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2017-02B: Ectopically erupting teeth- When and what to do


Below is a series of 3 sequential x-rays of the same patient. Note the ectopic unerupted 35 that is erupting distally on the initial OPG Jan 2015. It eventually erupts and contacts the mesial aspect of the 36 root (Nov 2015), then stops moving(compared with July 2016).

We referred him to an oral surgeon recently for an orthodontic exposure of 35, whom only had the last two x-rays, without the first panorex x-ray, and concluded that 35 was ankylosed. In our experience it is rare to see a tooth whose root is still developing be ankylosed. 

 Jan 2015                                                      


                         Nov 2015    

                         July 2016


Another case study I would like to share is this boy in his mixed dentition that was referred by his dentist, for the ectopically mesially erupting 35 and 45. The key difference with the earlier case study was the unerupted and developing 35 and 45 was NOT in contact with the distal root/PDL surface. Both the 35 and 45 were still developing.


We fitted a lower lingual arch AFTER the lower deciduous 2nd molars 75 and 85 were removed. The OPG below was taken 12 months later. Note the significant improvement in the eruption paths of teeth 35 and 45.

At our final follow up, the teeth 35 and 45 had erupted into the alveolar arches (see photo below). They were very happy with the outcome as surgical exposure of teeth 35 and 45 was not required. This case reports highlights the possibility of self-correction of an ectopically or aberrantly positioned unerupted tooth, provided they have an open root apex and there are no clear obstructions to its eruption path.







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