Management of Bilateral Ectopically Erupting Maxillary Molars: A Case Report

Abstract

BackgroundEctopic eruption of the permanent first molar is a common eruption disorder occurring during mixed dentition. The prevalence of this condition ranges from 3% to 4% in children. It is described as an abnormal mesioangular eruption path of the first permanent molar with a possibility of initiating the premature resorption of the distal root of the adjacent primary second molar. Non-treatment can result in the early loss of the second primary molar, space loss, and impaction of second premolars. Various treatment modalities have been mentioned in the literature for the management of ectopic eruption.AimThis article presents the case of an eight-year-old boy with irreversible bilateral ectopic eruption of the permanent maxillary first molars.Case descriptionA modifed Croll's appliance was the treatment of choice to correct the path of eruption of the latter molars. An activation of the appliance was performed at intervals of two weeks.ConclusionThe result was obtained six weeks later and a regular follow-up was scheduled.How to cite this articleAmbriss B, Moukarzel C, et al. Management of Bilateral Ectopically Erupting Maxillary Molars: A Case Report. Int J Clin Pediatr Dent 2019;12(2):153–156.

Ectopic Permanent Molars: A Review

“…The treatment of ectopic molars and the time of intervention depend on several factors [ 30 ]. Although previous studies have agreed that by the age of seven 66% of ectopic molars are self-corrected, others have stated that spontaneous eruption will not happen if the first permanent molar is not fully erupted at that age [ 4 , 29 ]. Therefore, the initiation of the treatment should be started immediately after the diagnosis is established.…”

“…Multiple fixed or removable appliances are used in the distal tipping technique [ 7 , 30 ]. Examples are a removable appliance with active cantilever springs [ 34 ], the Humphrey appliance, the Halterman appliance ( Figure 3 and Figure 4 ) [ 35 ], sectioned wire with an open coil spring, a k-loop, and Croll’s appliance ( Figure 5 ) [ 4 , 30 ]. Some authors used these appliances along with surgical exposure of the first permanent molar for better accessibility to button bonding [ 36 ].…”

“…Nikiforuk defined ectopic eruption as a condition in which the permanent teeth, because of a deficiency of growth in the jaw or segment of the jaw, assume a path of eruption that intercepts a primary tooth, causing its premature loss and producing a consequent malposition of the permanent tooth [ 1 ]. Throughout the literature, the terms ectopic eruption and impaction have been used interchangeably, and this is due to the fact that an ectopically erupting tooth might present with various degrees of impaction [ 2 , 3 , 4 ]. This can be seen in cases where the impaction (failure of eruption) of the first permanent molar takes place at the distal prominence of the second primary molar, and thus studies that have referred to the ectopic eruption as impaction were included.…”

Prevalence and characteristics of ectopic eruption of the first permanent molar and predictive factors for clinical outcome

“…12,13 While the etiology of ectopic eruption of FPMs remains unclear, it is believed that both local factors and genetic factors play a role in its development. 14 According to extensive studies, the possible etiologic factors causing this anomaly include the abnormal eruption pathway of the permanent molars, bone-tooth size discrepancies (abnormally large first permanent and second primary molars), 15,16 delayed calcification and development of the FPM, 15,17 crowding, 16 malocclusion, 17 small arches, 3,15 posteriorly positioned maxilla relative to the cranial base, 15,18 and inadequate anterior movement of primary dentition. 3 Also, it has been reported that ectopic eruption has a familial tendency considering to the increased prevalence reported in siblings.…”