Republic of Iraq

Ministry of Higher Education

and Scientific Research
Bilad Al-Rafidain University College
Department of Dentistry

The Influence of Primary Teeth Root

Development on the Eruption and Health of
Permanent Teeth:
A Project Submitted to the Bilad Al-Rafidain University College,
Department of Dentistry in Partial Fulfillment for the Bachelor of
Dental Surgery

By:
Zahraa Khalil Ibrahim
Zahraa Mohammed Nassif
Balsam Mohammed Abdulkhaliq

Supervised by:

Dr. Sally Talib

2024
‫ﳠ ﳢ ﳣ ﳤ ﳥﱠ‬
‫ﳡ‬ ‫ﱡ ﳘﳙﳚ ﳛ ﳜ ﳝﳞ ﳟ‬

‫المجادلة‪١١ :‬‬
 Dedication

To my dear family who has been with me every step of the way
and never left me alone until this moment of my life, having the
biggest role in my success. They gave me the strength to stay
strong and never fall down .

To my supervisor, Assistant Lecturer Sally, who encouraged me to

keep going in my academic life. To my friends, thank you for your
continuous support.
 List of Contents

Contents
Dedication
Acknowledgment
Summary
List of Contents
List of Tables
List of Figures
List of Abbreviations
Abstract
Introduction
Aims of the study
Chapter One:
1.1: The importance of the primary teeth
1.1.1: Chewing and Nutrition:
1.1.2: Speech Development:
1.1.3: Space Maintainers:
1.1.4: Facial Structure:
1.1.5: Self-Esteem:
1.1.6: Guiding Permanent
1.2: Stages of Primary Teeth Root Development
1.2.1: Initial Formation:

1.2.2: Full Root Development:

1.2.3: Functionality:
1.2.4 Root Resorption:
1.2.5: Initiation (6-8 Weeks of Gestation):

1.2.6: Root Growth and Maturation (Birth to 3

Years)
1.2.7: Functional Stage (3-6 Years):

1.2.8: Root Resorption (5-12 Years):

1.2.9: Exfoliation (Shedding):
1.3: The Importance Of primary teeth in the
eruption and health of permanent teeth
1.3.1:Space Maintainers:
1.3.2: Guidance for Eruption
1.3.3: Development of Jaw and Facial Structures:
1.3.4: Oral Health Foundation
1.3.5: Speech and Chewing:
1.4: The Oral Health of the primary teeth and It
is effect on the eruption of permanent teeth
1.4.1: Prevention of Infections:
1.4.2: Maintenance of Proper Space:
1.4.3: Guidance for Eruption
1.4.4: Impact on Jaw Development
1.4.5: Overall Oral Hygiene:
1.4.6: Avoidance of Dental Trauma
Chapter Two:
2.1: Genetic disorders of the primary teeth their
effects on the health and eruption of permanent
teeth
2.1.1: Hypophosphatasia (HPP)
2.1.2: Dentin Dysplasia
2.1.3: Amelogenesis Imperfecta (AI)
2.1.4: Cleidocranial Dysplasia (CCD)
2.1.5: Regional Odontodysplasia
2.2:Environmental factors can significantly
influence the development of primary teeth
roots, which in turn can affect the eruption and
health of permanent teeth.
2.2.1: Nutritional Deficiencies
2.2.2: Fluorosis
2.2.3: Infectious Diseases

2.2.4: Trauma
2.2.5: Radiation Exposure
2.2.6: Environmental Toxins
2.2.7: Maternal Health and Medication Use
Chapter Three
3.1: Preventive care for primary teeth plays
crucial roles for ensuring the proper eruption
and long-term health of permanent teeth
3.1.1: Prevention of Early Tooth Loss:
3.1.2: Maintaining Oral Health:
3.1.3: Supporting Proper Eruption Timing:
3.1.4: Jaw and Facial Development
3.1.5: Establishing Good Oral Habits:
3.1.6: Early Detection of Problems:
3.2: Ankylosis
3.2.1: Delayed Eruption of Permanent Teeth

