Diagnosis and Treatment Planning for Primary Molar Ankylosis along with Un-erupted Maxillary Premolar: Case Report

Abstract

Journal of Surgery Keywords:Submerged deciduous teeth; Dental ankyloses; Ectopic eruption IntroductionA favorable sequence of tooth eruption can be broken by a disturbance in the mixed dentition period leading to permanent tooth impaction [1]. Studies have related that the prevalence of impacted or unerupted premolars rank third in frequency after third molars and maxillary canines [2,3]. The prevalence of impacted premolars has been varied according to age [3,4]. The overall prevalence in adults has been reported to be 0.5% with a range is 0.1% to 0.3% for maxillary premolars and 0.2% to 0.3% for mandibular premolars [3,5].Tooth impaction refers to tooth that fail to erupt [5][6][7] whose etiological factors may involve arch length deficiency, mechanical blockage, ectopic positioning, malformed teeth, trauma, systemic diseases, and overretention of primary teeth or ankylosed primary teeth [2,8].Dentoalveolar ankylosis is an eruption anomaly defined as the union of the tooth root to the surrounding bone [2,[8][9][10][11][12][13][14][15] with local elimination of the periodontal ligament and it may impede the normal development of teeth [14,16]. The affected teeth are usually deciduous molars with the condition affecting the mandibular second molar most often and the maxillary first molar least often [17]. The etiology of this condition is still not well-defined [6,11,14,[17][18][19][20][21] and there is a debate due to the lack of knowledge about its biological mechanisms [22]. It is associated with trauma, metabolic disorders [9,23], developmental disturbance [24], genetic tendency [8], and a deficiency in vertical-bone growth [10]. A higher incidence occurs at the molar region during the deciduous and mixed dentition [15]. The incidence of deciduous-tooth dentoalveolar ankylosis was reported to be 1.5% to 9.9% [15].Diagnosis of dental ankylosis is generally established through clinical findings in which include metallic sounds upon percussion, lack of tooth AbstractBackground: Dentoalveolar ankyloses of the deciduous tooth may lead to collapse of the dental arch complicating eruption and development of the succedaneous permanent dentition. The early interceptive orthodontic treatment is recommended to avoid complications on the eruptive process of the successor tooth.Objective: The aim of this article is to report the orthodontic treatment of a patient with dentoalveolar ankylosis of the deciduous upper molar and impaction of the succeeding permanent teeth. Materials and methods:A 15 year-old female patient presented with a complaint about severely intruded maxillary left second deciduous molar and inclination of the adjacent tooth. Computed tomography scam (CT) showed that the premolars were found to be ankylosed and were extracted. The extraction spaces were closed by moving the posterior teeth mesially through NiTi closed springs with miniscrew anchorage. Results:In the maxillary arch, the first molars were positioned in the place of the second premolars. The occlusal posttreatment evaluation revealed a Cl...