Permanent First Molar Eruption Failure in Children: clinical management of three clinical scenarios

Background Eruption failure in the mixed dentition presents many\r\nchallenges, but eruption disorders in a child patient offer solutions\r\nthat are not possible in adult patients. The opportunity to remedy\r\nthe occlusal outcomes for eruption problems in the mixed dentition\r\ndepends on the type of problem; we consider three major categories\r\nof eruption problems and corresponding management strategies.\r\nThe distinction between a mechanical failure of eruption (MFE),\r\nankylosis of a single tooth, or Primary Failure of Eruption (PFE) due\r\nto a genetic defect that alters dental eruption is key to the potential\r\nintervention. The therapeutic solutions proposed in the literature differ\r\ngreatly for the three clinical scenarios. In MFE, orthodontic therapy\r\ncan be successful if the obstacle to eruption is identified early. For\r\ncases of ankylosis, the affected tooth can be extracted, and the\r\nspace closed orthodontically if timed appropriately. A diagnosis of\r\nPFE, however, carries a certain poor prognosis with a continuous arch\r\nwire; orthodontic forces will result in the intrusion of adjacent teeth.\r\nCase report We evaluated the clinical outcomes of three patients\r\npresenting with eruption failure of the permanent first molar(s) due to:\r\n1) ankylosis; 2) MFE; and 3) PFE. Taken together, these cases provide\r\nindications for treatment possibilities supporting the growing patient.\r\nConclusion Early treatment of ankylosis can yield positive results, but\r\nthe possibility of failure must be considered and, therefore, monitored\r\ncarefully. For MFE, the timing of intervention should align with patients\r\nin the late mixed dentition. Finally, a diagnosis of PFE carries the\r\ncertainty that affected teeth cannot be moved orthodontically; the\r\nresultant dentoskeletal development may however benefit from a\r\nfunctional orthopaedic appliance to prevent asymmetric growth.