The conservative approach to managing unerupted lower premolars -- two case reports

Spontaneous Eruption of Severely Impacted teeth: The Report of Two Cases

The unerupted and impacted tooth is a common problem and the reason for many orthodontic and pediatric dental referrals, yet the approach to their management is still an area of controversy. This article presents two cases of severely impacted teeth that spontaneously erupted in the maxillary and mandibular arches. The first patient, a 9-year-old girl, presented a severe impaction of mandibular right and left second premolars. The second patient, a 7-year-old girl, presented with a severely impacted maxillary central incisor. In both cases, the teeth spontaneously erupted into excellent positions without surgical procedures and orthodontic traction. This raises important questions concerning the possible treatment options for such teeth as well as the timing of any interceptive treatment. In cases of unerupted or impacted teeth, a multidisciplinary approach is indicated involving orthodontics, paedodontics and oral surgery to establish the optimal treatment plan.

Key words:Tooth eruption, tooth, impacted, orthodontics, interceptive, case reports.

[Current situation of clinical research on impacted premolars]

Teeth impaction is a common developmental malformation in oral diseases. Impacted teeth are usually the canines, third molar, central incisors, premolars, and second molars. The prevalence of impaction of maxillary canines and mandibular wisdom teeth is higher than that of other teeth. Most recent studies have focused on the canines and third molars, but research on impacted premolars is limited. In clinical practice, the majority of orthodontic patients require premolar extraction. Thus, impacted premolars play important roles in orthodontic design and prognosis. This article provides an overview of recent research on impacted premolars and summarizes epidemiological features, localizations, and treatments, with the aim of guiding practitioners on orthodontic design and therapy.

Prevalence of impacted and transmigrated canine teeth in a Cypriote orthodontic population in the Northern Cyprus area

Background

The aim of this study was two-fold; (1) to evaluate the prevalence and patterns of impacted canines and transmigrated canine teeth, and (2) to evaluate the possible relationships between impacted teeth, malocclusions and systemic conditions in an orthodontic patient population.

Methods

The clinical records and panoramic radiographs of 453 patients [201 (44.3%) male and 252 (55.7%) female] referred to our outpatient clinic between January 2008 and January 2012 were retrospectively evaluated. The number, position, localization (right/left) and transmigration of teeth, as well as sex, age and systemic conditions of patients, were noted. An impacted canine was considered to be transmigrated when at least part of its length had crossed the midline. Complications related to impacted teeth (pain, cystic changes, root resorption or eruption disturbance of adjacent teeth) were also noted. A p-value less than 0.05 was considered statistically significant.

Results

Impacted and transmigrated canine teeth were found in 16 (3.53%) and two (0.44%) patients in the study group, respectively. Root resorption was seen in four teeth adjacent to impacted canines. No statistical difference was found among gender, location, malocclusion and impaction of the teeth (p > 0.05). However, maxillary canine impaction occurred significantly more frequently than mandibular canine impaction (p < 0.05).

Conclusions

The early detection of impacted as well as transmigrated teeth is crucial for successful treatment, therefore demographic studies are important. Although larger samples are required, this study provides a baseline regarding the frequency and type of impacted canines in this particular population.

Management of complete impacted maxillary second deciduous molar with the aid of cone-beam computed tomography: Case report and a review of the literature

Complete impaction of primary teeth is a very rare condition and less seen at the dental office compared with permanent dentition. To report the use of cone-beam computed tomography in the management of a 7-year-old boy with completely impacted maxillary second deciduous molar due to the presence of odontoma and a cystic lesion.

Erbium laser treatment of an impacted first mandibular premolar: a case report

Dental impaction defines a tooth that, instead of erupting to occupy its functional position, is partially or totally retained and remains within the bone. Retained teeth can be placed in the normal arch position through a combination of orthodontics and conventional surgical techniques, or a combination of orthodontics and laser surgery, as in the case here presented of a 14-year-old boy with an impacted first mandibular premolar, covered by bone, and with complete root formation and an erupted second premolar. The impacted premolar was surgically exposed using an Er,Cr:YSGG laser and at the same time an orthodontic bracket was bonded to provide traction to move the first premolar into its arch position.