Tooth Emergence Research Articles

Sequence and Chronology of Permanent Teeth Eruption in 5–18‐Year‐Old School Children of Chennai and the Influence of Sex, BMI, and Socio‐Economic Status

ABSTRACTObjectivesThis study aimed to determine the sequence and eruption chronology of permanent teeth in school children and adolescents of Chennai and compare the findings with an existing standard table. Additionally, the study also attempted to explore the influence of sex, body mass index (BMI), and socioeconomic status (SES) on tooth eruption patterns.MethodsA cross‐sectional study was designed, and 12,650 children aged 5–18 years were selected from thirty‐five schools using a multistage random sampling method. The clinical eruption status of all permanent teeth was evaluated using a new grading system. The chronology of permanent teeth eruption was determined using probit regression analysis while the intergroup comparison was carried out using the unpaired t‐test and anova test.ResultsThe study sample included 6414 males and 6236 females. The mandibular first molar emerged as the first tooth at 5.5 years, whereas the maxillary second molar was the last to erupt, appearing at 11.9 years. A statistically significant difference (p < 0.0001) was noted between the sexes, BMI, and SES categories for most teeth; however, the variation was only 1–3 months.ConclusionAn accelerated eruption pattern was observed for all teeth, except the mandibular canines, with a notable reversal in the maxillary sequence, where canines erupted before the first premolars. Tooth eruption occurred earlier in females, in the lower jaw, right side, in normal BMI, and high SES categories. A new eruption chart has been proposed for the Indian population, based on robust data from this study, providing an updated standard reference for assessing permanent tooth emergence.

Management of Anterior Single Tooth Emergence Profile in Implantology

Management of Anterior Single Tooth Emergence Profile in Implantology

Dental trauma in primary dentition and possible outcomes on permanent successors

Objectives. The aim of this study is to determine if there is a correlation between a traumatic dental injury suffered by a deciduous tooth and the alterations that may appear in the structure of the permanent one. Materials and methods. For this narrative review, we collected articles written in English from PubMed, Scopus, and Embase. A total of 116 papers were assessed, with 20 included in the review. Results. The review found that there is a strong relationship between a traumatic incident suffered by the temporary tooth and the developmental disturbances that appear in the permanent successors. The majority of traumatic dental injuries take place around the age of 1-3 years, when the child is learning how to walk. The developmental disturbances that may appear are categorized as mild or severe, with the difference between them being the age of the child when the trauma occurred, the type of trauma, the degree of root resorption, and the force of the impact. Conclusion. The amount of injury to a primary tooth without address it when it happens has detrimental effects on the growth and emergence of permanent teeth, requiring more prolonged and costly treatment.

Mammalian Life History: Weaning and Tooth Emergence in a Seasonal World.

The young of toothed mammals must have teeth to reach feeding independence. How tooth eruption integrates with gestation, birth and weaning is examined in a life-history perspective for 71 species of placental mammals. Questions developed from high-quality primate data are then addressed in the total sample. Rather than correlation, comparisons focus on equivalence, sequence, the relation to absolutes (six months, one year), the distribution of error and adaptive extremes. These mammals differ widely at birth, from no teeth to all deciduous teeth emerging, but commonalities appear when infants transit to independent feeding. Weaning follows completion of the deciduous dentition, closest in time to emergence of the first permanent molars and well before second molars emerge. Another layer of meaning appears when developmental age is counted from conception because the total time to produce young feeding independently comes up against seasonal boundaries that are costly to cross for reproductive fitness. Mammals of a vast range of sizes and taxa, from squirrel monkey to moose, hold conception-to-first molars in just under one year. Integrating tooth emergence into life history gives insight into living mammals and builds a framework for interpreting the fossil record.

Transcriptional programs of Pitx2 and Tfap2a/Tfap2b controlling lineage specification of mandibular epithelium during tooth initiation.

