To extract or not to extract? Management of infraoccluded second primary molars without successors

Abstract

Infraocclusion is a term used to describe a tooth which has stopped its relative occlusal growth into the arch after the period of active eruption; as a result, the tooth becomes depressed below the occlusal plane. Although many aetiological mechanisms have been proposed, ankylosis is considered the primary cause of infraocclusion. Complex cases benefit from multidisciplinary management. This paper concentrates on the diagnosis and management of infraoccluded second primary molars, without permanent successors and without significant malocclusion, and provides clinicians with a treatment decision tree to aid in treatment planning.

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References

  1. 1.

    Ekim S L, Hatibovic-Kofman S. A treatment decision-making model for infraoccluded primary molars. Int J Paediatr Dent 2001; 11: 340-346.

  2. 2.

    Via W F Jr. Submerged deciduous molars: familial tendencies. J Am Dent Assoc 1964; 69: 127-129.

  3. 3.

    Bjerklin K, Kurol J, Valentin J; Ectopic eruption of maxillary first permanent molars and association with other tooth and developmental disturbances. Eur J Orthod 1992; 14: 369-375.

  4. 4.

    Kurol J. Infraocclusion of primary molars: an epidemiologic and familial study. Community Dent Oral Epidemiol 1981; 9: 94-102.

  5. 5.

    Andlaw R J. Submerged deciduous molars: a review, with special reference to the rationale of treatment. J Int Assoc Dent Child 1974; 5: 59-66.

  6. 6.

    Brearley L J, McKibben D H Jr. Ankylosis of primary molar teeth. I. Prevalence and characteristics. ASDC J Dent Child 1973; 40: 54-63.

  7. 7.

    Dewhurst S N, Harris J C, Bedi R. Infraocclusion of primary molars in monozygotic twins: report of two cases. Int J Paediatr Dent 1997; 7: 25-30.

  8. 8.

    Douglass J, Tinanoff N. The aetiology, prevalence, and sequelae of infraclusion of primary molars. ASDC J Dent Child 1991; 58: 481-483.

  9. 9.

    Mueller C T, Gellin M E, Kaplan A L, Bohannan H M. Prevalence of ankylosis of primary molars in different regions of the United States. ASDC J Dent Child 1983; 50: 213-218.

  10. 10.

    Krakowiak F J. Ankylosed primary molars. ASDC J Dent Child 1978; 45: 288-292.

  11. 11.

    Biederman W. The incidence and aetiology of tooth ankylosis. Am J Orthod 1956; 42: 921-926.

  12. 12.

    Kjaer I, Fink-Jensen M, Andreasen J O. Classification and sequelae of arrested eruption of primary molars. Int J Paediatr Dent 2008; 18: 11-17.

  13. 13.

    Steigman S, Koyoumdjisky-Kaye E, Matrai Y. Submerged deciduous molars in preschool children: an epidemiologic survey. J Dent Res 1973; 52: 322-326.

  14. 14.

    Rune B. Submerged deciduous molars. Odontol Revy 1971; 22: 257-273.

  15. 15.

    Andlaw R J. Submerged deciduous molars: a prevalence survey in Somerset. J Int Assoc Dent Child 1977; 8: 42-45.

  16. 16.

    Leonardi M, Armi P, Baccetti T, Franchi L, Caltabiano M. Mandibular growth in subjects with infraoccluded deciduous molars. Angle Orthod 2005; 75: 927-934.

  17. 17.

    Noble J, Karaiskos N, Wiltshire W A. Diagnosis and management of the infraerupted primary molar. Br Dent J 2007; 203: 632-634.

  18. 18.

    Teague A M, Barton P, Parry W J. Management of the submerged deciduous tooth: I. Aetiology, diagnosis and potential consequences. Dent Update 1999; 26: 292-296.

  19. 19.

    Biederman W. The problem of the ankylosed tooth. Dent Clin North Am 1968; 409-424.

  20. 20.

    Curl L, Tan C W, Dreyer C W, Samspson W. A qualitative investigation of RANKL, RANK and OPG in a rat model of transient ankylosis. Aust Orthod J 2014; 30: 143-151.

