Volume 6, Issue 1, June 2020, Page: 1-6
Unusual Impaction - Rosettes of Multiple Unerupted Molars: Review Article
Nikolay Yanev, Maxillofacial Unit – UMAH N. I. Pirogov, Sofia, Bulgaria
Bistra Blagova, Maxillofacial Surgery Devision, Specialized Hospital for Active Treatment in Dental and Maxillofacial Surgery Medicron, Sofia, Bulgaria
Laura Andreeva, Orthodontic Department, Dental Medicine Faculty, Medical University of Sofia, Sofia, Bulgaria
Received: Nov. 24, 2019;       Accepted: Dec. 9, 2019;       Published: Jul. 6, 2020
DOI: 10.11648/j.ijdm.20200601.11      View  139      Downloads  39
Background: There is a wide spectrum of syndromes that include dental, oral and craniofacial disorders. Early diagnosis is often crucial for their effective treatment. However, not all syndromes can be clinically identified on time, especially in cases of absence of known family history. Moreover, the treatment of these patients is often complicated because of insufficient medical knowledge and because of the dento-alveolar and craniofacial developmental variations. Objective: The cases of a single impacted tooth are common. But the ones of multiple unerupted permanent molars are a rare phenomenon. They could be either isolated or associated with local or general pathologic factors. When identified, they present a challenging problem for the dentist, or the oral and maxillofacial surgeon. The aim of the article is to review the possible etiology and management modalities in cases of multiple unerupted molars. Results: The Pubmed and Medline database was searched. The information found was presented mainly by case reports. Unfortunately, because of the rarity of this clinical finding and the great clinical diversity, it is difficult to propose clinical procedure protocols. So, we assume, that the real incidence of that condition might be higher than the one mentioned in the literature. Discussion: It seems that due to the rare occurrence of severe complaints, many patients with multiple unerupted molars do not regularly present to their dentists, until other conditions take place. Clinical phenotyping together with reviewed data and evidence-based conclusions will ultimately pave the way for preventive strategies and therapeutic options in the future. This will improve the prognosis for better functional and aesthetic outcome for these patients and lead to a better quality of life. Conclusion: Care of individuals with syndromes affecting craniofacial and dento-alveolar structures is mostly treated by an interdisciplinary team who becomes more frequently involved in the refined diagnostic and etiological processes of these patients. The dentist and the surgical specialist must have a thorough knowledge about the various forms and possible etiology of tooth non-eruption. It can be a sign of various medical conditions. Therefore, detailed and specific investigations are further required, preceding a patient-tailored treatment plan.
Impacted Teeth, “Kissing” Molars, “Rosettes” of Molars, Unusual Impaction
To cite this article
Nikolay Yanev, Bistra Blagova, Laura Andreeva, Unusual Impaction - Rosettes of Multiple Unerupted Molars: Review Article, International Journal of Dental Medicine. Special Issue: Dento-alveolar Disorders. Vol. 6, No. 1, 2020, pp. 1-6. doi: 10.11648/j.ijdm.20200601.11
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Palma C., Coelho A., Yndira González Y., Cahuana A. 2003. Failure of eruption of first and second permanent molars. J Clin Pediatric Dent, 27 (3): 239-45.
Raghoebar G. M, Boering G., Vissink A, Stegenga B. 1991. Eruption disturbances of permanent molar: a review. J Oral Pathol Med, 20: 159-66.
Andreasen J. O., Petersen J. K., Laskin D. M. 1997. Textbook and color atlas of tooth impactions. Copenhagen, Denmark. Munksgaard; pp. 199–208.
Kaban L. B., Needleman H. L., Hertzberg J. 1976. Idiopathic failure of eruption of permanent molar teeth. Oral Surg, 42: 155-63.
Grover P. S. & Norton L. 1985. The incidence of unerupted permanent teeth and related clinical cases. Oral Surg Oral Med Oral Path, 420-5.
Sawicka M., Racka-Pilszak B., Rosnowska-Mazurkiewicz A. 2007. Uprighting partially impacted permanent second molars. Angle Orthod, 77: 148–54.
Bondemark L. & Tsiopa J. 2007. Prevalence of ectopic eruption, impaction, retention and agenesis of the permanent second molar. Angle Orthod, 77 (5): 773–8.
