DELAYED ERUPTION IN PRIMARY TEETH
Lateness of eruption of teeth can of either systemic or local origin in etiology. It may also be associated with prematurity (early birth) or low birth weight.
Late eruption of teeth of both dentitions may happen in association with Down syndrome and Turner's syndrome. It may also be associated with nutritional abnormalities or endocrine disorders of low secretion and signals such as hypothyroidism or hypopituitarism.
An example of a disorder of delayed eruption is Cleidocranial Dysplasia is an autosomal dominant condition composed of aplasia or hypoplasia of the clavicles and evident cranial changes. These include a brachycephalic skull (short in the antero-posterior region), frontal and parietal bulging, malformation of the maxilla and zygomatic arches, hypertelorism and also delayed closure of the anterior fontanelle and skull sutures.
Wormian bones are observed in the cranial sutures, lamboid in most cases.
In the jaws, the most significant dental feature is presence of the multiple supernumerary teeth, particularly of the permanent dentition, and in the anterior parts of the jaws.
Permanent tooth eruption is mostly delayed often or even total failure of eruption, partly because of the number of the available supernumerary teeth.
The primary teeth may fail to resorb. Although it has been suggested that there may be hypoplasia of cementum on the roots of the teeth, this has not been definitively established.
Hereditary gingival fibromatosis may be relayed to delayed eruption, possibly because of a local effect whereby the teeth are unable to penetrate through the enlarged and thickened gingivae during eruption.
Other causes include truly localized causes of delayed eruption such as ectopic crypt position.
This often affects the upper or lower permanent canines, or may present with the impaction of the maxillary first permanent molars which is impacted against the distal aspect of the adjacent primary second molar.
Local causes such as the presence of supernumeraries or odontomes may also interfere with eruption of an adjacent permanent tooth.
A delay or lateness of eruption of more than 6 months between the eruption of a tooth and its exfoliation especially for primary tooth requires
investigation, most usually radiographically.
The position of the permanent canines, particularly those in the maxilla, should be assessed by palpation not later than the 10th birthday of the child.
The potential for palatal impaction of these teeth may be recognised by this simple measure and simple intervention in some selected cases, maybe by the prompt removal of the primary canine which may possibly prevent the need for later surgery that could be caused by impaction.
Delayed eruption of permanent teeth can also be due to dilaceration leading to bending in the structure of the developing roots and crowns as a result of trauma to the deciduous dentition.
Last but not least, early extraction of a primary tooth may likely be associated with the delayed and late eruption of the permanent successor due to thickening of the overlying mucosa of the underlying permanent tooth germs.
That's all as regards the post on delayed eruption of tooth atleast for now. More would be greatly reviewed in the subsequent posts on etiologies of delayed tooth eruption. Thanks for the decorum given to the post up to this juncture and happy blogging.
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4100.241 SRY