How the dorsal-ventral axis of the vertebrate jaw, particularly the position of tooth initiation site, is established remains a critical and unresolved question. Tooth development starts with the formation of the dental lamina, a localized thickened strip within the maxillary and mandibular epithelium. To identify transcriptional regulatory networks (TRN) controlling the specification of dental lamina from the naïve mandibular epithelium, we utilized Laser Microdissection coupled low-input RNA-seq (LMD-RNA-seq) to profile gene expression of different domains of the mandibular epithelium along the dorsal-ventral axis. We comprehensively identified transcription factors (TFs) and signaling pathways that are differentially expressed along mandibular epithelial domains (including the dental lamina). Specifically, we found that the TFs Sox2 and Tfap2 (Tfap2a/Tfap2b) formed complimentary expression domains along the dorsal-ventral axis of the mandibular epithelium. Interestingly, both classic and novel dental lamina specific TFs-such as Pitx2, Ascl5 and Zfp536-were found to localize near the Sox2:Tfap2a/Tfap2b interface. To explore the functional significance of these domain specific TFs, we next examined loss-of-function mouse models of these domain specific TFs, including the dental lamina specific TF, Pitx2, and the ventral surface ectoderm specific TFs Tfap2a and Tfap2b. We found that disruption of domain specific TFs leads to an upregulation and expansion of the alternative domain's TRN. The importance of this cross-repression is evident by the ectopic expansion of Pitx2 and Sox2 positive dental lamina structure in Tfap2a/Tfap2b ectodermal double knockouts and the emergence of an ectopic tooth in the ventral surface ectoderm. Finally, we uncovered an unappreciated interface of mesenchymal SHH and WNT signaling pathways, at the site of tooth initiation, that were established by the epithelial domain specific TFs including Pitx2 and Tfap2a/Tfap2b. These results uncover a previously unknown molecular mechanism involving cross-repression of domain specific TFs including Pitx2 and Tfap2a/Tfap2b in patterning the dorsal-ventral axis of the mouse mandible, specifically the regulation of tooth initiation site.

Association of parent-reported timing of first tooth emergence and ECC: a secondary analysis of a case-control study.

Tooth eruption is a dynamic process. Appearance of any part of the cusp through gingiva may be a clinical marker of eruption. Early childhood caries (ECC) is a public health problem globally. This study aimed to assess the relationship between parent-reported timing of first tooth emergence and ECC in toddlers. This study is a secondary data analysis of 627 toddlers involved in a case-control study on sleep-time feeding practises in children. The children were categorised into four groups based on the parent-reported timing of first primary tooth emergence (G1-when the first primary tooth emerged before 6months of age, G2-between 7 and 9months; G3-10 to 12months and G4-when the first primary tooth emerged after 12months of age). Univariate binary logistic regression analysis was performed to evaluate the association between timing of first tooth emergence and ECC. The mean age of the children was 24.4 ± 7.3months (cases, that is children with ECC-25.4 ± 6.9months, controls, that is children without ECC-23.6 ± 7.5months). Of 60 children, whose first tooth erupted before 6months of age, 35 (12%) were cases compared to 25(8%) controls. Amongst the cases, boys had more caries than girls (p < 0.05). Of the anterior teeth, 22% of the emerged teeth were decayed in the first group, followed by 19%, 16% and 10% in the second, third and fourth groups, respectively (p < 0.05). Analysis of the posterior teeth showed a lower percentage of decayed teeth with delayed emergence of the first primary tooth (p < 0.05). Children whose teeth emerged before 6months of age had an odds ratio of 3.5 (95% CI 1.49, 8.42) (p = 0.004). This study concluded that the early emergence of the first primary tooth, as reported by the parent, was associated with an increased risk of developing ECC.

Dental Developmental Stages and Decayed, Missing, and Restored Teeth in Neurofibromatosis Type 1-affected Children and Adolescents.