3.2.2: Malocclusion
3.2.3: Ectopic Eruption

3.2.4: Resorption and Root Damage

3.2.5: Aesthetic Concerns

3.2.6: Psychological and Functional Issues
3.3: Conclusion
Reference

List of Figures

Figures Title Page

No.
2-1
Hypophosphatasia (HPP)
Dentin Dysplasia
Amelogenesis Imperfecta (AI)
Cleidocranial Dysplasia (CCD)
Regional Odontodysplasia
Fluorosis
Infectious Diseases
Ankylosis
Malocclusion
 Ectopic Eruption
Aesthetic Concerns

Abstract

This study investigates the influence of primary teeth root development on

the eruption and health of permanent teeth. By analyzing the root
resorption of primary teeth and its effect on the timing and positioning of
permanent teeth eruption, we aim to understand the connection between
early dental development and long-term oral health. The research
highlights how variations in root development can lead to common dental
issues such as malocclusion, impaction, and increased susceptibility to
caries in permanent teeth. The findings offer valuable insights into
pediatric dental care and potential preventive measures for improving oral
health outcomes.
Introduction
Teeth root development refers to the process by which the roots of teeth
form and mature. This process occurs during both primary (baby) teeth
and permanent (adult) teeth development. The root development begins
after the crown of the tooth has formed and continues as the tooth erupts
into the oral cavity. The main functions of root development are to
provide stability for the tooth and to ensure proper positioning within the
jaw.

Aim of the study

The aim of study is to understand how the growth, development, and

eventual resorption (breakdown) of primary teeth roots affect the timing,
positioning, and overall health of the permanent teeth that follow. This
research can provide insights into:

1.Eruption Patterns: Determining how the development and

resorption of primary teeth roots influence when and how permanent
teeth emerge.

2. Alignment and Positioning: Exploring how the condition of primary

teeth roots impacts the alignment of permanent teeth, potentially
affecting occlusion (bite) and the need for orthodontic treatment.

3.Dental Health: Assessing the role of primary teeth root development

in maintaining the health of permanent teeth, including risks of decay,
infection, or other dental issues if primary teeth do not develop or
resorb properly.

4.Early Intervention: Identifying potential problems early on,

allowing for preventive or corrective measures that can improve
long-term dental health outcomes.

1
Definition

Primary teeth, also known as baby teeth, milk teeth, or deciduous teeth,
are the first set of teeth that develop in young children. These teeth begin
to appear at around six months of age and typically consist of 20 teeth--
10 in the upper jaw and 10 in the lower jaw. Primary teeth play an
essential role in a child's development, aiding in speech, chewing, and
the alignment of permanent teeth that will replace them as the child
grows.

2
 Chapter One
1.1: The importance of the primary teeth

1.1.1: Chewing and Nutrition: They allow children to chew food

properly, aiding in proper digestion and nutrition.

1.1.2: Speech Development: Primary teeth are essential for the

development of clear speech and pronunciation.

1.1.3: Space Maintainers: They hold space in the jaws for the proper
alignment and spacing of permanent teeth

1.1.4: Facial Structure: These teeth help maintain the shape and structure
of a child's face

1.1.5: Self-Esteem: Healthy primary teeth contribute to a child's

self-esteem and social interactions

1.1.6: Guiding Permanent Teeth: Primary teeth guide the eruption of

permanent teeth, helping them come in straight and reducing the risk of
future dental problems

1.2: Stages of Primary Teeth Root Development

1.2.1: Initial Formation:

- Primary teeth begin to develop in utero, around the sixth to eighth

week of gestation.
- The roots start to form after the crowns (the visible part of the teeth)
are fully developed, typically before the teeth erupt into the mouth.
- The root formation continues as the primary teeth emerge, anchoring
them securely in the jawbone.

3
1.2.2: Full Root Development:

- The roots of primary teeth continue to grow and fully develop

after the tooth has erupted, usually completing this process by
the time the child is around three years old.
- Fully developed roots of primary teeth are critical for holding
the teeth in place and ensuring they function properly for
chewing, speaking, and maintaining space for permanent teeth.

1.2.3: Functionality:

- The roots of primary teeth anchor them in the jawbone, enabling

them to withstand the forces of chewing.
- Healthy root development is essential for the stability of primary
teeth, allowing them to remain in the mouth until the permanent
teeth are ready to erupt.

