Lec. 5 Pediatric Dentistry Dr.

Nada Alsharaa
Development of occlusion
The study of this development of occlusion can be divided into the following
developmental periods :

• Pre-dental /dentate period

• The deciduous dentition period
• The mixed dentition period
• The permanent dentition period

Pre-dental /dentate period :

Characteristic features :

1. The alveolar processes at this stage called "gum pads"

2. The gum pads are pink, firm and are covered by a dense layer of periodontium
3. Horse –shoe shaped
4. Developed in two parts , the labiobuccal portion and lingual portion that
separated from each other by dental groove
5. They are divided by transverse grooves in to ten segment ,each segment has the
deciduous tooth sac
6. The transverse groove between the canine and 1st deciduous molar segment
called lateral sulcus
7. The palate in upper arch and the floor of the mouth in lower arch separated
from the gum pads by gingival groove.
8. The upper gum pad is both wider and longer than the mandibular gum pad.
9. Contact occurs between the upper and lower gum pads in the 1st molar region.
10. The upper lateral sulcus is positioned much anteriorly to the lower lateral
sulcus.
Lec. 5 Pediatric Dentistry Dr. Nada Alsharaa
Deciduous dentition period
Characteristic features :

1. Spacing
2. Terminal plane relation
3. Beep bite
4. The dental arch are U in shape
5. Flat curve of Spee

Spacing in deciduous teeth :

• Called physiological or developmental spaces.

• It is important in development of permanent teeth.
• Spacing seen mesial to the max. canine and distal to mand. Canine are wider
than other areas , this space called primate space.

Terminal plane relation of the deciduous molars:

The mesiodistal relation between the distal surfaces of the max. and mand. 2nd
deciduous molars.

They can be divided into three types:

1. Flush terminal plane: the normal feature when the distal surfaces of the upper
and lower 2nd deciduous molars at the same vertical plane
2. Mesial step terminal plane: when the distal surface of the lower 2nd deciduous
molar are more mesial to the upper 2nd deciduous molar.
3. Distal step terminal plane : when the distal surface of the lower 2nd deciduous
molar are more distal to the upper 2nd deciduous molar.
Lec. 5 Pediatric Dentistry Dr. Nada Alsharaa
Mixed dentition period:
Characteristic features:

1. The 1st transitional period include the emergence of the 1st permanent molars
and the exchange of the deciduous incisors with permanent incisors.
2. The 2nd transitional period include the replacement and alignment of the
deciduous molars and canines by premolars and permanent canine respectively.
there are two characteristic features of this period include leeway space and ugly
duckling stage.
3. The inter – transitional period between the 1st and 2nd period where no active
tooth eruption.
Leeway Space: is the difference between the combined mesio-distal widths of the
primary cuspid and molars and their permanent successors. According to Nance, this
difference is 1.7 mm in the mandible and 0.9 mm in the maxilla, in each quadrant.
Lec. 5 Pediatric Dentistry Dr. Nada Alsharaa

Permanent dentition period :

The permanent dentition is complete with eruption and alignment of the maxillary
canine which is the last tooth to erupt into the oral cavity expecting the 3rd molars.

Self- correcting anomalies :

Pre-dentate period:

Problem/ correction

1. retrognathic mandible/ corrected by forward development of the mandible

2. anterior open bite / corrected by eruption of primary incisors
3. infantile swallowing pattern/ corrected in the 1st year of life with the eruption of
teeth
primary dentition :

Problem /correction

1. anterior deep bite/ corrected by eruption of deciduous molars, attrition of

incisal edge , forward and downward growth of the mandible then the eruption
of permanent molars
2. flush terminal space / corrected by early mesial shift
3. spacing/ corrected by eruption of permanent teeth

Mixed dentition:

problem/correction

1. anterior deep bite / corrected by eruption of all permanent posterior teeth and
the downward /forwards growth of jaws
2. mandibular teeth crowding / corrected by jaw growth and expansion
3. ugly duckling stage / Also called Broadbent phenomenon, a self-correcting
malocclusion is seen around 9-11 years of age or during eruptions of canine. As
the permanent canines erupt, they displace the roots of lateral incisors mesially.
This force is transmitted to the central incisors and their roots are also
displaced mesially. Thus, the resultant force causes the distal divergence of the
crown in an opposite direction, leading to midline spacing (diastema in the
incisor region). The term ugly duckling stage indicates the anesthetic
appearance of the child during this stage. This condition corrects itself after the
canines have erupted when it apply pressure on the crowns of the incisors
thereby causing them to shift back to original positions. No orthodontic
treatment should be attempted at this stage, as there is danger of deflecting the
canine from its normal path of eruption.
Lec. 5 Pediatric Dentistry Dr. Nada Alsharaa