Neurofibromatosis type 1 (NF1) is an autosomal dominant inherited tumor predisposition disease with a highly variable phenotype. The influence of the characteristic NF1 tumors (neurofibromas) on dentition has not yet been examined in detail. The aim of the study was to assess the dentition of NF1 children and adolescents, considering the symmetry of tooth development. The panoramic radiographs of 59 patients with a confirmed NF1 diagnosis were compared with 59 age-and-sex-matched controls. The stages of tooth development on the sides of the jaw, added to a score, were assessed. In addition, the number of filled or decayed teeth, and the number of retained or missing teeth were assessed. The tooth development of both study groups is symmetrical for almost all parameters and in the same developmental stage according to the sum score of the tooth development stages. Discrete developmental delays of teeth, in particular in the oral area of facial plexiform neurofibroma (PNF) are noticeable. NF1 patients' teeth showed less decay and more restorations than that of the control group. The facial PNF (FPNF) does not impair emergence of deciduous teeth. Development of dentition of NF1 patients does not differ from the general population. However, FPNF with oral tumor components often prevent mesial movement of permanent molars and premolars, so these teeth do not develop contact (spacing), hardly emerge or may stay retained in bone. Oral PNF may have a low-retarding effect on some tooth root development (e.g., wisdom teeth). This effect is negligible when comparing the affected and unaffected sides of the jaw and is probably non-specific. Key words:Neurofibromatosis type 1, plexiform neurofibroma, dentition, mixed dentition, symmetry, oral health, tooth development.

Oral Health Care Strategies in Rural Communities: A Case Study.

Dental caries affect 97% of the world's population during their lifetime. Early childhood caries are the number one chronic disease affecting young children, and it disproportionately affects children of low-income families. American Academy of Pediatrics recommends fluoridated toothpaste to all children starting at tooth eruption, regardless of caries risk. In addition, fluoride varnish is recommended in all children every 3 to 6 months from tooth emergence until they have an established dental home. The health disparities that are most apparent in the rural communities are inadequate prenatal care, low birth weight, cancer, chronic respiratory disease, heart disease, unintentional injury, and stroke. When it comes to oral health, water fluoridation is one of the most cost-effective strategies in preventing dental caries. The need for oral health education in physician assistant/associate (PA) programs is well documented. Implementation has largely been performed using interprofessional education. This article describes an interprofessional education program that teaches PA students to apply fluoride varnish so that they are practice-ready when they graduate and practice medicine.

Effect of breastfeeding on the HMGA2 single nucleotide polymorphisms in relation to first primary tooth emergence among Iraqi infants

AbstractBackgrounds:Breastfeeding provides a large group of functional components that improve the infant’s health and development.additionally, the impact of human milk and genetic variants on complicated outcomes has also been the subject of several gene–nutrition interaction studies. This could also play a key part in the kinship that exists between offspring and their parents.Objectives:The purpose of this study was to compare breastfeeding to infants who were fed formula in order to determine if human milk affected the timing of teething in relation to genetic polymorphisms.Materials and Methods:This study is a cross-sectional comparative study concerning genetic analysis with a prospective view concerning the timing of eruption. The chosen sample included 40 breastfed infants and 40 infants who consumed formula milk. It was compiled from Baghdad’s health centers. For the genetic analysis, DNA samples were obtained from saliva throughout the buccal swab. Standard DNA extraction and real-time PCR techniques have been used according to the manufacturer’s instructions for the Quick-DNA™ MiniPrep kit (catalog nos. D3024 and D3025). For the whole sample, clinical examination and monitoring for emerging teeth were performed using a particular criterion.Results:findings showed that there were highly significant differences between breastfeeding and early eruption time for the first primary tooth. Also, there was a significant association between single nucleotide polymorphisms in the heterozygous AG genotype and eruption time.Conclusion:The results of the current study may support the genetic influence of breast milk on early primary teeth eruption when juxtaposed with infants fed formula.

Epithelial-specific deletion of FAM20A leads to short root defects

Short Root Defects defined by a reduced ratio of root to crown, may culminate in root resorption and subsequent tooth loss, in spite of the absence of apparent symptoms. Such defects present considerable impediments to orthodontic treatment and restoration. Recent identification of Fam20a, an emergent pseudokinase, has been associated with enamel development and tooth eruption, yet its definitive role in root formation and eruption remains ambiguous. In this research, we initially ascertained that the targeted knockout of Fam20a within the epithelium led to truncated tooth roots, irregular breaks in the epithelial root sheath initiation of the WNT signaling pathway, and decreased expression of the cell polarity-related transcription factor Cdc42 in murine models. This was concomitant with the participation of the associated epithelial root sheath developmental pathways BMP2, Gli1, and Nfic. Furthermore, we observed that Fam20a predominantly affects the intraosseous eruption phase of tooth emergence. During this phase, the osteoclast peak around the mandibular first molar in cKO mice is delayed, leading to a slower formation of the eruption pathway, ultimately resulting in delayed tooth eruption in mice. The findings of this study enrich the extant knowledge regarding the role of Fam20a, suggesting its potential regulatory function in tooth root development through the WNT/β-catenin/Cdc42 pathway.