Magnusson C. & Kjellberg H. 2009. Impaction and retention of second molars: diagnosis, treatment and outcome. A retrospective follow-up study. Angle Orthod, 79 (3): 422–7.
Vedtofte H., Andreasen J. O., Kjaer I. 1999. Arrested eruption of the permanent lower second molar. Eur J Orthod, 21: 31–40.
Andreasen J. & Kurol J. 1977. The impacted first and second molar. Andreasen J. O. & Petersen J. K. L. D., eds In: Textbook and color atlas of tooth impactions Copenhage. Munksgaard, pp. 197-218.
Boffano P., Gallesio C., Bianchi F., Roccia F. 2010. Surgical extraction of deeply horizontally impacted mandibular second and third molars. J Craniofac Surg, 21 (2): 403-6.
Oliver R. G., Richmond S., Hunter B. 1986. Submerged permanent molars: four case reports. Br Dent J, 160: 128-30.
Raghoebar G. M., Boering G., Jansen H. W. B., Vissink A. 1989. Secondary retention of permanent molar: a histologic study. J Oral Pathol Med, 18: 427-31.
Van Hoof R. F. 1973. Four kissing molars. Oral Surg Oral Med Oral Pathol, 35: 284.
Robinson A. J., Gaffrey W. Jr., Soni N. N. 1991. Bilateral kissing molars. Oral Surg Oral Med Oral Pathol, 72: 760.
Nakamura T., Miwa K., Kanda S., Nonaka K., Anan H., Higash S., Beppu K. 1992. Rosette formation of impacted molar teeth in mucopolysaccharidoses and related disorders. Dentomaxillofac Radiol, 21: 45-9.
McIntyre G. 1997. Kissing molars: an unexpected finding. Dent Update, 24 (9): 373–4.
Juneja M. 2008. Not kissing. Br Dent J, 204: 597.
Ashok D., Pradeep A., Ram Rashad Y., Arun Kumar M., Anjani Kumar Y., Ashish S., Mehul Rajesh J. 2017. Kissing canines associated with dentigerous cyst, a case report of transmigrated bilateral impacted mandibular canines. Int J Oral Craniofac Sci, (1): 014-6.
Bakaeen G. & Baqain Z. H. 2005. Interesting case: Kissing molars. Br J Oral Maxillofac Surg, 43: 534.
Jomhawi J. M., Odat A. M., Sethuraman R., Al-Nabulsi M. H. 2018. Kissing premolars and follow up of the eruption of the impacted premolar over 3 years: a rare case report. J Dent Health Oral Disord Ther, 9 (2): 00329.
Krishnan B. 2008. Kissing molars. Br Dent J, 204: 281-2.
Shahista P., Mascarenhas R., Shetty S., Husain A. 2013. Kissing molars: an unusual unexpected impaction. Archiv Med Health Sci, 1: 52-3.
Varpio M. & Wellfelt B. 1988. Disturbed eruption of the lower second molar: clinical appearance, prevalence, and etiology. ASDC J Dent Child, 55: 114–8.
Baykul T., Saglam A. A., Aydin U., Basak K. 2005. Incidence of cystic changes in radiographically normal impacted lower third molar follicles. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 99: 542-5.
Kenrad J., Vedtofte H., Andreasen J. O., Kvetny M. J., Kjær I. 2011. A retrospective overview of treatment choice and outcome in 126 cases with arrested eruption of mandibular second molars. Clin Oral Invest, 15: 81–7.
Sun C. X., Ririe C., Henkin J. M. 2010. Hyperplastic dental follicle: review of literature and report of two cases in one family. Chin J Dent Res, 13: 71–5.
Sandler H. J., Nersasian R. R., Cataldo E., Pochebit S., Gayal Y. 1988. Multiple dental follicles with odontogenic fibroma-like changes (WHO-type). Oral Surg Oral Med Oral Pathol, 66: 78–84.
Cho Y. A., Yoon H. J., Hong S. P., Lee J. I., Hong S. D. 2011. Multiple calcifying hyperplastic dental follicles: comparison with hyperplastic dental follicles. J Oral Pathol Med, 40: 243–9.
Hata S., Maruyama Y., Fujita Y., Mayangi H. 2001. The dentofacial manifestations of XXXXYsyndrome: a case report. Int J Paediat Dent, 11: 138-42.
Frazier-Bowers S. A., Simmons D., Koehler K., Zhou J. 2009. Genetic analysis of familial non-syndromic primary failure of eruption. Orthod Craniofac Res, 12: 74–81.
