 10

what is the aim by age 8 and 1/2

Answer 10

• complete eruption of upper and lower permanent incisors
• reasonable alignment
• coincident centrelines

Question 11

describe the eruption of the canines and premolars

Answer 11

• 4s develop buccally
• 5s develop palatally
• upper canines
  
  • develop palatally
  • migrate buccally and can be palpated from ages 9-10
  • become impacted/ectopic relatively frequently

Question 12

What is the ideal occlusion?

what do we use for it?

Answer 12

Andrew’s 6 keys

1. ​correct molar relationship
2. correct angulation (mesio-distal)
3. correct inclincation (bucco-lingual)
4. no spaces
5. no rotations
6. flat curve of spee

Question 13

what is archform determined by?

Answer 13

• skeletal pattern
• soft tissues
  
  • tongue, lips, cheecks
• dental
  
  • (crowding)
• environmental influences
  
  • .e.g tongue thrust, digit sucking