The prevalence of infraoccluded or impacted primary molars was reported to be from 1.3% to 8.9% of the population with higher incidence between siblings. This is a report of a rare case of a 10-year-and-11-month-old boy with a previously erupted primary maxillary right second molar that was restored by with an amalgam filling at about three years of age. After seven years, the said tooth was found X-ray photographically to be completely embedded into the alveolar bone with an "impacted" maxillary permanent second premolar. There was also mesial tipping of the adjacent permanent first molar. The management of this case included the use of a space regainer to correct the molar tipping, surgical removal of the ankylotic infraoccluded primary molar and the use of a palatal holding arch to correct the torsiversion. This report underscores the need for early recognition of infraoccluded/ ankylosed primary teeth by dentists for regular monitoring and timely and appropriate intervention. Infraocclusion in primary dentition is mainly in primary molars which develop during the early mixed dentition. The prevalence of infraoccluded primary molars was reported to be from 1.3% to 8.9% of the population 1,2) with higher incidence between siblings 3,4). In many cases, they appear below the plane of occlusion above the gingival margin but a few can be severely occluded to be covered by gingiva 2) or become totally embedded in bone 5). If left untreated, the commonly reported occlusal consequences are space loss due to tipping of adjacent teeth and/or over eruption of the opposing teeth 2). Other complications include the insufficient development of adequate width and height of supporting bone which may complicate future dental treatment 6). Severe infraocclusion in primary molars
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