IADR Abstract Archives
Case Report: Spontaneous Tooth Eruption following Odontoma Enucleation
Objectives: Odontomas are the most common benign odontogenic tumors with no age or gender tendency and are associated with tooth impaction. They are asymptomatic swellings of the jaw, slow growing with mild tenderness upon pulpation. Detection is following routine dental radiographic inspection of un-erupted permanent teeth or retained primary teeth and WHO classified them into compound and complex subtypes.
Methods: A 7 year old boy with a mixed dentition, over retained deciduous maxillary incisors and mild bone bulging in the region of impacted teeth. Following complete enucleation of the tumor orthodontic buttons tied with twisted pigtail ligature wires were cemented to impacted teeth. Thereafter, it was histopathologicaly diagnosed as complex odontoma. Management options of the impacted teeth include follow-up for a spontaneous eruption or orthodontic traction immediately after enucleation process. No consensus could be found regarding the best treatment approach for impacted teeth associated with odontomas. The conservative and preferable consideration is spontaneous eruption, however it depends on chronological age, apical displacement, root developmental stage, arch space and impacted tooth position and depth.
Results: The impacted incisors slowly and spontaneously erupted into their location in the dental arch. The twisted pigtail ligature wires which were connected to the impacted incisors (in case an active orthodontic traction would be required) were elongated during the eruption process serving as a reference for the proceeding eruption. They were then cut and re-twisted to prevent any discomfort.
Conclusions: In every case of impacted teeth even if spontaneous eruption or active traction is expected, cementation of orthodontic appliance on exposed impacted crowns is recommended in order to avoid a second surgery and ensure tooth eruption.
Methods: A 7 year old boy with a mixed dentition, over retained deciduous maxillary incisors and mild bone bulging in the region of impacted teeth. Following complete enucleation of the tumor orthodontic buttons tied with twisted pigtail ligature wires were cemented to impacted teeth. Thereafter, it was histopathologicaly diagnosed as complex odontoma. Management options of the impacted teeth include follow-up for a spontaneous eruption or orthodontic traction immediately after enucleation process. No consensus could be found regarding the best treatment approach for impacted teeth associated with odontomas. The conservative and preferable consideration is spontaneous eruption, however it depends on chronological age, apical displacement, root developmental stage, arch space and impacted tooth position and depth.
Results: The impacted incisors slowly and spontaneously erupted into their location in the dental arch. The twisted pigtail ligature wires which were connected to the impacted incisors (in case an active orthodontic traction would be required) were elongated during the eruption process serving as a reference for the proceeding eruption. They were then cut and re-twisted to prevent any discomfort.
Conclusions: In every case of impacted teeth even if spontaneous eruption or active traction is expected, cementation of orthodontic appliance on exposed impacted crowns is recommended in order to avoid a second surgery and ensure tooth eruption.