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Delayed eruption is a commonly encountered problem and its management poses an orthodontic challenge that should be considered on a case-by-case basis. The stage of root development, root morphology and degree of ectopia, as well the patient's age and any relevant medical history, are essential in determining the prognosis for spontaneous eruption. This case series demonstrates three cases where spontaneous eruption was unexpected, owing to various factors. These cases highlight the importance of removal of occlusal obstructions and an observation period to allow for improvement in position of an unerupted tooth before definitive treatment decisions are made.
CPD/Clinical Relevance: Determining the potential for future spontaneous eruption, or improvement in position, can minimize the need for prolonged orthodontic management or potential prosthetic replacement.
Article
Eruption is the process of a tooth moving occlusally from its developing position within the alveolar bone, through the oral mucosa, to a functioning position within the oral cavity. Various factors may cause disturbances in the process of eruption.
The terms impacted, ectopic, and impeded are often erroneously used interchangeably. An impacted tooth refers to one that cannot erupt owing to a space deficiency within the arch. This may present alongside the ectopic position of the developing tooth germ. An ectopic tooth refers to one that is malpositioned and may be unerupted and impacted, or emerge in an aberrant position. An impeded tooth, on the other hand, is one that has developed in the correct position with sufficient space within the arch, but its eruption is blocked by the presence of an obstacle, such as a supernumerary or retained deciduous tooth.
Unerupted teeth are a common finding within any new orthodontic patient clinic, with third permanent molars being the most frequently impacted tooth in 24.4% of the population worldwide.1
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