European Archives of Paediatric Dentistry

, Volume 10, Issue 4, pp 201–210 | Cite as

Treatment strategies for ankylosed primary molars

  • D. B. KennedyEmail author


AIM: The purpose of this article is to focus on aetiology and appropriate treatment techniques concerning anklyosis of primary molars. LITERATURE: The dental literature is reviewed in detail concerning aetiology, frequency of occurrence, diagnosis and longevity of ankylosed primary molars without successors. Treatment concepts are discussed. Long term implications of treatment decisions made in the mixed dentition are emphasised. Areas of treatment that are unsupported by evidence are identified as potential research topics. CONCLUSION: When the underlying premolar is present and the infra-occlusion is not progressive, then observation is appropriate. Only when there is severe disruption to the occlusion and/or the underlying premolar, extraction and space management may be appropriate. When the ankylosed primary molar has no underlying premolar, orthodontic input is needed to determine if extraction and space closure, extraction and transplantation or extraction and prosthetic replacement is the best plan.

Key words

ankylosis primary molars infra-eruption treatment 


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  1. Baccetti T. A controlled study of associated dental anomolies Angle Orthod. 1998 66:267–74Google Scholar
  2. Becker A, Karnei-Rém RM. The effects of infraocclusion Part I: Tilting of the adjacent teeth and local space loss. Amer. J. Orthod. 1992a 102:256–264Google Scholar
  3. Becker A, Karnei-Rém RM. The effects of infraocclusion Part II: The type of movement of the adjacent teeth and their vertical development. Amer. J. Orthod. 1992b 102:302–309Google Scholar
  4. Becker A, Karnei-Rém RM, Steigman S. The effects of infraocclusion Part III: Dental arch length and midline. Amer. J. Orthod. 1992c 102:427–433Google Scholar
  5. Biederman W. Etiology and Treatment of Tooth Ankylosis.Am. J. Orthod. 1962 48; 670–684CrossRefGoogle Scholar
  6. Bjerklin K, Bennett J. The long term survival of lower second primary molars in subjects with agenesis of the premolars. Eur. J. Orthod. 2000 22:245–255PubMedCrossRefGoogle Scholar
  7. Bjerklin K, Kurol J, Valentin J. Ectopic eruption of maxillary first permanent molars and association with other tooth and development disturbances. Eur. J. Orthod. 1992 14:369–375PubMedCrossRefGoogle Scholar
  8. Brearley LJ, McKibben DH. Ankylosis of primary molar teeth (i) Prevalence and characteristics (ii) A Longitudinal Study J. Dent. Chil. 1973 40:54–63Google Scholar
  9. Garib DG, Peck S, Gomes SC. Increased occurrence of dental anomolies associated with second premolar agenesis. Angle Orthod 2009 79:436–441PubMedGoogle Scholar
  10. Hansen K, Kjaer I. Persistence of deciduous molars in subjects with agenesis of the second premolars. Eur. J. Orthod 2000 22:239–243CrossRefGoogle Scholar
  11. Jonsson T, Sigurdson TJ. Autotransplantation of premolars to premolar sites. A long term follow up study of 40 consecutive patients. Am. J. Orthod. Dentofacial Orthop. 2004 125:668–675PubMedCrossRefGoogle Scholar
  12. Kokich VG, Kokich VO. Congenitally missing mandibular second premolars: Clinical options. Am. J. Orthod. Dentofacial Orthop. 2006 130:437–444PubMedCrossRefGoogle Scholar
  13. Kurol J. Infra-Occlusion of Primary Molars: An Epidemiologic and Familial Study Community Dent. Oral. Epidemiol 1981 9:94–102CrossRefGoogle Scholar
  14. Kurol J. Infraocclusion of Primary Molars An epidemiological, familial, longitudinal, clinical and histological study. Swed Dent J Suppl 1984; 21:1–67PubMedGoogle Scholar
