Hakima Aghoutan

By Sana Alami, Hakima Aghoutan, Samir Diouny, Farid El Quars and Farid Bourzgui

Part of the book: A Textbook of Advanced Oral and Maxillofacial Surgery

By Fatiha Rhrich and Hakima Aghoutan

Dental development is a complex process by which teeth from embryonic cells grow and erupt into the mouth. It is governed by epithelio-mesenchymal interactions. The biological mechanism is the same for all teeth; however, epithelial signaling and homeogenous combinatorics are different from one type of tooth to another. The primary dental blade splits into the vestibular and primary dental blades opposite to the mesenchymal condensation. During dental development, three successive stages are described: bud, cup, and bell. The secondary dental blade responsible for the formation of germs in permanent teeth is formed from the primary dental blade in the bell stage. For the central incisor, lateral incisor, canine, first temporary molar, and second temporary molar, each primary dental blade gives rise to a single secondary dental blade for the corresponding permanent tooth. On the other hand, the primary dental blade of the second temporary molar will cause the formation of four secondary dental blades that will cause the formation of permanent germs of the second premolar, the first permanent molar, the second permanent molar, and the third permanent molar. The objective of this chapter is to focus on the cellular and molecular mechanisms explaining the normal development of molars by presenting the different current data and theories of science illustrating the human molar embryological development.

Part of the book: Human Teeth

By Hakima Aghoutan, Sanaa Alami, Amal El Aouame and Farid El Quars

In the daily practice, the orthodontist may be confronted with particular clinical situations with one or more missing teeth. This can complicate the therapeutic plan and influence the choice of possible extractions imposed by treatment requirements. In case of permanent molar absence, making decision becomes even more delicate. The practitioner must use his/her critical sense and clinical common sense to make the right choice between closing and redeveloping the residual spaces. Its choice must meet the patient’s expectations and correct the clinical problem without risking overtreatment, or extending duration care. Several factors guide the therapeutic decision, ranging from the patient’s age to economic factors, not to mention the technical complexity, therapeutic predictability, and patient comfort, which determine proper compliance and therefore success. In this chapter, we will focus on these decision-making factors by determining the scientific evidence level in terms of success, survival, and patient-centered outcomes (quality of life and functional efficiency).

Part of the book: Human Teeth