  21. 21.

    Raghoebar G M, Boering G, Stegenga B, Vissink A. Secondary retention in the primary dentition. ASDC J Dent Child 1991; 58: 17-22.

  22. 22.

    Tieu L D, Walker S L, Major M P, Flores-Mir C. Management of ankylosed primary molars with premolar successors: a systematic review. J Am Dent Assoc 2013; 144: 602-611.

  23. 23.

    Becker A, Karnei-R'em R M. The effects of infraocclusion: Part 1. Tilting of the adjacent teeth and local space loss. Am J Orthod Dentofacial Orthop 1992; 102: 256-264.

  24. 24.

    Arhakis A. Boutiou E. Etiology, Diagnosis, Consequences and Treatment of Infraoccluded Primary Molars. Open Dent J 2016; 10: 714-719.

  25. 25.

    Santos L L. Treatment planning in the presence of congenitally absent second premolars: a review of the literature. J Clin Paediatr Dent 2002; 27: 13-17.

  26. 26.

    Henderson H Z. Ankylosis of primary molars. a clinical, radiographic, and histologic study. ASDC J Dent Child 1979; 46: 117-122.

  27. 27.

    Thornton M, Zimmerman E R. Ankylosis of primary teeth. J Dent Child 1964; 31: 120-126.

  28. 28.

    Fernandes M, de Ataide I, Wagle R. Tooth resorption part II - external resorption: Case series. J Conserv Dent 2013; 16: 180-185.

  29. 29.

    Bjerklin K, Bennett J. The long-term survival of lower second primary molars in subjects with agenesis of the premolars. Eur J Orthod 2000; 22: 245-255.

  30. 30.

    Altay N, Cengiz S B. Space-regaining treatment for a submerged primary molar: a case report. Int J Paed Dent 2002; 12: 286-289.

  31. 31.

    Sabri R. Management of over-retained mandibular deciduous second molars with and without permanent successors. World J Orthod 2008; 9: 209-220.

  32. 32.

    Kurol J, Thilander B. Infraocclusion of primary molars with aplasia of the permanent successor: A longitudinal study. Angle Orthod 1984; 54: 283-294.

  33. 33.

    Evans R D, Briggs P F. Restoration of an infraoccluded primary molar with an indirect composite onlay: A case report and literature review. Dent Update 1996; 23: 52-54.

  34. 34.

    Kennedy D B. Treatment strategies for ankylosed primary molars. Eur Arch Paediatr Dent 2009; 10: 201-210.

  35. 35.

    Ostler M S, Kokich V G. Alveolar ridge changes in patients with congenitally missing mandibular second premolars. J Prosthet Dent 1994; 71: 144-149.

  36. 36.

    Kokich V G, Kokich V O. Congenitally missing mandibular second premolars: Clinical options. Am J Orthod Dentofacial Orthop 2006; 130: 437-444.

  37. 37.

    Sandor G K, Kainulainen V T, Queiroz J O, Carmichael R P, Oikarinen K S. Preservation of ridge dimensions following grafting with coral granules of 48 post-traumatic and post-extraction dento-alveolar defects. Dent Traumatol 2003; 19: 221-227.

  38. 38.

    Smalley W M. Comprehensive Interdisciplinary Management of Dentitions with Missing and/or Abnormally Proportioned Teeth. In Cohen M (ed) Interdisciplinary Treatment Planning: Principles, Design and Implementation. New Malden: Quintessence, 2008.

  39. 39.

    Fines C D, Rebellato J, Saiar M. Congenitally missing mandibular second premolar: Treatment outcome with orthodontic space closure. Am J Orthod Dentofacial Orthop 2003; 123: 676-682.

  40. 40.

    Becker A, Shochat S. Submergence of a deciduous tooth: its ramifications on the dentition and treatment of the resulting malocclusion. Am J Orthod 1982; 81: 240-244.

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Correspondence to Lewis Hua.

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Hua, L., Thomas, M., Bhatia, S. et al. To extract or not to extract? Management of infraoccluded second primary molars without successors. Br Dent J 227, 93–98 (2019). https://doi.org/10.1038/s41415-019-0207-9

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