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SUPERNUMERARY
Cause:

LOCAL FACTORS

1 2

SUPERNUMERARY SUPERNUMERARY
effect: management:
1. failure of eruption of perm. CI

3 4

SUPERNUMERARY SUPERNUMERARY
management: effect:
2. displacement

5 6

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SUPERNUMERARY SUPERNUMERARY
management effect:
3. crowding

7 8

SUPERNUMERARY
effect:
4. no effect

9 10

MISSING TEETH
Effects:

11 12

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MISSING TEETH MISSING TEETH

13 14

Management:
1.For missing upper incisors/lower second premolars
1. Extract primary tooth, close the space orthodontically
2. Opening of space orthodontically, then place prosthesis/implant
2.For missing maxillary lateral incisor
1. Move max. canine mesially, use canine as lateral incisor
2. Create space for future prosthesis/implant

15 16

Management:
3.For missing premolar
• Maintain primary molar
• Extract primary molar, replace with prosthesis or autotransplanted tooth
• Orthodontic closure of space

17 18

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19 20

21 22

23 24

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25 26

• Peg Lateral
• EFFECT:

27 28

• exag. cingulum/heavy marginal ridge • lower 5 with extra lingual cusp

• Effect: • Effect:

29 30

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• Normal Development of Frenum • Blanch Test

31 32

frenectomy or space closure first?

33 34

CAUSES:
INCISORS
caries
effect:
premature exfoliation
planned extraction

EFFECT:
adjacent teeth will drift or tilt around into the space

35 36

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CANINES • CANINES
Effect: • Effect:

37 38

FIRST PRIMARY MOLARS • SECOND PRIMARY MOLARS

Effect: • Effect:

39 40

• SECOND PRIMARY MOLARS • SECOND PRIMARY MOLARS

• Effect: • Effect:

41 42

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• Balancing extraction is the removal of the Prolonged Retention

contralateral tooth – rationale is to avoid midline
effect:
shift problems

• Compensating extraction is the removal of the Abnormal Resorption

equivalent opposing tooth – rationale is to effect:
maintain occlusal relationships between the arches

43 44

45 46

47 48

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49 50

• maintain the tooth-shedding timetable at the • Causes:

same time, at about the same level for each of
• Effects:
the four buccal segments

51 52

General causes Local causes

hereditary gingival fibromatosis congenital absence
Down syndrome crowding
cleidocranial dysostosis delayed exfoliation of primary predecessor
cleft lip and palate supernumerary tooth
dilaceration
rickets
abnormal position of crypt
primary failure of eruption

53 54

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• PFE – partial/complete non-eruption of permanent teeth

in the absence of mechanical obstruction or syndrome

55 56

• hallmark features: • Cause:

• posterior open bite in the presence of normal vertical growth
• Effects:
• infraocclusion of affected teeth
• inability to move affected tooth orthodontically • Types of Ectopic Eruption
• caused by heterozygous mutations in the gene encoding the G • those that self-correct
protein-coupled receptor for parathyroid hormone and • those that remain impacted
parathyroid hormone-like hormone (PTH1R)

57 58

• ECTOPIC ERUPTION

59 60

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• Mild Cases
• separators
• Severe Cases
• brass wire
• removable appliance with spring
• sectional wires with open coil spring
• sling-shot appliance
• Halterman appliance

no treatment

61 62

Halterman appliance
brass wire

63 64

• diagnosis • cause:
• clinical
• effect:
• radiograph
• treatment

65 66

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• Replacement resorption is a process of

physiological remodeling of bone and • Effect:
erroneously the adjacent root cementum
and/or dentin, which results in
replacement of the root with bone tissue
• It usually accompanies ankylosis, so that
when a tooth is proven as ankylosed,
the clinician should anticipate and
radiographically look for replacement
resorption as a progressive process
accompanying ankylosis

67 68

• Too Tight Contact • large/overextended proximal restoration

• Effect: • Effect:

69 70

• poor contact • lack of anatomic detail

effect: • Effect:

71 72

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