Postoperative prognosis of unerupted teeth after removal of supernumerary teeth or odontomas

Abstract

Impacted teeth do not always erupt spontaneously after removal of supernumerary teeth or odontomas. The purpose of this study was to examine the effect of several variables on eruption of impacted teeth in children with supernumeraries or odontomas. The sample consisted of 53 patients with 69 impacted teeth; the supernumeraries or odontomas were removed without other interventions. The patients were identified retrospectively and followed until the impacted teeth erupted to their correct positions or until orthodontic traction was started. Loss of space, a second surgical procedure, a third surgical procedure, and orthodontic treatment were recorded in 77.6%, 53.8%, 9.4%, and 85% of the patients, respectively. Spontaneous eruption occurred in 83%, 75%, 46%, 19%, and 32% of the impacted teeth with normal and small size superlative, conical, tuberculated, and odontoma forms, respectively. In the univariate analysis, spontaneous eruption correlated with apex distance of the impacted tooth relative to its estimated position (P <.001), extent of vertical impaction (P <.001), obstacle form (P <.019), stage of root development of supernumerary tooth (P = .006), angle of impaction relative to the midline (P = .015), and time of surgery (P = .05). In the multivariate logistic regression analysis, higher distraction of the apex of the impacted tooth relative to its estimated correct position and the obstacle form (tuberculated and odontomas) were independently associated with impediment of spontaneous eruption (P = .03 and P = .04, respectively). Spontaneous eruption of impacted teeth correlated mostly with lower distraction of the impacted tooth apex and obstacle form (conical and superlative). Immediate orthodontic traction is recommended concomitantly with the first surgery to remove supernumerary teeth.