Maxillary tooth transpositions and pressure root resorption: a case report

Abstract

Introduction: Tooth developmental disturbances may occur by anomalies in position, number, shape and tooth size [1], and is genetic-related [2–4]. Transposition is an unique and extreme form of ectopic eruption in which a permanent tooth develops and erupts in the position normally occupied by another [5]. Although transpositions are quite common in canines [6–8], this condition rarely occurs with incisors or premolars [6,9]. On the other hand, pathologic root resorption can be observed during eruption of permanent dentition [10], but is very unusual in maxillary first molar. Materials and methods: A 12-year-old male was referred to the Orthodontics Department of Egas Moniz Dental Clinic complaining with severe pain on the left side of the maxillary and premolars transposition on the right side. After clinical and radiographic examination, through orthopantomography and cone-beam computerized tomography (CBCT) severe root resorption of the left maxillary first molar caused by abnormal eruption of the second premolar was diagnosed. Futhermore, the transposition of the upper right premolars was confirmed and severe transversal collapses (Pont’s Premolar Index: -13,5 mm; Pont’s Molar Index: -14,4 mm), ectopic upper canines, maxillary compression, crossbite between 1.6 and 4.6, skeletal Class I and unilateral Angle Class II, diagnosed. Discussion and conclusions: According to the literature, the frequency of tooth transposition is less than 0.4% [7,8,11,12]. In most cases they are more common with unilateral occurrence [4,8,9], on the left side as opposed to the right side [7,8], and have been found more often in the maxilla [4,7]. Our case is significant because this patient is male and typically this has been found more often in females [4,6,7] and tooth transpositions in premolars and pressure root resorption of the maxillary first molar are extremely rare [6,9,10]. Figure 1. Intraoral view of transposition of maxillary permanent first and second premolars, bilateral ectopic of maxillary permanent canines, absence of the second premolar. Central image show a radiographic view that demonstrates impacted tooth pressure root resorption of maxillary first molar by an impacted second premolar. Right image show transposition of maxillary permanent first and second premolars.