PART  4 GROWTH AND DEVELOPMENT

CHAPTER 
19
Eruption of the Teeth: Local,
Systemic, and Congenital
Factors That Influence the
Process
s  Jeffrey A. Dean and Erwin G. Turner

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CHAPTER OUTLINE

CHRONOLOGIC DEVELOPMENT Eruption Hematoma (Eruption Cyst) Ankylosed Permanent Teeth

AND ERUPTION OF THE TEETH
Influence of Premature Loss of
Primary Molars on Eruption Time
of Their Successors
Variations in Sequence of Eruption
LINGUAL ERUPTION OF
MANDIBULAR PERMANENT
INCISORS
TEETHING AND DIFFICULT
ERUPTION
Eruption Sequestrum Trisomy 21 Syndrome (Down
Ectopic Eruption Syndrome)
NATAL AND NEONATAL TEETH Cleidocranial Dysplasia
EPSTEIN PEARLS, BOHN NODULES, Hypothyroidism
AND DENTAL LAMINA CYSTS Hypopituitarism
LOCAL AND SYSTEMIC FACTORS Achondroplastic Dwarfism
THAT INFLUENCE ERUPTION Other Causes
Ankylosed Teeth
Ankylosis of Primary Molars with
Absence of Permanent Successors

of the primary teeth should be changed to central inci-

CHRONOLOGIC DEVELOPMENT
AND ERUPTION OF THE TEETH
A variety of developmental defects that are evident af-
ter eruption of the primary and permanent teeth can be
­related to systemic and local factors that influence matrix
formation and the calcification process. Thus it is impor-
tant that the dentist be able to explain to the parents the
time factors related to the early stages of tooth calcifica-
tion both in utero and during infancy.
Past classic studies and reviews of the literature involv-
ing calcification of the primary teeth have compared their
findings with the values in Table 19-1 showing the Logan
and Kronfeld chronology of the human dentition, which
has been the accepted standard for many years.1 Their
findings offered revisions that established earlier ages
than those previously accepted for initial calcification
and later ages at which the primary teeth erupt.
These studies and reviews concluded that Table 19-1
should be modified and that the sequence of calcification
sor, first molar, lateral incisor, canine, and second molar.
They determined that the times of initial calcification of
the primary teeth are 2 to 6 weeks earlier than those given
in Table 19-1, and they also concluded that the maxil-
lary teeth are generally ahead of the mandibular teeth in
development. Exceptions are the second molars, which
generally are advanced in the mandible, and the lateral
incisors and canines, which at times may be ahead in the
mandible.
These studies also propose that the lateral incisor, first
molar, and canine tend to erupt earlier in the maxilla than
in the mandible, compared with the Logan and Kronfeld
table, which suggests that eruption in the mandible is
generally ahead of that in the maxilla. The ages at which
primary teeth erupt are 2 or more months later than sug-
gested in the Logan and Kronfeld table. The study by Her-
nandez and colleagues provides confirmation that more
recent studies in different white populations have findings
similar to those from these classic studies on eruption

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