Local factors that can influence tooth eruption include infection, supernumerary teeth, gingival fibromatosis, and ankylosed teeth. Ankylosed teeth become fused to the bone, preventing normal eruption. Diagnosis involves tapping teeth and examining radiographs. Problems associated with ankylosed primary teeth include prevented exfoliation and delayed eruption of permanent teeth. Management may involve surgical removal, space maintenance, or watchful waiting depending on the situation. Ankylosed permanent teeth can also impact eruption and require techniques like luxation or surgery to encourage proper positioning.

1. LOCAL FACTORS THAT
INFLUENCE ERUPTION
Presented by:
Dr. Shady A. M. Negm
Bachelor's Degree of Dental Surgery,
School of Dentistry, Pharos University.
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2. 1. Infection:-
• Near the eruption time
cause early eruption
“soft tissue tearing,
bone resorption”
• Before long period
cause late eruption
“healing and fibrosis”.
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3. 2. Supernumerary teeth:
Cause late eruption.
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4. 3. Gingival fibromatosis:
Very hard tissue of the gum.
It prevents eruption.
It is hereditary condition, treated by
gingivectomy
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5. • 4. Ankylosed teeth:
It is a dental situation
in which the roots of
the tooth lose their
normal attachment to
the bone (small
ligament) and
become directly fused
to the bone.
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6. Diagnosis:
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7. • 1- The diagnosis of an ankylosed tooth is not
difficult to make. Ankylosis can be partially
confirmed by tapping the suspected tooth and
an adjacent normal tooth with a blunt instrument
and comparing the sounds. The ankylosed tooth
will have a solid sound, whereas the normal
tooth will have a cushioned sound because it
has an intact periodontal membrane that
absorbs some of the shock of the blow.
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8. • 2- The radiograph is often a valuable aid
in making a diagnosis. A break in the
continuity of the periodontal membrane
indicating an area of ankylosis is often
evident radiographically.
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9. Problem associated
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10. 1- Submerged tooth.
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11. • 2- Malposition of
tooth.
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12. • 3- Super eruption of
apposing tooth.
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13. • 4- Delayed eruption or impaction of
permanent tooth.
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14. A. Primary teeth
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15. • Extensive bony ankylosis of the primary tooth
may prevent normal exfoliation, as well as the
eruption of the permanent successor.
• The mandibular primary molars are the teeth
most often observed to be ankylosed.
Ankylosis involved second molar may be
indication of agenesis of succedanous tooth.
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16. Causes
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17. • 1- The cause of ankylosis in the primary
molar areas is unknown.
2- The observation of ankylosis in several
members of the same family lends support
to the theory that it follows a familial
pattern.
3- Very slow root resorption was observed
for most of the ankylosed teeth.
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18. Management
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19. • 1- In the management of an ankylosed tooth,
early recognition and diagnosis are extremely
important.
2- The eventual treatment may involve surgical
removal and place space maintainer.
3- However, unless a caries problem is unusual
or loss of arch length is evident, the dentist may
choose to keep the tooth under observation or
build up occlusal surface.
4- A tooth that is definitely ankylosed may at
some future time undergoes root resorption and
be normally exfoliated.
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20. • 5- When patient cooperation is good and
recall periods are regular, a watchful
waiting approach is best.
6- In situations in which permanent
successors of ankylosed primary molars
are missing, attempts have been made to
establish functional occlusion using
stainless steel crowns, overlays, or
bonded composite resins on the affected
primary molars. This treatment is
successful only if maximum eruption of
permanent teeth in the arch has occurred.
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21. • 7- If adjacent teeth are still in a state
of active eruption, they will soon
bypass the ankylosed tooth.
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22. B. Permanent teeth
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23. • The incomplete eruption of a permanent
molar may be related to a small area of
root ankylosis. If the permanent tooth is
exposed in the oral cavity and at a lower
occlusal plane than the adjacent teeth,
ankylosis is the probable cause.
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24. Causes
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25. • 1- Familial.
2- Unerupted permanent teeth may
become ankylosed by inostosis of enamel.
The process follows the irritation of the
follicular or periodontal tissue resulting
from chronic infection.
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26. Management
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27. • 1- The removal of soft tissue and bone
covering the occlusal aspect of the crown
should be attempted first, and the area
should be packed with surgical cement to
provide a pathway for the developing
permanent tooth.
2- Luxation technique effective in breaking
the bony ankylosis.
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28. • 3- If the rocking technique is not
immediately successful, it should be
repeated in 6 months. A delay in treatment
may result in a permanently ankylosed
molar.
4- Surgery exposure + orthodontics
traction + RCT.
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