The Sequence of Shedding of Deciduous and Emergence of Permanent Teeth in Children of Dakshina Kannada Region: A Probit Regression Model

The Sequence of Shedding of Deciduous and Emergence of Permanent Teeth in Children of Dakshina Kannada Region: A Probit Regression Model

A Novel Digitized Method for the Design and Additive Manufacturing of Orthodontic Space Maintainers

Primary dentition is crucial in influencing the emergence of permanent teeth. Premature primary tooth loss can result in undesired tooth motions and space loss in the permanent dentition. Typically, fixed or removable dental appliances are adopted to maintain edentulous space until the eruption of permanent teeth. However, traditional space maintainers have limitations in terms of variability in tooth anatomy, potential allergic reactions in some individuals (i.e., nickel sensitivity), difficulties in maintaining oral hygiene, and patient acceptance. The present study introduces a fully digital framework for the design and manufacturing of customized pediatric unilateral space maintainers using generative algorithms. The proposed approach overcomes the current challenges by using a biocompatible resin material and optimizing the device’s size, design, and color. The methodology involves intraoral scanning, surface selection, and trim, generative 3D modeling, finite element analysis (FEA), and additive manufacturing (AM) through vat photopolymerization. FEA results demonstrate the device’s mechanical performance and reliability, while additive manufacturing ensures design freedom, high resolution, surface finishing, dimensional accuracy, and proper fit. The mechanical interlocking system facilitates easy and effective positioning of the device. This digital approach offers the potential for wider usage of space maintainers and can be further validated through experimental assessments and clinical studies.

Time and sequence of the replacement of the deciduous by the permanent dentition in dogs and its applicability for age estimation.

This study investigated the influence of several covariates on the time and sequence of permanent dentition emergence following exfoliation of the deciduous teeth in puppies. The aim was to determine whether the emergence of permanent dentition can be used to assess whether a puppy that is traded across borders in the EU has reached the legally required minimum age of 15 weeks. The events were evaluated in a longitudinal study, with some cross-sectional observations, of 440 puppies belonging to 82 breeds. No significant differences were found between the left and right sides of a puppy's dentition nor between male and female puppies. Breed size and skull type had a significant impact: both the appearance and the completion of tooth eruption occurred considerably later in small or toy breeds and brachycephalic skull type breeds. The sequence of emergence differed little between maxillary or mandibular quadrants or between breeds. The first emerging elements were the maxillary first premolars or first incisors or the mandibular first incisors. The emergence of a permanent tooth usually occurred within 3 days before or after exfoliation of its precursor, except for the canines, which demonstrated a wider tooth replacement interval. This study presents standards for age assessment based on the emergence of permanent dentition for breeds of different sizes, using median ages or cumulative emergence percentages. However, the legal age determination of puppies with an assumed age of 15 weeks cannot be performed based on permanent dentition emergence, as this occurred at a later age in a large proportion of dogs (at least 95%) in our studied population. The probability of being at least 15 weeks old when at least one maxillary tooth has emerged was at least 72.25%, depending on breed size.

