Eruption Disturbances in Children (Part I)

Radhika Chigurupati, DMD
Associate Clinical Professor
Department of Oral and Maxillofacial Surgery
School of Dentistry, University of California, San Francisco

Eruption disturbances in children can vary from ectopic eruption to impaction and require timely orthodontic and surgical management. This is a clinical review with examples of some cases illustrating the surgical management of eruption disturbances commonly encountered by orthodontists.

Aetiology of Eruption Disturbances: The movement of a tooth from its developmental position in the jaw to a functional position in level with the occlusal plane can be altered at any stage and affected by numerous factors. Some of the causes of delayed eruption, ectopic eruption and impaction have been listed below.  (Fig. 1a, b, c; 2a, b, c)

(Click on image for larger size)

   
Fig. 1a. 14-year-old female with cleidocranial dysostsis. Lateral cephalometric view shows maxillary hypoplasia and angulation of the impacted permanent anterior teeth.
Fig. 1b, 1c.  Intraoral and panoramic views show retained primary teeth and delayed eruption of permanent incisors.

   
Fig.2a. 12-year old male with painless slow growing facial swelling
Fig. 2b. Note the intraoral swelling in the buccal vestibule with bony expansion.
Fig. 2c. Panoramic radiograph shows left maxillary radiolucent lesion with displaced premolar and retained primary molar. Diagnosis after biopsy dentigerous cyst.

• Lack of adequate arch length resulting from tooth and/or jaw size disproportion
• Loss of space due to premature exfoliation of primary teeth
• Mechanical obstruction in the path of eruption caused by a supernumerary tooth or odontogenic cyst / tumor
• Craniofacial syndromes such as cleidocranial dysostosis
• Genetic disorders: osteopetrosis, mucopolysaccharidosis
• Endocrine disorders: hypothyroidism, hypopituitarism, or vitamin D-deficiency,
• Surgical intervention, trauma, or radiation during early childhood
• Primary failure of eruption

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