  15. Kurol J, Koch G. The effect of extraction of infraoccluded primary molars. A longitudinal study. Am. J. Orthod. 1985 87:46–55PubMedCrossRefGoogle Scholar
  16. Kurol J, Thilander B. Infra-Occlusion of Primary Molars with Aplasia of the Permanent Successor A Longitudinal Study Angle Orthod 1984a 54:283–294PubMedGoogle Scholar
  17. Kurol J, Thilander B. Infra-occlusion of primary molars and the effect on occlusal development A longitudinal study Eur. J. Orthod. 1984b 6:277–293Google Scholar
  18. Kurol J, Olson L. Ankylosis of Primary Molars — A Future Periodontal Threat to the First Permanent Molars? Europ J of Ortho 1991 13:404–409CrossRefGoogle Scholar
  19. Malmgren B, Cvek M, Lundberg M, Frykholm A. Surgical treatment of ankylosed and infrapositioned re-implanted incisors in adolescents. Scand J Dent Res 1984 92:391–9.PubMedGoogle Scholar
  20. Messer LB, Cline JT. Ankylosed primary molars. Results and treatment recommendations from an eight year longitudinal study. Ped. Dent. 1980 2:37–47Google Scholar
  21. Noble J, Karaiskos N, Wiltshire WA. Diagnosis and Management of the Infra-Erupted Primary Molar Brit Dent J 2007 203:632–634CrossRefGoogle Scholar
  22. Ostler MS, Kokich VG. Alveolar ridge changes in patients with congenitally missing mandibular second premolars. J. Prosth. Dent. 1994 71:144–149CrossRefGoogle Scholar
  23. Rule JT, Zacherl WA, Pfefferle AM. The relationship between ankylosed primary molars and multiple enamel defects. J. Dent. Child. 1972 39:29–35Google Scholar
  24. Rune B, Sarnas KV. Root resorption and submergence in retained deciduous second molars. Eur. J. Orthod. 1984 6:123–131PubMedGoogle Scholar
  25. Ruprecht A, Wright GZ. Ankylosis with and without oligodontia: Report of seven cases. J. Can. Dent. Assoc. 1967 9:444–447.Google Scholar
  26. Sabri R. Management of over-retained mandibular deciduous second molars with and without permanent successors. World J. Ortho. 2008:9:209–219.Google Scholar
  27. Sandor GKB, Kainulainen VT, Queiroz JO, Carmichael RP, Oikarinen KS. Preservation of ridge dimensions following grafting with coral granules of 48 post-traumatic and post-extraction dento-alveolar defects. Dental Traumatology 2003 19:221–7PubMedCrossRefGoogle Scholar
  28. Scurrin MS, Bader JD Shugars DA. Meta-analysis of fixed partial denture survival; prostheses and abutments. J. Prosth. Dent. 1998 79:459–464CrossRefGoogle Scholar
  29. Sletten DW, Smith BM, Southard KA, Casko JS Southard TE. Retained deciduous mandibular molars in adults. A radiographic study of long term changes. Am. J. Orthod Dentofac Orthop 2003 124:625–630CrossRefGoogle Scholar
  30. Smalley WM. Comprehensive Interdisciplinary Management of Dentitions with Missing and/or Abnormally Proportioned Teeth. Ed. Cohen M. Comprehensive Interdisciplinary Treatment Planning — Principles, Design, Implementation. Quintessence, Chicago 2008Google Scholar
  31. Steigman S, Koyoumdjisky-Kaye E, Matrai Y. Submerged Deciduous Molars in Preschool Children; an Epidemiologic Survey J. Dent Research Res 1973 52:322–326CrossRefGoogle Scholar
  32. Teague AM, Barton T, Parry WJ. Management of the Submerged Deciduous Tooth: I. Aetiology, Diagnosis and Potential Consequences. Dental Update 1999 26:292–296PubMedGoogle Scholar
  33. Teague AM, Barton T, Parry WJ. Management of the Submerged Deciduous Tooth: 2. Treatment Dental Update 1999 26:350–352Google Scholar
  34. Zachrisson BU, Stenvik A, Haanaes HR. Management of missing maxillary anterior teeth with an emphasis on autotransplantation. Amer J. Orthod Dentofac Orthoped 2004 126:284–288Google Scholar

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© Adis International 2009

Authors and Affiliations

  1. 1.VancouverCanada

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