Trends in Primary Tooth Emergence Pattern and Associated Factors in Japanese Infants

The purposes of this study were to analyse trends in primary tooth emergence patterns and to identify physical factors potentially associated with them. The participants were 27,454 infants who underwent routine 18-month-old health examinations in Ebetsu City, Japan, between 1980 and 2012. This study was conducted using data from infants' 18-month-old health examinations over a 33-year period. The mean number of emerged primary teeth was analysed by sex using a general linear model. For logistic regression analysis, the proportion of infants with 16 emerged teeth or more at 18 months old was used as a dependent variable. Examination year; birth order; birth weight; weight, height, and chest girth at 18 months old; number of fused teeth; and mother's age were used as independent variables. The mean number of emerged primary teeth decreased over the 33-year period. Birth weight and weight and height at 18 months old decreased, and the proportion of low-birth-weight (<2500 g) infants increased over the 33-year period. On general linear model analysis, the yearly change in the mean number of emerged primary teeth was -0.0188 for boys and -0.0181 for girls. Birth weight and weight and height at 18 months old were significantly associated with the presence of 16 emerged primary teeth or more, according to the logistic regression analysis. The results demonstrated that, over the 33-year period examined, the mean number of emerged primary teeth decreased and birth weight and weight and height at 18 months old were associated with the pattern of tooth emergence.

Breastfeeding Effect on Primary Teeth Emergence in Relation to Craniofacial Growth among Iraqi Infants

Background: Breastfeeding is more than just nutrition; it can be viewed as a natural orthotic device for the harmonious development of the face. Sucking has an impact on a child’s premaxillary region’s growth, and mandibular movements encourage mandibular growth. Along with the advantages for general health, breastfeeding also helps with the right development of teeth, face muscles, and occlusion. Hence symmetric, well-proportioned face and appropriate occlusion depend on balanced facial growth. Objectives: This study aims to evaluate the effect of breastfeeding on the timing of teething in relation to craniofacial development. Materials and Methods: This study is a cross sectional comparative study concerning craniofacial growth assessment, with prospective view concerning timing of eruption. Sample was composed of 100 breastfed infants compared with 100 infants depending on formula milk. Clinical examinations and follow-up for teeth emergence was done for whole sample. Results: Breastfeeding was found to be associated with early teeth emergence. Additionally, although, there were no significant differences between facial growth and feeding pattern there was a significant correlation between delay eruption time of primary dentition and facial growth parameters (mandible and maxilla depths) among bottle-feeding group. Conclusion: The current study confirms the effect of breastfeeding on the early teething emergence of primary dentition; however, there were no significant differences between type of feeding and facial growth parameters. While a significant relation between delay eruption time and facial growth parameters (mandible and maxilla depths) was found among bottle-feeding infants.

Breastfeeding Effect on The Genetic Variations of Primary Teeth Emergence in Relation to Salivary Transforming Growth Factor-B 1 Among Iraqi Infants

Breastfeeding Effect on The Genetic Variations of Primary Teeth Emergence in Relation to Salivary Transforming Growth Factor-B 1 Among Iraqi Infants

Emergence Time and Sequence of Primary Teeth in a Sample of Nepalese Children

Background Primary teeth emergence is an important milestone in children and timing of emergence varies among populations.&#x0D; Objective To determine the emergence time and sequence of primary teeth in a sample of Nepalese children visiting Dhulikhel Hospital.&#x0D; Method A descriptive cross-sectional study was conducted in children of 5 months to 4 years visiting Dhulikhel Hospital. The emergence of incisal tip to incisal margin for incisors and canines, cusp tip to occlusal margin of molars visible were recorded along with age in months and gender. Descriptive statistics was done to calculate the mean age of emergence of each tooth with standard deviation. Unpaired t-test was used to assess the difference between the mean age of emergence of teeth between right and left sides and between boys and girls.&#x0D; Result The first teeth to emerge was mandibular central incisor at the age of 9.37 ± 1.42 months and the last one was maxillary second molar at the age of 32.91 ± 6.39 months. There was no significant difference in the mean emergence time between the maxillary and mandibular jaws, between right and left sides of jaws and between boys and girls except for primary maxillary right central incisor and mandibular right second molar which was found to be emerged early in girls.&#x0D; Conclusion The emergence time and sequence of primary teeth observed in the present study can be used as a baseline data for the children of Kavre district.

