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Delayed Eruption of Teeth: High-yield Dental Notes

Eruption is considered delayed if emergence has not occurred within 12 months of the normal range or by the time 75% root formation is complete 

Emergence is the moment of eruption when the first part of the cusp or crown is visible through the gingiva. 

This process normally occurs when the dental root is approximately two-thirds its final length 

Delay of up to 6 months from the date of eruption is usually considered normal

Local Conditions Associated with Delayed Eruption:

  • Ankylosis of deciduous tooth
  • Arch-length deficiency
  • Ectopic eruption
  • Enamel pearls
  • Failure of resorption of deciduous tooth
  • Gingival fibromatosis or hyperplasia
  • Impaction of deciduous tooth
  • Injury or infection of deciduous tooth
  • Mucosal barriers, such as scar tissue
  • Oral clefts
  • Premature loss of deciduous tooth
  • Radiation damage
  • Regional odontodysplasia
  • Segmental odontomaxillary dysplasia
  • Supernumerary teeth
  • Tumors, odontogenic and nonodontogenic 
Delayed eruption Local causes mnemonic
Delayed eruption Local causes mnemonic

Systemic Conditions Associated with Delayed Eruption:

  • Anemia
  • Celiac disease
  • Cerebral palsy
  • Chemotherapy
  • Dysosteosclerosis
  • Drugs, such as phenytoin
  • Endocrine disorders (e.g., hypothyroidism, hypopituitarism, hypoparathyroidism, pseudohypoparathyroidism)
  • Genetic disorders
  • Heavy metal intoxication
  • Human immunodeficiency virus (HIV) infection
  • Hypobaria
  • Ichthyosis
  • Inadequate nutrition
  • Low birth weight
  • Renal failure
  • Tobacco smoke
  • Vitamin D–resistant rickets
Delayed eruption systemic causes mnemonic
Delayed eruption systemic causes mnemonic

Clinical and Radiographic Features:

The failure of eruption may be localized or diffuse 

Diffuse delayed eruption often is more problematic and frequently is associated with a systemic disorder 

Localised delayed eruption readily apparent upon radiographic examination

X-ray needed: IOPA, OPG, Standard occlusal view


Generalized delayed eruption of teeth:

  • No local treatment
  • Regular recall
  • Wait & see signs of eruption
  • Intervene when necessary

Localized delayed eruption:

  1. Remove the causes:
  • Extraction of retained deciduous teeth, supernumerary teeth
  • Removal of cyst and tumor
  • If root completion is incomplete, close observation for eruption
  • If root completion is complete, orthodontic extrusion is needed

2. Space for uneruptive tooth:

  • If space is sufficient: Space maintainer
  • If space is insufficient: Recreate the space by orthodontic means

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