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Management of infra-occluded primary molars

From Volume 45, Issue 7, July 2018 | Pages 625-633

Authors

Roshanak Attwall

BChD, MFDS RCS(Ed)

Maxillofacial Surgery Senior House Officer, Northwick Park Hospital, Harrow Middlesex

Articles by Roshanak Attwall

Kate Parker

BDS(Hons), BA(Hons), MJDF RCS(Eng), MOrth RCS(Eng), FDS(Orth) RCS(Eng)

Orthodontic Specialty Registrar, Department of Orthodontics, Eastman Dental Hospital

Articles by Kate Parker

Daljit S Gill

BDS, BSc, MSc, FDS RCS, MOrth, FDS(Orth) RSC(Eng)

Consultant Orthodontist/Honorary Senior Lecturer, UCL Eastman Dental Institute, Honorary Consultant Orthodontist, Great Ormond Street Hospital, London

Articles by Daljit S Gill

Abstract

Abstract: This article reviews the aetiology, diagnosis and management of infra-occluded primary molars. The different treatment options are detailed as well as the differences in the management of patients depending on their age, the severity of the infra-occlusion and whether the permanent successor is present or absent.

CPD/Clinical Relevance: The ability to identify and diagnose infra-occluded primary molars is crucially important for their subsequent management. Knowledge of the different treatment options and their relevance in different clinical situations is important for all dental healthcare professionals.

Article

Infra-occlusion occurs when the eruptive mechanism of a tooth fails, which leads to the tooth failing to maintain its vertical position relative to the adjacent teeth.1 The marginal ridges of the infra-occluded tooth are below the marginal ridges of the adjacent teeth and the tooth lies below the occlusal plane2 (Figure 1). Infra-occlusion can affect both the primary and permanent dentition.3 It predominantly affects mandibular primary molars, with the mandibular second primary molar being most commonly affected followed by the mandibular first primary molar.4 The incidence of infra-occluded primary molars has been reported to range from 1.3–8.9%,5,6 however, some reports suggest that it can be as high as 38.5%.7 The incidence varies with patient age, but most frequently develops in the mixed dentition between the ages of 8–9 years old.4,8,9

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