Evaluación de la cronología y secuencia de erupción dental en pacientes infantiles de la Comunidad de Madrid

  1. Muñoz Cano, Laura
Supervised by:
  1. Montserrat Diéguez Pérez Director
  2. Marta Paz Cortés Co-director

Defence university: Universidad Europea de Madrid

Fecha de defensa: 13 January 2022

Committee:
  1. Mª Rosa Mourelle Martínez Chair
  2. Fátima Cerdán Gómez Secretary
  3. Anabella Reyes Committee member

Type: Thesis

Abstract

Introduction The sequence and chronology of eruption of permanent teeth is associated with parameters such as dental and skeletal maturation, making it possible to identify the development and age of individuals. We use this information in fields such as legal and forensic odontology, orthodontics, and pediatric dentistry. Traditionally it is established that dental replacement occurs between 6 and 13 years of age. However, currently in the children's dental clinic a change is observed in the pattern of emergence of the permanent dentition. The researchers of various studies attribute this fact to the advancement of puberty and indirectly to an improvement in nutrition and health. The general objective of this study was to evaluate the eruptive process in permanent dentition. Methodology A cross-sectional descriptive epidemiological study was carried out with a total sample of 725 patients made up of 367 girls and 358 boys between 4 and 14 years of age. It was carried out between November 2020 and September 2021. The accessible study population consisted of randomly selected children who attended the Dental Clinic of the European University of Madrid and two private clinics in the north of the Community of Madrid. . The investigation was carried out by recording the permanent teeth emerged after an intraoral exploration in a dental office with access to a dental chair with led lighting and with the help of an intraoral mirror. The age of dental eruption was considered as the moment in which the tooth penetrated the gingival mucosa and became clinically visible. The sample selection criteria were patients without dental pathology, especially development such as agenesis and supernumeraries, healthy boys and girls, without syndromes or systemic alterations. Height was measured with the help of a stadiometer with a precision of 0.01m and weight was calculated with a KERN scale with a precision of 0.1kg. Subsequently, the body mass index (BMI) of the patients was recorded to relate it to the early or late eruption of the permanent dentition. In addition, the percentiles of height and weight of the patients were calculated in order to establish a relationship between these and the emergence and dental sequence. The socioeconomic level of each patient was recorded based on their occupation or educational level in several groups. Results The first tooth to erupt in the upper arch was the first permanent molar, while in the lower arch it was the central incisor. In relation to the symmetry of the eruption, it occurred in less than half of the population studied with a p-value of 2.06 x 106. However, a percentage of the boys and girls presented asymmetry in both arches. Age and sex did not influence this eruptive aspect. In reference to sex, it stands out that the probability of eruption of piece 46 is 3,359 times greater in boys than in girls. Regarding BMI, it was a predictor variable of eruption symmetry, more frequent in overweight children. The probability of symmetry in dental eruption increased for South American children for each month of age and each meter of height. The BMI influenced the first tooth to emerge, but only in the fourth quadrant. Conclusions Regarding the eruption chronology, it is observed that the average age range of the emergence in the permanent dentition is from 8 to 13 years and 7 months. Age, height, weight and height percentile have a significant influence on whether the first permanent molar is the first tooth to erupt in the four quadrants, acting as predictor variables. Age, height, weight, BMI and BMI category behave as predictors of the symmetry of the eruption.