Replacing buried teeth: A Review of primary failure of eruption of permanent teeth and case report

Primary failure of eruption (PFE) is a condition that involves malfunction of the eruptive mechanism, and results in incomplete eruption of the dentition in the absence of any identifiable mechanical obstacle or recognizable disorder.¹ PFE is an uncommon condition with a reported prevalence of 0.06% and which affects females more than males at a ratio of 2:1.^2,3

Although the aetiology of PFE is poorly understood, there is a growing body of evidence to suggest that it is genetic in origin.^2,4 In particular, studies have found a strong link between eruption failure and the mutation of the PTH1R gene.^4,5,6 As such, a positive test for the PTH1R gene mutation is considered confirmatory diagnosis of PFE, although it is accepted that a negative test does not necessarily rule out the condition.^4,5,7 More recent studies have supported PFE as an inherited condition.^4,8 A systematic review found that a familial pattern existed in 84% of cases.⁸ In addition, Frazier-Bowers et al found that 26% subjects with PFE had a previous family history.⁹ For subjects who did not have a family history, it has been speculated that spontaneous mutations are likely to have occurred.^1,8