Dixon A. Observations on submerging deciduous molars. Dental Practitioner. 1963; 303-315
Peretz B, Absawi-Huri M, Bercovich R, Amir E. Inter-relations between infraocclusion of primary mandibular molars, tipping of adjacent teeth, and alveolar bone height. Pediatr Dent. 2013; 35:325-328
Kurol J, Thilander B. Infraocclusion of primary molars with aplasia of the permanent successor. A longitudinal study. Angle Orthod. 1984; 54:283-294
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:(5)369-75 https://doi.org/10.1093/ejo/14.5.369
Kurol J, Olson L. Ankylosis of primary molars – a future periodontal threat to the first permanent molars?. Eur J Orthod. 1991; 13:404-409 https://doi.org/10.1093/ejo/13.5.404
Odeh R, Townsend G, Mihailidis S Infraocclusion: dental development and associated dental variations in singletons and twins. Arch Oral Biol. 2015; 60:1394-1402 https://doi.org/10.1016/j.archoralbio.2015.06.010
Douglass J, Tinanoff N. The etiology, prevalence, and sequelae of infraclusion of primary molars. ASDC J Dent Child. 1991; 58:481-483
Andlaw RJ. Submerged deciduous molars: a prevalence survey in Somerset. J Int Assoc Dent Child. 1977; 8:42-45
Leonardi M, Armi P, Baccetti T Mandibular growth in subjects with infraoccluded deciduous molars: a superimposition study. Angle Orthod. 2005; 75:927-934
Noble J, Karaiskos N, Wiltshire WA. Diagnosis and management of the infraerupted primary molar. Br Dent J. 2007; 203:632-634 https://doi.org/10.1038/bdj.2007.1063
Teague AM, Barton P, Parry WJ. Management of the submerged deciduous tooth: I. Aetiology, diagnosis and potential consequences. Dent Update. 1999; 26:292-296 https://doi.org/10.12968/denu.1999.26.7.292
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
Brearley LJ, McKibben DH Ankylosis of primary molar teeth. I. Prevalence and characteristics. ASDC J Dent Child. 1973; 40:54-63
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
Arhakis A, Boutiou E. Etiology, diagnosis, consequences and treatment of infraoccluded primary molars. Open Dent J. 2016; 10:714-719 https://doi.org/10.2174/1874210601610010714
Andreasen JO. Analysis of pathogenesis and topography of replacement root resorption (ankylosis) after replantation of mature permanent incisors in monkeys. Swed Dent J. 1980; 4:231-240
Kurol J, Thilander B. Infraocclusion of primary molars with aplasia of the permanent successor. A longitudinal study. Angle Orthod. 1984; 54:283-294
Jenkins FR, Nichol RE. Atypical retention of infraoccluded primary molars with permanent successor teeth. Eur Arch Paediatr Dent. 2008; 9:51-55 https://doi.org/10.1007/BF03321597
Tieu LD, Walker SL, Major MP, Flores-Mir C. Management of ankylosed primary molars with premolar successors: a systematic review. J Am Dent Assoc. 2013; 144:602-611 https://doi.org/10.14219/jada.archive.2013.0171
Innes NP, Evans DJ, Stirrups DR. The Hall Technique; a randomized controlled clinical trial of a novel method of managing carious primary molars in general dental practice: acceptability of the technique and outcomes at 23 months. BMC Oral Health. 2007; 7 https://doi.org/10.1186/1472-6831-7-18
Sabri R. Management of over-retained mandibular deciduous second molars with and without permanent successors. World J Orthod. 2008; 9:209-220
Sletten DW, Smith BM, Southard KA Retained deciduous mandibular molars in adults: a radiographic study of long-term changes. Am J Orthod Dentofacial Orthop. 2003; 124:625-630 https://doi.org/10.1016/j.ajodo.2003.07.002
Ram D, Peretz B. Restoring coronal contours of retained infraoccluded primary second molars using bonded resin-based composite. Pediatr Dent. 2003; 25:71-73
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
Pjetursson BE, Tan WC, Tan K A systematic review of the survival and complication rates of resin-bonded bridges after an observation period of at least 5 years. Clin Oral Implants Res. 2008; 19:131-41 https://doi.org/10.1111/j.1600-0501.2007.01527.x
Jung RE, Pjetursson BE, Glauser R A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clin Oral Implants Res. 2008; 19:119-130 https://doi.org/10.1111/j.1600-0501.2007.01453.x
Ostler MS, Kokich VG. Alveolar ridge changes in patients congenitally missing mandibular second premolars. J Prosthet Dent. 1994; 71:144-149 https://doi.org/10.1016/0022-3913(94)90022-1
Kokich VG, Kokich VO. Congenitally missing mandibular second premolars: clinical options. Am J Orthod Dentofacial Orthop. 2006; 130:437-444 https://doi.org/10.1016/j.ajodo.2006.05.025
Malmgren B, Cvek M, Lundberg M, Frykholm A. Surgical treatment of ankylosed and infrapositioned reimplanted incisors in adolescents. Scand J Dent Res. 1984; 92:391-399 https://doi.org/10.1111/j.1600-0722.1984.tb00907.x
Smalley WM. Comprehensive interdisciplinary management of dentitions with missing and/or abnormally proportioned teeth. In: Cohen M (ed.). New Malden: Quintessence; 2008
Disappearing teeth. The story of infra-occlusion of primary molars: diagnosis, aetiology and management Sean Hamilton Graham Oliver Ourvinder Chawla Nicola E Atack Dental Update 2024 50:4, 707-709.
Post-CCST Orthodontics, University Hospitals Plymouth NHS Trust and Bristol Dental Hospital, Bristol. Specialist Orthodontist, River Practice Specialist Centre, Truro
This article outlines the aetiology, diagnosis and treatment options available for the management of infra-occluded primary molars. Treatment decisions are mainly guided by the clinical presentation of the infra-occluded tooth, the malocclusion, the age of the patient, the presence or absence of the permanent successor and, of course, the wishes of the patient and/or parents.
CPD/Clinical Relevance: It is important that infra-occlusion is diagnosed and managed in a timely way to prevent potentially avoidable complications.
Article
A submerging tooth was classically defined by Dixon1 as one that fails to maintain its position in the developing occlusion. More recently, the term infra-occlusion is defined as being when teeth are present with their occlusal surface below that of their neighbouring teeth, long after they should have reached occlusion (Figure 1).2,3,4 In this regard, the primary teeth affected appear to remain stationary, while the adjacent teeth continue to erupt occlusally, with the normal vertical development of the face. It is common in the literature for the terms ‘submerged’ and ‘ankylosed’ to be used synonymously with infra-occlusion, which can create an element of confusion. The term we prefer is that of infra-occlusion.5
The prevalence of a condition is the proportion of a population who have a specific characteristic in a given time period. As individuals with infra-occluded teeth get older, some of these teeth may be shed naturally and therefore, the prevalence of infra-occluded teeth is lower within older age groups. Incidence is the rate of occurrences of new cases in a population and the differing use of these terms hampers the ability to undertake direct comparisons between studies. The reported prevalence of infra-occluded teeth is between 1.3%3 and 8.9%.5 The prevalence of infra-occlusion is higher in patients affected by hypodontia,6 occurs bilaterally4 and is more common in females than males.7 The primary mandibular molars are affected more than 10 times as often as the primary maxillary molars.7,8
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
