Abstract
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.
Highlights
Tooth impaction is a relatively common clinical situation in dental offices and about 1% to 2% of orthodontic patients have impacted tooth [1]
The lack of eruption of these elements may be associated with several factors, such as the presence of a supernumerary tooth, prolonged retention of the deciduous tooth, abnormal position of the impacted tooth, lack of space for eruption, root lacerations, alveolar or dental trauma and ankylosis [3,4,5,6,7]
A permanent tooth erupts from the alveolar bone when approximately two-thirds of the root have formed and erupts into the oral cavity at approximately three fourths to complete root formation with a wide-open apex [10,11]
Summary
Tooth impaction is a relatively common clinical situation in dental offices and about 1% to 2% of orthodontic patients have impacted tooth [1]. The first phase of the treatment was over and the lingual arch was kept in place until the eruption of the mandibular second premolars two years later (Fig. 1D). Due to the clinical aspects, the aim of the treatment was to correct the Angle Class II malocclusion and anterior deep bite as well as to allow the eruption of the left central and lateral incisors. The treatment plan involved the extraction of the maxillary left deciduous central incisor and two interceptive treatment alternatives were purposed: to keep the space for the development of the dentition and wait for the spontaneous irruption of the permanent teeth and the complete rhizogenesis of maxillary left canine. Two years later, with almost complete rhizogenesis, the permanent maxillary left lateral incisor begun to erupt without the need for orthodontic traction (Fig. 2A-H)
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