1.2.4 Root Resorption:

- As the child grows, the roots of primary teeth begin to

resorb (break down) in preparation for the eruption of
permanent teeth.
- This resorption process typically begins a few years before
the primary teeth are due to fall out, starting around age 5
or 6.
- Root resorption occurs because the pressure from the
developing permanent teeth triggers cells called
odontoclasts to dissolve the primary tooth roots.

# Primary teeth root development** occurs in distinct

stages that are crucial for the proper formation, function,
and eventual shedding of these teeth. Understanding these
stages helps in appreciating the role of primary teeth in a
child’s oral development.

4
Stages of Primary Teeth Root Development:

1.2.5: Initiation (6-8 Weeks of Gestation):

- Formation Begins: Primary teeth development begins in the embryo

around the sixth to eighth week of pregnancy. The dental lamina, a
band of epithelial tissue, forms, which eventually gives rise to the
tooth buds.
- Early Root Formation: After the crowns of the teeth start forming,
the roots begin to develop from the tooth buds. This process starts
with the formation of the root sheath, which guides the development
of the root structure.

1.2.6: Root Growth and Maturation (Birth to 3 Years)

- Post-Eruption Root Development: Once the primary teeth erupt

(between 6 months and 3 years of age), their roots continue to grow
and mature. This is when the roots reach their full length, anchoring
the teeth firmly in the jawbone.
- Full Root Formation: By the time a child is around 3 years old, the
roots of primary teeth are fully developed. These roots are essential
for holding the teeth in place and ensuring they function properly
for chewing, speaking, and maintaining space for the permanent
teeth.
1.2.7: Functional Stage (3-6 Years):

- Stability:During this stage, the roots of the primary teeth are fully
functional, helping maintain the position and health of the teeth.
They support the teeth in their role in chewing, speech, and facial
development.
- Preparation for Resorption: Although fully developed, the roots are
eventually destined to resorb to make way for the permanent teeth.
The body starts preparing for this process as the child approaches
the age of 5 or 6.

5
1.2.8: Root Resorption (5-12 Years):

- Initiationof Resorption: As the permanent teeth develop and begin to

exert pressure on the primary teeth, the roots of the primary teeth
start to resorb. This process is gradual, beginning several years
before the primary teeth are shed.
- Progressive Breakdown: The roots break down slowly, which
loosens the primary teeth, making them ready to fall out and allowing
the permanent teeth to emerge.
- Completion: Resorption typically completes as the primary tooth is
shed. The timing of this varies by tooth type, starting with the
incisors (around age 6-7) and ending with the second molars (around
age 10-12).

1.2.9: Exfoliation (Shedding):

- Tooth Loss: The final stage of root development is the natural shedding
of the primary teeth, which occurs as the roots are almost entirely
resorbed. The permanent teeth then erupt in the space previously
occupied by the primary teeth.

1.3: The Importance Of primary teeth in the

eruption and health of permanent teeth
1.3.1:Space Maintainers: Primary teeth act as natural space maintainers
for the permanent teeth that will eventually replace them. They ensure
that there is enough space for the permanent teeth to erupt properly. If
primary teeth are lost too early due to decay or injury, adjacent teeth
may shift into the vacant space, leading to crowding or misalignment of
the permanent teeth.

1.3.2: Guidance for Eruption: The roots of primary teeth play a crucial
role in guiding the eruption of permanent teeth. As the roots of primary
teeth begin to resorb (break down), this process helps in the correct
alignment and timely eruption of the permanent teeth.

6
1.3.3: Development of Jaw and Facial Structures: Primary teeth support
the development of the jawbone and facial muscles. Proper alignment
and health of primary teeth contribute to the overall development of the
oral and facial structures, which are essential for the alignment and
positioning of permanent teeth.

1.3.4: Oral Health Foundation: Healthy primary teeth are essential for
maintaining good oral hygiene and preventing the spread of bacteria
that could affect the underlying permanent teeth. Decay or infections
in primary teeth can compromise the health of developing permanent
teeth, leading to potential issues such as cavities or enamel defects.

1.3.5: Speech and Chewing: Primary teeth are important for proper
speech development and efficient chewing, which are critical during
childhood. Maintaining the health of primary teeth ensures that these
functions are not compromised, contributing to overall oral and
nutritional health, which in turn affects the health of permanent teeth.

