Etiology, Diagnosis, Consequences and Treatment of Infraoccluded Primary Molars

Abstract

Infraocclusion is a condition where teeth are found with their occlusal surface below the adjacent teeth, long after they should have reached occlusion. Many terms have been used to describe this condition; the most commonly used being submergence and ankylosis. Infraocclusion is classified as slight, moderate or severe. Studies have shown the commonness ratio of infraocclusion in kids being 1.3-8.9% with an equal male: female ratio. The frequency of infraocclusion of primary molars of mandible is 10-fold higher in contrast to those of the maxilla. Some studies showed that the first mandibular primary molars are most often affected, but others support the second one. Infraoccluded primary molars appear with an increase in 3 year-old children reaching a peak in 8-9 years of age. The main cause is ankylosis, followed by heredity, trauma, infection and various other theories. However, the etiology is still uncertain. Radiographically, an obliteration of the periodontal ligament can be seen using conventional methods and the CT-method can also be used to reveal greater detail. Clinically, other than submersion, a sharp, solid sound is heard on percussion, in contrast to a softer sound in the normal teeth. Infraoccluded primary teeth can cause occlusal disturbances, tilting of the adjacent teeth, supra-eruption of the antagonists, ectopic eruption or impaction of the successor premolars. A treatment decision must take into account whether there is a permanent successor or not. In the first case, patient monitoring is recommended, because these primary teeth usually exfoliate normally. However, in the second case, the therapeutic approach is not standard. The aim of this review of literature was to elucidate the available evidence concerning infraocclusion, its etiology, diagnosis, clinical characteristics, consequences and treatment.

Gömülü Süt Azı Dişlerin Prevalansı: Retrospektif Bir Çalışma

“…Arkharis ve Boutiou ile Kara ve ark. çalışmalarında belirttiği gibi, cinsiyet ile gömülü süt azı gözlenme sıklığı arasında çalışmada istatistiksel olarak anlamlı bir farklılık bulunmasa da erkeklerde kadınlardan daha fazla izlendi (8,18).…”

“…Fiziksel bir bariyer veya dişin anormal pozisyonu nedeniyle sürmenin durması olan gömülü kalma olayı klinik veya radyografik olarak saptanabilmektedir (5). Bir diş hiç sürmeden gömülü olarak kalmışsa primer gömülü (Şekil 1a), sürdükten sonra tekrar gömülü kalmışsa yani oral mukozaya ulaştıktan sonra daha fazla sürememiş ise sekonder gömülü olarak adlandırılmaktadır (Şekil 1b) (6)(7)(8). Literatürde sekonder gömülü terimi yerine batık, infraoklüzyon, sekonder retansiyon, yarı retansiyon, reimpaksiyon ve reinklüzyon terimleri de kullanılmaktadır (7,9).…”

“…Süt dişlerinin gömülü kalmasına sık rastlanılmasa da eğer sürme zamanı geldiği halde diş ağız içinde görülmüyorsa diş hekimi durumdan şüphelenmeli ve radyografi alarak kesin tanıya varmalıdır (10). Gömülü süt dişleri kistik lezyonlar, odontojenik tümörler, nevraljiform ağrılar, alveol proses gelişiminde eksiklik, temporamandibular eklem sorunları, komşu dişlerde rezorbsiyon, malpozisyon ve periodontal problemler, karşıt dişlerde supraerüpsiyon, ortodontik kuvvetlere cevap vermeme, altında bulunan daimi dişlerin sürmesini engelleme, dişlerin normal mezial driftini engelleme ve maloklzyon gibi sorunlara yol açabilmektedir (4,8,10). Eğer gömülü kalma durumu erken dönemde meydana gelirse ve geç teşhis edilirse ortaya çıkabilecek sorunların riski çok daha ciddi düzeyde olmakta ve bu durum tedavi planını direkt olarak etkilemektedir (11).…”

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

“…A high-pitched percussive tone has been described due to the ankylosis of the tooth to the surrounding bone, but this is a largely a subjective measure as it only occurs when at least 20% of the root surface is ankylosed 22 . Other clinical features include an apical position of the gingival margin, overeruption of opposing teeth, lateral open bites and incomplete alveolar process development 24 .…”

Developmental Dental Anomalies of Primary and Permanent Dentition

“…The exfoliation of ankylosed primary molars typically follows the normal exfoliation schedule with a normal resorption pattern that warrants no further treatment. However, when evidence of tipping of adjacent teeth or supra-eruption of opposing primary teeth are noted, then definitive restorations such as stainless-steel crowns ( Figure 7) or a composite build-ups can be planned to restore the occlusal plane [56]. When ectopic eruption of the succedaneous, premolar, is noted then extraction of ankylosed primary molar should be considered [54].…”