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References

Kurol J, Thilander B Infraocclusion of primary molars and the effect on occlusal development, a longitudinal study. Eur J Orthod. 1984; 6:277-93 https://doi.org/10.1093/ejo/6.4.277
Kurol J Infraocclusion of primary molars: an epidemiologic and familial study. Community Dent Oral Epidemiol. 1981; 9:94-102 https://doi.org/10.1111/j.1600-0528.1981.tb01037.x
Steigman S, Koyoumdjisky-Kaye E, Matrai Y Submerged deciduous molars in preschool children: an epidemiologic survey. J Dent Res. 1973; 52:322-326 https://doi.org/10.1177/00220345730520022201
Bjerklin K, Bennett J The long-term survival of lower second primary molars in subjects with agenesis of the premolars. Eur J Orthod. 2000; 22:245-255 https://doi.org/10.1093/ejo/22.3.245
Biederman W The problem of the ankylosed tooth. Dent Clin North Am. 1968; 409-424
Via WF Submerged deciduous molars: familial tendencies. J Am Dent Assoc. 1964; 69:127-129 https://doi.org/10.14219/jada.archive.1964.0258
Kurol J, Magnusson BC Infraocclusion of primary molars: a histologic study. Scand J Dent Res. 1984; 92:564-576 https://doi.org/10.1111/j.1600-0722.1984.tb01298.x
Bjerklin K, Kurol J, Valentin J Ectopic eruption of maxillary first permanent molars and association with other tooth and developmental disturbances. Eur J Orthod. 1992; 14:369-375 https://doi.org/10.1093/ejo/14.5.369
Baccetti T A controlled study of associated dental anomalies. Angle Orthod. 1998; 68:267-274
Hvaring CL, Øgaard B, Stenvik A, Birkeland K The prognosis of retained primary molars without successors: infraocclusion, root resorption and restorations in 111 patients. Eur J Orthod. 2014; 36:26-30 https://doi.org/10.1093/ejo/cjs105
Sidhu HK, Ali A Hypodontia, ankylosis and infraocclusion: report of a case restored with a fibre-reinforced ceromeric bridge. Br Dent J. 2001; 191:613-616 https://doi.org/10.1038/sj.bdj.4801247
Adamson K The problem of impacted teeth in orthodontics. Aust J Dent. 1952; 56:74-84
Hua L, Thomas M, Bhatia S To extract or not to extract? Management of infraoccluded second primary molars without successors. Br Dent J. 2019; 227:93-98 https://doi.org/10.1038/s41415-019-0207-9
Becker A, Karnei-R'em RM The effects of infraocclusion: part 1. Tilting of the adjacent teeth and local space loss. Am J Orthod Dentofacial Orthop. 1992; 102:256-264 https://doi.org/10.1016/s0889-5406(05)81061-3
Becker A, Karnei-R'em RM, Steigman S The effects of infraocclusion: part 3. Dental arch length and the midline. Am J Orthod Dentofacial Orthop. 1992; 102:427-433 https://doi.org/10.1016/s0889-5406(05)81189-8
Attwall R, Parker K, Gill DS Management of infra-occluded primary molars. Dent Update. 2018; 45:625-633
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McGeown M, O'Connell A Management of primary molar infra-occlusion in general practice. J Ir Dent Assoc. 2014; 60:192-198
Messer LB, Cline JT Ankylosed primary molars: results and treatment recommendations from an eight-year longitudinal study. Pediatr Dent. 1980; 2:37-47
Brearley LJ, McKibben DH Ankylosis of primary molar teeth. I. Prevalence and characteristics. ASDC J Dent Child. 1973; 40:54-63
Kjaer I, Fink-Jensen M, Andreasen JO Classification and sequelae of arrested eruption of primary molars. Int J Paediatr Dent. 2008; 18:11-17 https://doi.org/10.1111/j.1365-263X.2007.00886.x
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Infra-occluded primary molars: diagnosis and management

From Volume 16, Issue 2, April 2023 | Pages 85-90

Authors

Trishna Patel

MChD/BChD BSc, MFDS RCPS (Glasg), PGCert

Orthodontic Specialty Registrar 3, Derby and Sheffield

Articles by Trishna Patel

Email Trishna Patel

Catherine A Brierley

BDS(Hons), MFDS RCS, MClinDent, Orthodontic, Post-CCST

Sheffield and Chesterfield, Chesterfield, Derbyshire, UK

Articles by Catherine A Brierley

Abstract

Infra-occluded primary molars can be challenging in terms of their surgical management and potential sequelae. The prognosis of these teeth needs to considered allowing treatment planning for a stable long-term outcome for the patient. This article outlines the key principles to consider following a diagnosis of an infra-occluded primary molar, and it provides a management tool to aid decision making.

CPD/Clinical Relevance: Timely diagnosis and management of infra-occluded primary molars is vital within the overall care pathway for these patients.

Article

Infra-occlusion is when a tooth has failed to maintain its occlusal level relative to adjacent teeth and is therefore found below the occlusal plane.1 In 1981, Kurol described infra-occlusion as when the occlusal surface of a tooth is 1 mm below the occlusal surface of a fully erupted adjacent tooth.2 The timely management of infra-occluded primary teeth avoids the need for more complex surgical management as well as allows planning for the resultant space. This article highlights the key principles behind management of such cases.

The prevalence of infra-occluded primary molars ranges between 1% and 39%, with mandibular molars being much more affected than maxillary molars.2,3 The incidence is greater the older the patient, with infra-occlusion recorded from the age of 3 years suggesting a cumulative process.3 Bjerklin, however, demonstrated that there was little increase in infra-occlusion after the age of 20 years, suggesting primary molars after this age had a good long-term prognosis.4 There also appears to be equal frequency in males and females, as well as the site of occurrence.

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