1.4: The Oral Health of the primary teeth and It is effect

on the eruption of permanent teeth
1.4.1: Prevention of Infections: Healthy primary teeth help prevent
infections that could spread to the underlying permanent teeth. If a
primary tooth becomes infected, the bacteria can travel through the
roots and affect the developing permanent tooth beneath it, potentially
leading to enamel defects, discoloration, or early decay in the
permanent tooth.

1.4.2: Maintenance of Proper Space: Healthy primary teeth maintain

the necessary space for permanent teeth to erupt correctly. If a
primary tooth is lost prematurely due to decay or trauma, the adjacent
teeth can shift into the vacant space, leading to crowding or
misalignment of the permanent teeth. This can result in the need for
orthodontic treatment later on.

1.4.3: Guidance for Eruption: The roots of primary teeth guide the

7
eruption of permanent teeth by resorbing at the correct time, allowing
permanent teeth to emerge in their proper positions. If primary teeth
are lost early or are damaged, this guidance can be compromised,
potentially leading to malpositioned permanent teeth.

1.4.4: Impact on Jaw Development: Primary teeth play a role in the

development of the jaw and facial bones. Decay or loss of primary teeth
can lead to improper development of these structures, which can affect
the alignment and spacing of permanent teeth. A well- developed jaw
with properly aligned primary teeth is crucial for accommodating the
permanent teeth that will follow.

1.4.5: Overall Oral Hygiene: Good oral health practices learned during
the care of primary teeth set the foundation for the health of permanent
teeth. Children who develop cavities or other dental issues in their
primary teeth are at higher risk of experiencing similar issues in their
permanent teeth. Establishing good oral hygiene habits early can reduce
the risk of decay and other problems in permanent teeth.

1.4.6: Avoidance of Dental Trauma: Primary teeth that are well-

maintained and free from decay are less likely to experience fractures
or other forms of dental trauma. Damage to a primary tooth can result
in complications for the permanent tooth underneath, including
delayed eruption or damage to the enamel.

8
 Chapter Two

2.1: Genetic disorders of the primary teeth their effects

on the health and eruption of permanent teeth
2.1.1: Hypophosphatasia (HPP)
- Overview: Hypophosphatasia is a rare genetic disorder
affecting the development of bones and teeth due to mutations
in the ALPL gene, which encodes an enzyme crucial for
mineralization.
- Effect on Primary Teeth Roots:
- Premature Tooth Loss: Children with hypophosphatasia often
experience premature loss of primary teeth, particularly the
incisors, due to improper root development and lack of
cementum, a tissue that anchors the root to the jawbone.
- Inadequate Root Formation: Roots may be underdeveloped or
completely absent, leading to instability of the primary teeth.
- Impact on Permanent Teeth:
- Delayed Eruption: The premature loss of primary teeth can
disrupt the timing and sequence of permanent teeth eruption,
leading to delays or misalignment.
- Weak Enamel: Permanent teeth may also have weakened
enamel, increasing susceptibility to decay.
- Malocclusion: Misalignment of permanent teeth is common due
to the loss of primary teeth at inappropriate times.

9
2.1.2: Dentin Dysplasia

- Overview: Dentin dysplasia is a genetic disorder affecting the dentin,

the tissue beneath the enamel, leading to abnormal root development.
It is classified into two types: Type I (radicular dentin dysplasia) and
Type II (coronal dentin dysplasia).
- Effect on Primary Teeth Roots:
- Type I: Roots of primary teeth are short or completely absent,
leading to tooth mobility and early loss.
- Type II: Roots are slightly less affected, but there is abnormal dentin
formation, leading to discoloration and potential structural weakness.
- Impact on Permanent Teeth:
- Root Abnormalities: Permanent teeth may also have short or
malformed roots, leading to instability and an increased risk of tooth
loss.
- Increased Susceptibility to Fractures: Weak or absent roots make
permanent teeth more prone to fractures.
- Delayed Eruption and Malocclusion: Similar to other disorders, the
improper root formation in primary teeth can lead to delayed or
irregular eruption patterns for permanent teeth.