Assesment of Root Apices Closureof Permanent Incisors and First Molars in Digital Orthopantomographs: A Pilot Study From Pakistan

Objective:The purpose of the current study is to assess the degree of closure of the root apices of primary molars and permanent incisors in young children. Study Design:Retrospective study Place and Duration: This study was carried out at Department of Oral Biology, Sardar Begum Dental College, Peshawar from January, 2022 to July 2022. Methods: There were 130 patients of both genders with ages 4-16 years were presented. After obtaining informed written consent, the enrolled cases' detailed demographics, including age, sex, body mass, and locale, were computed. Digital orthopantomographs of all the patients were taken. Chi square test was used to assess differences among closure of root apices of permanent incisors and first molars among all cases. SPSS 22.0 was used to analyze all data. Results:Among 130 included cases, 80 (61.5%) were females and the rest were males 50 (38.5%).Mean age of the cases were 12.6±4.72 years. 85 (65.4%) cases had body mass index &lt;18 kg/m2 and 45 (34.6%) patients had BMI &gt;18kg/m2. There were 76 (58.5%) cases had urban and 54 (41.5%) patients had rural residency. Permanent incisors were 82 (63.1%) and first molars were 48 (36.9%). At age between 5-9 years frequency of closed root apices of mandibular central incisors was 50 (60.9%) and closed maxillary first molars were 22 (51.2%). At age 10-15 years number of closed root apices of central incisors were 65 (79.3%) and closed root apices of first molars were 30 (62.5%) with p value &lt;0.003. Conclusion:In this study, we came to the conclusion that the majority of root apices of permanent incisors and first molars in children in the studied sample close early compared to earlier reports, which is consistent with the pattern of emergence of permanent teeth previously reported in children. Keywords:Root Apices, First Molars, Permanent Incisors, Children

Non syndromic congenital agenesis of multiple permanent teeth: Case series and recent literature review

Abstract Introduction: Hypodontia refers to the congenital absence of less than six teeth. This absence may be unilateral or bilateral. Though the congenital agenesis of bilateral mandibular/maxillary incisors has often been reported in literature, however, the congenital absence of bilateral mandibular and maxillary incisors, as well as the mandibular second molar-giving rise to a total of six missing permanent teeth in an apparently healthy individual has not been reported earlier. Case presentation: This case series presents two cases of a 10- and 11-year-old children with presence of retained deciduous anterior in both arches with absence of permanent successors and also aims to review the literature regarding etiology, clinical implications and management in such cases. Conclusions: It is essential that practitioners monitor the developing dentition with establishment of a proper review schedule. Non-eruption of the permanent tooth more than one year later than expected, or even after six months following the emergence of the contralateral tooth, warrants a high degree of suspicion. A multidisciplinary team, including pediatric, restorative and orthodontic specialists, is advised. In addition, prior to formulation of any treatment plan, due consideration to the general issues such as the patient’s systemic and oral health, motivation and expectations should be given.

Effect of Dietary Pattern on the Emergence of Permanent Teeth of the Children of Larkana, Pakistan

Abstract Objective The aim of this study was to determine the association of eruption of permanent teeth of Sindhi children of Pakistan with the consumption of wheat, rice, meat, and milk. Methodology A team of two dentists (one male and one female) and two assistants (one male and one female) was trained and calibrated before the study and visited all the 26 selected schools on the prearranged time and date and all the children from kindergarten 1 to class 8 were screened. Children with at least one “just erupted” tooth were taken out of the class for further examination. Number of days of eating meat, rice, vegetable, and milk in a week along with date of birth and some other personnel information was recorded on a questionnaire sheet. Results One thousand two hundred five cases were collected from 26 schools, located in the city of Larkana and its suburbs. The minimum median value belonged to tooth number 16 and the maximum value was for tooth number 27. Twenty-two out of 28 teeth (79%) showed early eruption who consumed the meat more frequently than lesser time. Twenty-three out of 28 teeth (82%) showed early eruption for the children who consumed the vegetable diet a lesser number of times as compared with more frequent. Nineteen out of 28 teeth (68%) showed delayed eruption for those who consumed the rice a lesser number of times as compared with more frequent. Eighteen out of 28 teeth (64%) showed early eruption for the children who consumed a lesser amount of milk as compared with a greater amount. Conclusion The study concludes that a protein-rich diet accelerated, while calcium, mineral, and carbohydrate-rich food items delayed the eruption of permanent teeth among the children of Larkana.