Republic of Iraq

Ministry of Higher Education and

Scientific Research
Al-turath University
College of Health and Medical Technology

Development of normal occlusion

Seminar (1)
Orthodontic

Supervised By
Elaf Jamal Harb
M.Sc
4Th year Orthodontic Seminar

Introduction

Dental occlusion undergoes significant changes from birth until adulthood and
beyond. This continuation of changes in the dental relationship during various
stages of the dentition can be divided into four stages:

• Gum pads stage: 0–6 months

• Deciduous dentition: 6 months–6 years

• Mixed dentition: 6–12 years

• Permanent dentition: 12 years and beyond.

1.Gum Pad Stage

The upper gum pad is horseshoe shaped and the lower is narrow “U” shaped. The
upper gum pad is both wider as well as longer than the mandibular gum pad.
When gum pads are in contact, they occlude only in the posterior region .

Figure (1) show gum pad

The newly born child's mouth usually contains 20 elevations (this elevation called
gum pads) which are corresponding to the future 20 deciduous teeth. (10 of them
in the upper jaw and 10 of them in the lower jaw). These elevations become
segmented by transverse grooves and each segment is a developing tooth site.

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Figure (2) show the elevation of the gum

Natal, Neonatal and Pre-erupted Teeth

Natal teeth: (present at birth),

Neonatal teeth: (erupted during the first month),

Pre-erupted: (erupting during the 2nd or 3rd months).

Figure (3) show the neonatal tooth

2.THE DECIDUOUS DENTITION STAGE (6 months- 6 years)

This stage starts from eruption of first deciduous mandibular central incisors
(around 4–6 months) and ends with the eruption of first permanent molar. The
Deciduous dentition completes by three years with root formation. The sequence
of eruption of deciduous dentitions A-B-D-C-E.

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4Th year Orthodontic Seminar

Figure (4) show Sequence of eruption of deciduous teeth

Features of deciduous teeth

1. Spaces present between deciduous teeth. Sufficient interdental space is

needed for the permanent teeth to erupt into an uncrowded condition and
for the establishment of their proper alignment. If there is no space in the
deciduous dentition, it will lead to crowding in the permanent dentition.

Figure (5) show spacing between teeth

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2. Deep bite
3. At about six years of age, there may be an edge-to-edge relationship
3.THE MIXED DENTITION PERIOD
This is the period where both deciduous and permanent teeth are present in the
oral cavity. This is also the most important period of development of normal
dentition and occlusion. During the mixed dentition period, various
malocclusions are encountered. It is an ideal time for functional appliances.

Figure (6) show mix dentition

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Mixed dentition = deciduous teeth + permanent teeth

It is divided into two periods:

Early mixed dentition—6–9 years

Late mixed dentition—9–12 years

Ugly Duckling Stage A transient malocclusion with appearance of midline

diastema and flaring of upper incisors is often observed to develop in the
maxillary anterior region during 8 to 12 years of age. As the upper canine slide
over the distal slope of upper lateral incisor and erupts into occlusion, the ugly
duckling stage disappears. The erupting canine pushes the lateral incisors toward
midline. Thus, flaring of upper incisors is corrected and spacings get closed. It is
described by Broadbent and hence it is also known as Broadbent phenomenon. It
is a self-correcting anomaly and it does not require any treatment.

Figure (7) show Ugly Duckling Stage

4.The Permanent dentition stages

The permanent dentition stage of dental development starts after shedding of the
last primary tooth and the eruption of all permanent teeth. The mandibular canines
and maxillary first premolars are usually the first to erupt at this stage.

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4Th year Orthodontic Seminar

Features of normal occlusion in the permanent dentition: -

The mesiobuccal cusp of the upper first permanent occludes with the
buccal groove of the lower first permanent molar.
The upper canine occludes in the embrasure between the lower canine
and the lower first premolar.
The overjet is 2 to 3 mm.
The arches are regular in form.
All teeth must be present, are of normal form and in correct alignment.

References
1. K Vijayalakshmi. Textbook of Orthodontics .book.2020.chapter one.