10
2.1.3: Amelogenesis Imperfecta (AI)

- Overview: Although primarily a disorder affecting enamel

formation, some forms of amelogenesis imperfecta also involve
root development abnormalities, particularly in the cementum.
- Effect on Primary Teeth Roots:
- Thin or Hypoplastic Enamel: The enamel of primary teeth is thin or
poorly formed, which can lead to rapid wear, decay, and potential
damage to the roots.
- Compromised Root Function: In some cases, root development is
compromised, leading to early tooth loss.
- Impact on Permanent Teeth:
- Enamel Defects: Permanent teeth are similarly affected, with thin
enamel that is prone to decay and wear.
- Eruption Issues: The defective primary teeth may not maintain
their position properly, affecting the eruption of permanent teeth.
- Increased Dental Care Needs: Individuals with AI often require
extensive dental care throughout their lives to manage the effects
on both primary and permanent teeth.

11
2.1.4: Cleidocranial Dysplasia (CCD)

- Overview: A genetic disorder characterized by delayed closure of

the skull sutures, abnormalities in the collarbone, and dental
anomalies, including issues with primary and permanent teeth.
- Effect on Primary Teeth Roots:
- Delayed Root Resorption: Primary teeth roots may not resorb
properly, leading to delayed exfoliation (shedding) and retention of
primary teeth.
- Supernumerary Teeth: Extra teeth may develop, complicating the
normal resorption and eruption process.
- Impact on Permanent Teeth:
- Delayed Eruption: Permanent teeth often erupt late or fail to erupt
due to the presence of retained primary teeth or supernumerary
teeth blocking their path.
- Crowding and Misalignment: The abnormal number and delayed
loss of primary teeth often lead to crowding and misalignment of
permanent teeth.
- Orthodontic Intervention: Extensive orthodontic treatment is

12
 usually required to manage these dental issues.

2.1.5: Regional Odontodysplasia

- Overview: A rare condition that affects the development of

teeth in a localized area, leading to “ghost teeth” with thin
enamel, poor dentin, and incomplete root formation.
- Effect on Primary Teeth Roots:
- Underdeveloped Roots: Roots are poorly formed or absent,
leading to instability and early loss of affected primary teeth.
- Weak Tooth Structure: The affected primary teeth are often
weak and prone to fractures or decay.
- Impact on Permanent Teeth:
- Delayed or Failed Eruption: The affected area may have delayed
eruption of permanent teeth, or the teeth may not erupt at all.
- Increased Dental Anomalies: The permanent teeth that do erupt
in the affected area are often malformed and require extensive
dental care.

13
2.2:Environmental factors can significantly influence
the development of primary teeth roots, which in turn
can affect the eruption and health of permanent teeth.
2.2.1: Nutritional Deficiencies

- Vitamin D Deficiency: Lack of vitamin D can lead to rickets,

which affects the mineralization of both primary and permanent
teeth. This may cause delayed eruption of permanent teeth and can
result in enamel hypoplasia, making the teeth more susceptible to
decay.
- Calcium Deficiency: Calcium is critical for proper tooth and bone
formation. Insufficient calcium during the development of primary
teeth can lead to weakened tooth structures, affecting the roots
and potentially causing abnormal resorption, which can delay or
complicate the eruption of permanent teeth.

2.2.2: Fluorosis

- Excessive Fluoride Exposure: High levels of fluoride during the

development of primary teeth can lead to dental fluorosis. This
condition causes hypomineralization of the teeth, resulting in
discoloration and structural weakness. Affected primary teeth may
have compromised roots, potentially leading to misalignment or
delayed eruption of permanent teeth.

14
2.2.3: Infectious Diseases

- Congenital Syphilis: This bacterial infection can disrupt the

development of primary teeth, leading to a condition called
Hutchinson's teeth, where the teeth are notched, peg- shaped, and
have underdeveloped roots. Such malformations can hinder the
proper eruption of permanent teeth and may cause misalignment or
crowding.

15
- Chronic Infections (e.g., otitis media): Persistent infections during
early childhood can interfere with the normal development of
primary teeth roots, potentially causing premature loss of primary
teeth. This can disrupt the natural timing and positioning of
permanent tooth eruption, leading to malocclusion.

2.2.4: Trauma
- Injury to Primary Teeth: Trauma to primary teeth can damage the
developing roots, leading to early loss or root resorption. Such
events can affect the alignment and eruption of the underlying
permanent teeth, potentially leading to impaction or ectopic
eruption (where the tooth emerges in the wrong place).

