References

Shaw L, Foster TD. Size and development of the dentition in endocrine deficiency. J Pedod. 1989; 13:155-160
Hauk MJ, Moss ME, Weinberg GA, Berkowitz RJ. Delayed tooth eruption: association with severity of HIV infection. Pediatr Dent. 2001; 23:260-262
Ondarza A, Jara L, Bertonati MI, Blanco R. Tooth malalignments in Chilean children with Down syndrome. Cleft Palate Craniofac J. 1995; 32:188-193
Wise GE, Frazier-Bowers S, D'Souza RN. Cellular, molecular, and genetic determinants of tooth eruption. Crit Rev Oral Biol Med. 2002; 13:323-334
Almonaitiene R, Balciuniene I, Tutkuviene J. Factors influencing permanent teeth eruption. Part one − general factors. Stomatologija. 2010; 12:67-72
McDonald RE, Avery DR, Dean JA Dentistry for the Child and Adolescent, 8th edn. Oxford: Mosby; 2004
Madhu S. Early eruption of permanent canines. Indian J Dent Res. 2012; 23:428-430
Bayrak S, Sen Tunc E, Tuloglu N, Acikgoz A. Timing of permanent teeth eruption in Turkish children. J Clin Pediatr Dent. 2012; 37:207-211
Bedi R, Brook AH. Changes in general, craniofacial and dental development in juvenile hypothyroidism. Br Dent J. 1984; 157:58-60
Loevy HT, Aduss H, Rosenthal IM. Tooth eruption and craniofacial development in congenital hypothyroidism: report of case. J Am Dent Assoc. 1987; 115:429-431

Early eruption of a mandibular third molar in a 13-year-old female

From Volume 45, Issue 4, April 2018 | Pages 367-368

Authors

Saurab Bither

Luxmi Bai Institute of Dental Sciences and Hospital, Patiala

Articles by Saurab Bither

Vineet Sharma

Luxmi Bai Institute of Dental Sciences and Hospital, Patiala

Articles by Vineet Sharma

Rupika Bither

Consultant Periodontist, Bither Hospital, Sirhind, Punjab

Articles by Rupika Bither

Article

Dental eruption is a dynamic and complex biological and physiological process that spans over several years and includes the formation of teeth and their migration in the jaws until they erupt in the mouth in their final functional position. Variation in the normal teeth eruption pattern is a common finding, but significant deviation from the established norms should alert us for some diagnostic procedures to be taken for assessment of the patient health and development.

Although permanent teeth eruption is under significant genetic control, various general factors such as gender, socioeconomic status, craniofacial morphology and body composition can influence this process. Most significant disturbances in teeth emergence is caused by systemic diseases; hypothyroidism, HIV, hypoparathyroidism and syndromes such as Down's syndrome, SOTO's syndrome, to name but a few.1,2,3

Case report

A 13-year-old female patient visited the outpatient department with a complaint of pain in the left lower posterior region during the previous 6 months. She gave the history of intermittent medication from unregistered/unqualified medical practitioners for pain control.

Her dental examination revealed a partially erupted tooth-like structure in the third quadrant region which was tender on palpation (Figure 1). Her medical history was non-significant and her growth pattern was found to be normal. The father of the patient gave a similar history of early tooth eruption.

Figure 1. A partially erupted tooth-like structure in the third quadrant region.

A panoramic radiograph was ordered which showed the presence of the third molars and root formation of both the mandibular third molars, which were near completion (Figure 2).

Figure 2. OPG of the third molars and root formation of both the mandibular third molars near completion.

Blood investigations were normal and vital parameters were within normal range. Her menstrual history dated back one year.

Treatment was planned to remove the left lower third molar surgically, which was uneventful.

Discussion

Certain syndromes result in failed or delayed dentition as there are many regulatory mechanisms that are involved in dentition and are also active in other developmental processes.4

There are certain genetic disorders that affect teeth eruption. Most of them are reported to delay permanent teeth eruption, others are associated with complete failure of teeth to erupt.

Genetic disorders can be divided into disorders that affect enamel formation and/or the tooth follicle (eg amelogenesis imperfecta, Hurler's syndrome, mucopolysaccharidosis VI) and disorders that interfere with osteoclastic activity (eg cleidocranial dysplasia, osteopetrosis).5

Hard tissue formation of the mandibular third molar begins at 8−10 years and enamel formation is completed at 12−16 years. Eruption is observed at 17−21 years of age with root completion at 18−25 years.6

Madhu has reported early eruption of permanent canines in a 7-year-old female patient.7 Bayrak et al reported in a study of Turkish children regarding timing of permanent tooth eruption that eruption tended to be earlier in females than in males, but this difference was significant only for maxillary and mandibular canines and mandibular first premolars.8

Disturbance of the endocrine glands usually has a profound effect on the entire body, including the dentition. Hypothyroidism, hypopituitarism, hypoparathyroidism and pseudohypoparathyroidism are the most common endocrine disorders associated with delayed permanent teeth eruption.9,10