Shedding of Teeth

SHEDDING OF TEETH
CONTENTS
 DEFINITION
 PATTERN OF SHEDDING
 HISTOLOGY OF SHEDDING
 MECHANISM OF RESORPTION &
SHEDDING
 CLINICAL CONSIDERATIONS
 REFERENCES
DEFINITION
 The physiologic process resulting in the
elimination of the deciduous dentition is called
shedding or exfoliation.
 It is a physiological process for elimination of
deciduous teeth by resorption of their roots
prior to the eruption of their permanent
successor.
PATTERN OF SHEDDING
 The shedding of deciduous teeth is the result of
progressive resorption of the roots of teeth and
their supporting tissue, the periodontal
ligament.
 the pressure generated by the growing and
erupting permanent tooth dictates the pattern
of deciduous tooth resorption.
 Pattern of shedding is symmetrical on booth
sides.
 Exfoliation occurs first in girls than boys.
 Sequence of shedding for mandible follows
anterior to posterior, for maxilla 1st molar then
canine.
 Pressure is directed at root surface of
deciduous teeth.
 Thin layer of lamella bone separates permanent
tooth germ and deciduous teeth.
FOR ANTERIOR TEETH
 The developmental position of the permanent
incisor and canine tooth germs and their
subsequent physiologic movement in an
occlusal and vestibular direction.
 Resorption of the roots of the deciduous
incisors and canines begins on their lingual
surfaces
 Resorption of primary anterior teeth occurs
along lingual surface of apical third of root.
 Permanent teeth crown lies directly below the
deciduous tooth ,resorption proceeds
horizontally in incisal direction.
 For mandibular incisors, labial movement of
permanent tooth germ does not cause complete
loss of primary teeth.
FOR POSTERIOR TEETH
 In posterior teeth, resorption of the roots of deciduous molars often
first begins on their inner surfaces because the early developing
premolars are found between them.
 This resorption occurs long before the deciduous molars are shed
and reflects the expansion of their growing permanent successors.
 the successional tooth germs come to lie apical to the deciduous
molars .
 This change in position provides the growing premolars with
adequate space for their continued development and also relieves
the pressure on the roots of the overlying deciduous molars.
 The areas of early resorption are repaired by the deposition of a
cementum-like tissue.
HISTOLOGY OF SHEDDING
 Odontoclast
 Role of RANKL
 Cementum.
 Periodontal ligament.
ODONTOCLAST
 The cells responsible for the removal of dental hard
tissue are identical to osteoclasts, and are called
odontoclasts.
 Under microscope: Large, multinucleated with
fewer nuclei.
 Originate from fusion of monocytes.
 Odontoclasts therefore are probably derived from
tartrate-resistant acid phosphatase (TRAP)-positive
circulating monocytes.
 odontoclast differentiation is promoted by RANKL
and is inhibited by OPG,
Distribution of odontoclasts
 Found in :
1. resorbed roots,
2. root canals,
3. pulp chamber.
 single-rooted teeth are usually shed before root

resorption is complete therefore, odontoclasts are not
found within the pulp chambers of these teeth.
 In molars the roots are usually completely resorbed
and the crown is also partially resorbed, before
exfoliation.
Cementum
 The process of tooth resorption is not
continuous since there are periods of rest and
repair.
 Repair is achieved by cells resembling
cementoblasts that lay down a dense
collagenous matrix .
 Acellular cementum: deposited in shallow and
smaller resorption bays.
 cellular cementum: larger and deeper
resorption bays
MECHANISM OF RESORPTION AND
SHEDDING
1. Pressure form erupting successional teeth.
2. Pressure due to forces of mastication
Clinical considerations
 Natal & neonatal teeth.
 Retained deciduous teeth.
 Submerged deciduous teeth(ankylosed teeth).
 Pre-matured shedding of teeth;
I. Trauma
II. Systemic factors;( cherubism, hypophospotasia)
References
 Ten Cate’s Oral Histology Development,
Structure, and Function by Antonio Nanci.
 Orban`s Oral Histology and Embryology 2nd
edition.
Thank you

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SHEDDING OF TEETH

 single-rooted teeth are usually shed before root

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