2.2.5: Radiation Exposure

- TherapeuticRadiation: Children undergoing radiation therapy for

head and neck cancers can experience disrupted root development

16
 in primary teeth. This may result in the stunting of permanent
tooth buds, leading to delayed or failed eruption and potential
dental anomalies.

2.2.6: Environmental Toxins

- Lead Exposure: High levels of lead in early childhood can

interfere with the normal development of primary teeth roots,
leading to abnormalities such as delayed eruption, tooth
discoloration, and increased risk of caries in permanent teeth.
- Mercury Exposure: Similar to lead, mercury exposure can affect
dental development, potentially causing defects in the enamel
and dentin of primary teeth, which may influence the health and
eruption of permanent teeth.

2.2.7: Maternal Health and Medication Use

- Maternal Smoking: Nicotine and other harmful substances in

tobacco smoke can interfere with the normal development of
primary teeth in utero. Affected primary teeth may have weaker
roots, which can delay the eruption of permanent teeth or result
in malformations.
- Use of Certain Medications During Pregnancy: Drugs such as
tetracycline can cross the placental barrier and affect tooth
development in the fetus, leading to discoloration and
malformation of primary teeth, which in turn can affect the
development and eruption of permanent teeth.

17
 Chapter 3

3.1: Preventive care for primary teeth plays

crucial roles for ensuring the proper eruption
and long-term health of permanent teeth
3.1.1: Prevention of Early Tooth Loss: Preventive care, including
regular dental check-ups, proper brushing, and fluoride treatments,
helps prevent cavities and decay in primary teeth. This reduces the
risk of premature tooth loss, which is essential for maintaining the
correct space needed for permanent teeth to erupt properly. Early
loss of primary teeth can lead to crowding or misalignment of
permanent teeth, often requiring orthodontic intervention.

3.1.2: Maintaining Oral Health: Preventive care ensures that primary

teeth remain healthy and free from infections. Since primary teeth act
as placeholders for permanent teeth, keeping them healthy prevents the
spread of infections to the developing permanent teeth beneath them.
For instance, untreated cavities in primary teeth can lead to abscesses
or other infections that might harm the enamel or development of
permanent teeth.

3.1.3: Supporting Proper Eruption Timing: Regular preventive care

helps monitor the development and eruption of primary teeth. Dentists
can identify and address issues like delayed eruption or misalignment
early on, ensuring that the primary teeth are lost at the appropriate
time. This, in turn, supports the timely and proper eruption of
permanent teeth.

3.1.4: Jaw and Facial Development: Preventive care supports the health
of primary teeth, which are crucial for the proper development of the
jaw and facial bones. Healthy primary teeth help maintain the structure
and space necessary for the correct alignment of permanent teeth. Poor
oral health in primary teeth can lead to underdevelopment of the jaw,
potentially resulting in overcrowding or other orthodontic problems.

18
3.1.5: Establishing Good Oral Habits: Preventive care during the
primary teeth stage helps establish good oral hygiene habits that carry
over into adulthood. Children who learn the importance of brushing,
flossing, and regular dental visits are more likely to maintain these
habits as their permanent teeth emerge, reducing the risk of decay and
other dental issues.

3.1.6: Early Detection of Problems: Through preventive care, dentists

can detect early signs of dental issues, such as misalignment,
overcrowding, or enamel defects, in both primary and developing
permanent teeth. Early intervention can address these issues before
they become more serious, ensuring that the permanent teeth develop
in a healthy environment.

3.2: Ankylosis

Ankylosis of Primary Teeth is a condition where the tooth becomes

fused to the surrounding alveolar bone, preventing it from erupting or
being shed naturally. This fusion occurs because the periodontal
ligament, which normally separates the tooth from the bone, is either
absent or damaged. Ankylosis most commonly affects primary molars
and can have significant implications for the eruption and health of the
permanent teeth.

19
Causes of Ankylosis in Primary Teeth

- Genetic Predisposition: Some individuals may have a genetic

tendency toward ankylosis.
- Trauma: Injury to a primary tooth can damage the periodontal
ligament, leading to ankylosis.
- Infection: Chronic infection or inflammation around a primary tooth
can cause ankylosis.
- Abnormalities in Tooth Development: Developmental anomalies in
the root or surrounding bone can lead to ankylosis.

