Orthotown June 2019 - 17

dhmjdds

I had another patient a few years ago with the same tooth ankylosed, but that case was more
obvious, and as I remember he had a history of severe caries in primary teeth with multiple
abscesses, so I always thought that was somehow related in that case. This current patient has
an immaculate mouth. ■

Member Since: 11/16/04
Post: 5 of 15

2/27/2019

fesdds

Especially since the UR7 is not through tissue I would extract UR6 and just allow the UR7
to drift mesially as long as possible. For what it is worth, I have seen quite a few of these scenarios.
None can remember an injury. A few we left the 6 submerged and just lined up all the other teeth
and the 7. The others we mesialized the 7. ■

Member Since: 05/22/08
Post: 6 of 15

2/27/2019

justinudm

I would also ask the OMFS if he/she thinks a bone graft after extraction of the UR6 would
be wise. I say this because I would not want to bring the UR7 through a boney defect later on. ■

Member Since: 09/29/14
Post: 7 of 15

2/28/2019

Terry Gruelle

I posted this a while back regarding a similar tooth. Maybe it will be relevant here.
[Editor's note: View this message board online to view this link.]
Best of luck. Terry ■

Member Since: 05/03/08
Post: 8 of 15
2/28/2019

lewbsample

If roots are not dilacerated and no other mechanical explanation can be found, then the only
explanation is primary failure of eruption (PFE). Have had a number of these. Can be limited
to a single tooth-most commonly a first molar-but can also involve multiple teeth. My oral
exam on the ABO included a case of PFE involving an entire segment. The problem is genetic.
Dr. Sylvia Frazier-Bowers at UNC has written and lectured on the problem. Here's a link to a
2007 article in the AJO.
[Editor's note: View this message board online to view this link.]
These teeth do not respond to orthodontic forces. I would extract the 6 and hope that the 7
is not involved and can be substituted. Good luck. ■

Member Since: 10/24/11
Post: 9 of 15

2/28/2019

dhmjdds

I have to disagree with your characterization of this as PFE. PFE affects all teeth distal to
the affected tooth; in this case, the second molar has erupted farther than the first molar. Now,
we cannot be certain that the second molar will continue to erupt, of course, but this is not
the presentation of PFE described in the literature. Also, it does appear that the first molar did
erupt at first, but then something happened, and it stopped erupting, giving it the appearance of
"de-erupting" as the rest of the teeth and jaws continued to grow. ■

Member Since: 11/16/04
Post: 11 of 15

3/4/2019

Every case is a journey with multiple paths!
This message board is a great example of how Townies can get advice and
share different techniques with their peers. To see more cases like this or to
share your own, visit orthotown.com/messageboard.

orthotown.com \\ JUNE 2019

17


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Orthotown June 2019

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