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Failure of eruption of teeth happens when a single or multiple teeth fail to erupt in the mouth. This can happen due to many reasons which may include obstruction from primary teeth, bone surrounding the unerupted tooth or other mechanical factors. The two types of failure of eruption are primary failure of eruption and mechanical failure of eruption. Primary failure of eruption has been known to be associated with Parathyroid hormone 1 receptor mutation.^[1]

Primary failure of eruption

The term primary failure of eruption was named by William Proffit and Katherine Vig in 1981.^[2]^[3] This type of failure of eruption has a genetic or familial background precursor as a cause. The prevalence is of PFE is about 0.06% in population. In this type of failure, teeth that are non-ankylosed fail to erupt in the mouth. These teeth do not have a precursor tooth that is blocking their path. These teeth tend to erupt partially but then fail to erupt as the time goes on. Profitt stated that only the posterior teeth are the ones to be affected and all the teeth which are distal to the affected tooth are also affected. Both permanent and primary teeth may equally be affected. This often results in posterior open bite in patients mouth who have primary failure of eruption. This phenomenon can occur in any quadrant of the mouth.

There are two types of primary failure of eruption. Type I involves failure of eruption of teeth distal to the most mesial affected tooth to be all same. Type II involves a greater eruption pattern, not complete, among the teeth distal to the most mesial affected tooth. It is difficult to diagnose between these two types of failure of eruption because 2nd molar does not erupt until a patient is 15 years of age. Plenty of times, patient's receive orthodontic care much before they turn 15 years old. Therefore, to properly diagnose between two types, a patient needs to be over 15 and a definitive proof of uneruption of 2nd molar is required.

Management

Management of teeth with PFE can include extractions of affected teeth, followed by orthodontic space closure or placement of a prosthetic implant with a bone graft. This option can only be applied to a single tooth that is affected. If multiple teeth are affected then, a segmental osteotomy may be performed to bring the entire segment into occlusion.^[4] However, minimal success has been shown following this procedure.^[5] These teeth usually are "non-responsive" to the orthodontic force and studies have shown that ankylosis of these teeth can occur if force applied.

Mechanical failure of eruption

This type of failure of eruption takes place when the affected tooth is ankylosed to the bone around it. This is different from primary failure of eruption where the affected tooth/teeth were not ankylosed. In mechanical failure of eruption, affected tooth has partial or complete loss of PDL in a panoramic radiograph and teeth distal to affected tooth do not have this condition.^[6]^[7] On a percussion test, a tooth with mechanical failure of eruption will have a dull metallic sound.

Eruption failure related to syndrome

There have been many syndromes which have been identified to be related to failure of eruption of teeth. These syndromes are Cleidocranial dyspalsia, Osteoporosis, Rutherford syndrome, GAPO syndrome and Osteoglophonic dysplasia.

References

^ Decker, Eva; Stellzig-Eisenhauer, Angelika; Fiebig, Britta S.; Rau, Christiane; Kress, Wolfram; Saar, Kathrin; Rüschendorf, Franz; Hubner, Norbert; Grimm, Tiemo (2008-12-01). "PTHR1 loss-of-function mutations in familial, nonsyndromic primary failure of tooth eruption". American Journal of Human Genetics. 83 (6): 781–786. doi:10.1016/j.ajhg.2008.11.006. ISSN 1537-6605. PMC 2668057. PMID 19061984.
^ Frazier-Bowers, Sylvia A.; Koehler, Karen E.; Ackerman, James L.; Proffit, William R. (2007-05-01). "Primary failure of eruption: further characterization of a rare eruption disorder". American Journal of Orthodontics and Dentofacial Orthopedics. 131 (5): 578.e1–11. doi:10.1016/j.ajodo.2006.09.038. ISSN 1097-6752. PMID 17482073.
^ Proffit, William R.; Vig, Katherine W. L. (1981-08-01). "Primary failure of eruption: A possible cause of posterior open-bite". American Journal of Orthodontics. 80 (2): 173–190. doi:10.1016/0002-9416(81)90217-7. PMID 6943937.
^ Ahmad, Sofia; Bister, Dirk; Cobourne, Martyn T. (2006-12-01). "The clinical features and aetiological basis of primary eruption failure". The European Journal of Orthodontics. 28 (6): 535–540. doi:10.1093/ejo/cjl033. ISSN 0141-5387. PMID 17041084.
^ Susami, Takafumi; Matsuzaki, Masako; Ogihara, Yuji; Sakiyama, Miyuki; Takato, Tsuyoshi; Sugawara, Yasushi; Matsumoto, Shigeyuki (2006-09-01). "Segmental alveolar distraction for the correction of unilateral open-bite caused by multiple ankylosed teeth: a case report". Journal of Orthodontics. 33 (3): 153–159. doi:10.1179/146531205225021572. ISSN 1465-3125. PMID 16926308. S2CID 19262770.
^ Rasmussen, P.; Kotsaki, A. (2017-02-01). "Inherited primary failure of eruption in the primary dentition: report of five cases". ASDC Journal of Dentistry for Children. 64 (1): 43–47. ISSN 1945-1954. PMID 9096818.
^ "Primary failure of eruption of primary molars: A review and case report". www.quintpub.com. Retrieved 2016-11-29.

Deep A, Thakur S, Jayam C. An interesting case of unilateral multiple impacted unerupted teeth in a young adolescent child: A case report and discussion. J Nat Sc Biol Med 2021;12:256‑9.

(PDF) An interesting case of unilateral multiple impacted unerupted teeth in a young adolescent child: A case report and discussion. Available from: https://www.researchgate.net/publication/353253108_An_interesting_case_of_unilateral_multiple_impacted_unerupted_teeth_in_a_young_adolescent_child_A_case_report_and_discussion [accessed Aug 10 2021].