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Resorption of maxillary first permanent molars by impacted maxillary second premolars: A case series Isabelle Heliotis Manpreet Gakhal Rosemary Whatling Dental Update 2024 47:11, 707-709.
Authors
IsabelleHeliotis
Specialty Trainee in Paediatric Dentistry, Royal London Dental Hospital, Turner Street, Whitechapel, London E1 1DE
Although rare, resorption of the first permanent molar caused by impaction of the second premolar does occur. Three paediatric patients with impacted upper second premolars, distinct symptoms and signs of resorption are described. One case with clear resorption of the upper molar on initial presentation was managed immediately with extraction of the first permanent molar. Eruption of the impacted premolars was monitored in the other two cases, but symptom changes and sectional cone beam computed tomography (CBCT) highlighted resorption of the first permanent molars. In both cases the resorbed first permanent molars required extraction. Frequent clinical and radiographic assessment is imperative in such cases, along with consideration for the use of CBCT.
CPD/Clinical Relevance: Many dental health professionals are unaware that resorption of maxillary molars induced by impacted premolars is possible, thus, this phenomenon is not monitored, resulting in misdiagnosis and avoidable patient morbidity.
Article
It is generally considered that impacted second premolars in both the mandible and maxilla will eventually erupt with or without displacement. Surgical removal of the impacted premolar is often avoided owing to the potential risk of damage to adjacent teeth and surrounding anatomical structures such as the mental nerve.1 Root resorption of first permanent molars by impacted premolars has been previously reported but remains a rare, clinical phenomenon.1,2,3 Resorption is most commonly documented relating to upper incisors associated with ectopic canines and supernumeraries or in the second molar region with impacted third molars.4,5
This case series describes the presentation of three female patients to the Royal London Paediatric Dental Department over a 5-year period. The patients had impacted maxillary second premolars that resulted in the resorption of the first permanent molar. The level of dental crowding in each patient ranged from mild to severe, and all three individuals experienced pain in clinically different manners.
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