Failure of eruption of first permanent molar teeth: a diagnostic challenge

Abstract

Ankylosis, mechanical and primary failure of eruption of molar teeth are rare and often difficult to distinguish between. All may have significant repercussions on the occlusion and successful management may involve invasive procedures. We present a case where an initial presentation characteristic of mechanical failure of eruption (ankylosis) of a first permanent molar tooth was excluded following a period of monitoring. Subsequent relief of crowding using a removable and then sectional fixed orthodontic appliance allowed spontaneous eruption of the tooth obviating the need for surgical intervention. This case highlights the utilisation of conservative treatment options until a diagnosis was confirmed to minimise the risk of iatrogenic damage and unnecessary treatment.

Correction of bilateral heavily impacted second molar with improved super-elastic nickel-titanium alloy wires

“…9 Because achieving extrusion of the ankylosed molars with orthodontic force is difficult, extraction is the most common solution. 30 As previously reported, extraction of permanent molars is an effective method to increase retromolar space to eliminate posterior crowding; moreover, premolar extractions may positively affect molar eruption space. 31 Orthodontic treatment with premolar extraction considerably increases retromolar space because of the mesial movement of the molars during space closure, compared with nonextraction treatment.…”

Review and case report of the treatment in a young girl with primary failure of eruption

“…An interdisciplinary approach is required when considering the management of this rare condition. The various treatment options include the following [22][23][24][25][26] :…”

“…An interdisciplinary approach is required when considering the management of this rare condition. The various treatment options include the following 22‐26 : Accept the infraocclusion. Restorative correction of the occlusion once growth has ceased. Coronal build‐up or onlay of the affected teeth. A removable prosthesis over the affected teeth. Extraction of affected teeth and prosthetic replacement. Surgical repositioning of the affected area with a segmental osteotomy once growth has ceased, although limited success has been reported using this approach …”

Sampling, testing and interpreting a test’s result

“…Let’s move now to scenario 1, where the percussion test is used indiscriminately to all patients entering our practice, be it young or old, and in any phase of their dentition without any specific clinical symptoms. In such a case, an experienced clinician might expect a very low rate of ankylosed teeth for the general population (Mubeen and Seehra, 2018)—let’s say of 1%.…”