predentate period pedo

predentate period pedo

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  Department Of Paediatricdentistry PREDENTATE PERIOD
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  PREDENTATE PERIOD Definition: Refersto the period from birth to the eruption of the first deciduous teeth in the oral cavity. GUM PADS :- The alveolar arches of an infant are called gum pads. Gum pads are firm & pink in color Gum pads develop in 2 parts. - Labial portion - Lingual portion These portions are separated from each other by a dental groove which is the site of origin of the dental lamina
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  UPPER GUM PAD •Horseshoe Shaped • Upper Gum pad is divided into 10 Segments by transverse groove. • Gingival groove separates the gum pad from palate. • Dental groove originates in the incisive papilla region & extends backwards to touch gingival groove in the camine region. • Lateral Sulcus:- Present between deciduous canine & first molar segment.
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  LOWER GUM PAD • U-Shaped with its anterior portion averted labially • Lower gum pad is divided into 10 segments by Transverse groove. • Gingival groove separates the gum pad from floor of the mouth. • Dental groove – Running backwards and join the gingival groove in the canine region. • Lateral sulcus – Present between deciduous canine & first molar segment.
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  RELATIONSHIP OF THE GUM PADS • At rest gum pads are separated by the tongue. • The lateral sulcus of lower gum pad lies distal to that of the upper. • Variable overjet with contact only In the first molar segment. • During function – Mandible moves vertically & in anteroposterior direction. Lateral movements are absent.
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  Growth of gumPads: • At birth the width of gum pads are inadequate to accommodate all the incisors. • Growth of gum pad is rapid in first year after birth. • More in transverse & labio-lingual direction. CLEANING OF GUM PADS • Started within the first week of birth • The parent can be instructed to:- Lay the baby down with his/her head in your lap & feet pointing away. • Take a small gauze ( 2” x2”) between thumb and forefinger & wipe vigorously over the gum pad
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  • Now a days specially designed:- – infant tooth brush – Finger coats – Wipes are used • Use adequate pressure just to remove the film that covers the gum pad. • Clean at least every day twice after morning & last feed in the night. • Duration of cleaning :- 2 to 3 minutes.
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  PRECOCIOUSLY ERUPTED TEETH. 2. Natal Teeth :- Present since birth 2. Neonatal teeth: Erupt during neonatal period. ( upto 28 days after birth) 3. Predeciduous dentition:- Erupted after 28 days and before six months after birth.
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  Soft Tissue lesionswhich are seen during predentate period. • CONGENITAL EPULIS :- Soft tissue tumer that occurs on the gum pads Clinical features :- Pink to red in color Smooth surfaced Polypoid mass. size – 2 cm. – 7.5 cm. Maxillary > mandibular Lateral to midline ( in lateral insisor and canine region) Female > Male Treatment :- Can be seen in utero by ultrasound After birth :- It diminishes in size. Otherwise :- Surgical excision
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  Epstein pearls orBohn’s nodule Small superficial, Keratin filled cysts that are found on the alveolar mucosa of infant. Clinical Feature:- – Small, usually multiple, whitish papules on the mucosa overlying the alveolar process of neonate. – Size of individual :- 2 to 3 mm. – Maxilla > mandible Treatment:- Spontaneous involute at a result of rupture of cyst. Rarely seen after 3 months of age.
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  Rega fede disease •Ulceration on the ventral surface of tongue caused by sharp edges of natal & neonatal teeth. Clinical Feature:- – Mild to severe ulcerations on ventral surface of tongue. – Interfere with infants feeding & suckling
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  Treatment:- –If the tooth is mature & root is sufficient to retain the tooth than • Smoothening of the incisal edge • Placement of a smooth & rounded composite – In case of larger lesion • Extraction of offending tooth with vitamin K supplementation ERUPTION CYST • Associated with natal and neonatal teeth.
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  • Clinical Feature:- – Usually symptomless – Sometimes : Interfere with feeding Bleed intermittently – Appear as clear or blood tinged, fluid filled masses on the crest of the alveolar ridge. • Treatment:- – Usually disappear when the underlying tooth erupt. – If it is painful or infected or if the lesion bleeds than it should be drained and natal or neonatal teeth are removed.
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  Transient Malocclusion During Predentate Period 1. RETROGNATHIC MANDIBLE • Mandible is severely retruded during predentate period. • It is retruded 14 degree at birth • Corrected by forward growth of mandible
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  2. OPEN BITE OF GUM PAD:- • Corrected when incisor teeth fully erupts.
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  References: • Textbook ofpedodontics- Shobha Tandon • Oral & maxillofacial pathology- 2nd edi.- Neville, Damm , Allen, Bouquot • A textbook of oral pathology- 4th edi.- Shafer