Effects of Ankylosis on Permanent Teeth

3.2.1: Delayed Eruption of Permanent Teeth

- Eruption Delay: Since the ankylosed primary tooth does not

20
 shed as it should, the corresponding permanent tooth may be
delayed in its eruption. This delay can vary depending on the
severity of the ankylosis and the age at which it occurs.
- Impaction: In severe cases, the permanent tooth may become
impacted, meaning it is unable to erupt normally. This is
particularly problematic if the ankylosis occurs in the primary
molars, as the permanent premolars may be blocked from
erupting.

3.2.2: Malocclusion

- Tilting of Adjacent Teeth: Ankylosed teeth are often lower than

the adjacent teeth, as they do not follow the natural eruptive
process. This creates a step in the dental arch, leading to tilting or
tipping of the adjacent teeth toward the ankylosed tooth.
- Space Loss: The lack of exfoliation of an ankylosed primary
tooth can lead to a reduction in arch space, resulting in crowding
and misalignment of the permanent teeth.
- Midline Shift: If the ankylosis occurs unilaterally (on one side),
it can cause a shift in the dental midline, leading to asymmetry in
the bite.

3.2.3: Ectopic Eruption

- Abnormal Path of Eruption: The presence of an ankylosed

primary tooth can cause the permanent tooth to erupt in an
abnormal position, often outside the normal arch, leading to an

21
ectopic eruption. This may require orthodontic intervention to
correct.

22
3.2.4: Resorption and Root Damage

- Disruption of Natural Resorption: Normally, the roots of primary

teeth are resorbed by the underlying permanent teeth, allowing for
natural exfoliation. In ankylosis, this process is disrupted, leading to
retention of the primary tooth and potential damage to the permanent
tooth.
- Root Resorption of Adjacent Teeth: The abnormal position of the
ankylosed tooth and the delayed eruption of the permanent tooth can
sometimes cause resorption of the roots of adjacent teeth,
complicating orthodontic treatments and long-term dental health.

3.2.5: Aesthetic Concerns

- Infraocclusion: Ankylosed teeth often appear shorter than the

surrounding teeth because they do not continue to erupt
alongside the growing jaw. This can create an aesthetic
concern, especially if the ankylosed tooth is visible when
smiling.

23
 - Crowding: The space lost due to an ankylosed primary tooth can
result in crowding of the permanent teeth, leading to compromised
dental aesthetics.

3.2.6: Psychological and Functional Issues

- Impact on Mastication: If the ankylosis affects multiple

teeth, it can interfere with normal chewing patterns, leading to
functional problems.
- Speech Development: In cases where ankylosis affects
anterior teeth, it may contribute to speech development issues,
particularly if the condition persists without intervention.
- Self-Esteem: Affected individuals, especially children, may
become self-conscious about the appearance of their teeth,

24
 leading to psychological impacts.

3.3: Conclusion
The development of primary teeth roots plays a crucial role in the
eruption and subsequent health of permanent teeth. This comprehensive
analysis reveals that proper root development of primary teeth is
essential for guiding the permanent teeth into their correct positions.
This research underscores the significance of primary teeth beyond
their temporary role in a child’s oral development. Understanding the
influence of their root development not only helps in preventing future
dental problems but also in promoting overall oral health.
Continued research and awareness are vital to ensuring that both
children and their caregivers recognize the importance of
maintaining the health of primary teeth.

25
Reference

1. Pediatric Dentistry by Arthur Nowak and Paul Casamassimo

2. Oral and Maxillofacial Pathology by Brad W. Neville, Douglas
D. Damm, Carl M. Allen, and Angela C. Chi
3. Cawson's Essentials of Oral Pathology and Oral Medicine by
Roderick A. Cawson and Edward W. Odell
4. Dental Anomalies and Syndromes by Jane A. Soxman –
5. Textbook of Oral Medicine, Oral Diagnosis and Oral
Radiology by Ravikiran Ongole and Praveen B. N.
6. Management of Dental Emergencies in Children and
Adolescents by Klaus W. Neuhaus and Adrian Lussi

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