Frazier-Bowers S. A., Simmons D., Wright J. T., Proffit W. R., Ackerman J. L. 2010. Primary failure of eruption and PTH1R: the importance of a genetic diagnosis for orthodontic treatment planning. Am J Orthod Dentofacial Orthop, 137 (160): 1–7.
Shapira Y., Finkelstein T., Shpack N., Lai Y. H., Kuftinec M. M., Vardimon A. 2011. Mandibular second molar impaction. Part I: genetic traits and characteristics. Am J Orthod Dentofacial Orthop, 140: 32–7.
Cawson R. A. 1962. The oral changes in gargoylism. Proc R Soc Med, 55: 1066–70.
Kirson L. E., Scheiber R. E., Tomaro A. J. 1982. Multiple impacted teeth in cleidocranial dysostosis. Oral Surg Oral Med Oral Pathol, 54: 604.
Yýlmaz H. H., Ucok O., Dogan N., Ozen T., Karakurumer K. 2002. Kleidokranial displazi (olgu raporu). CU Dishek Fak Derg, 5: 33-5.
Bradley J. F. & Orlowski W. A. 1977. Multiple osteomas, impacted teeth and odontomas – a case report of Gardner's syndrome. J N J Dent Assoc, 48: 32-3.
Lapeer G. L. & Fransman S. L. 1992. Hypodontia, impacted permanent teeth, spinal defects and cardiomegaly in a previously diagnosed case of the Yunis-Varon syndrome. Oral Surg Oral Med Oral Pathol, 73: 456-60.
Gorlin R. J & Sedano H. O. 1971. Cryptodonticbrachymetacarpalia. In: Birth Defects Original Article Series. New York, 7 (7): 200-3.
Muzio L. O. 2008. Nevoid basal cell carcinoma syndrome (Gorlin syndrome). Orphanet J Rare Diseases, 3: 32.
Almendros-Márques N., Alaejos-Algarra E., Quinteros-Borgarello M., Berini-Aytés L., Gay-Escoda C. 2008. Factors influencing the prophylatic removal of asynptomatic impacted lower third molar. Int J Oral Maxillofac Surg, 37: 29-35.
Bouloux G. F., Steed M. B., Perciaccante V. J. 2007. Complications of third molar surgery. Oral Maxillofac Surg Clin North Am, 19: 117-28.
Adeyemo W. L. 2006. Do pathologies associetes with impacted lower third molar justify prophylactic removal? A critical review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 102: 448-52.
Woldenberg Y., Gatot I., Bodner L. 2007. Iatrogenic mandibular fracture associated with third molar removal. Can it be prevented? Med Oral Patol Oral Cir Bucal, 12: 70-2.
Al-Belasy Fa, Tozoglu S., Ertas U. 2009. Mastication and late mandibular fracture after surgery of impacted third molars associated with no gross pathology. J Oral Maxillofac Surg, 67: 856-61.
Lee J. T. & Dodson T. B. 2000. The effect of mandibular third molar presence and position on the risk of an angle fracture. J Oral Maxillofac Surg, 58: 394-9.
Susarla S. M., Blaeser B. F., Magalnick D. 2003. Third molar surgery and associated complications. Oral Maxillofac Surg Clin North Am, 15: 177-86.
Valmaseda-Castellón E., Berini-Aytés L., Gay-Escoda C. 2001. Inferior alveolar nerve damage after lower third molar surgical extraction: a prospective study of 1117 surgical extractions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 92: 377-83.
Iida S., Hassfeld S., Reuther T., Nomura K., Mühling J. 2005. Relationship between the risk of mandibular angle fractures and the status of incompletely erupted mandibular third molars. J Craniomaxillofac Surg, 33: 158-63.
Gbotolorun O. M., Arotiba G. T., Ladeinde A. L. 2007. Assessment of factors associated with surgical difficulty in impacted mandibular third molar extraction. J Oral Maxillofac Surg, 65: 1977-83.
Marciani R. D. 2007. Third molar removal: an overview of indications, imaging, evaluation and assessment of risk. Oral Maxillofac Surg Clin North Am, 19: 1-13.
Arjona-Amo M., Torres-Carranza E., Batista-Cruzado A., Serrera-Figallo MA., Crespo-Torres S., Belmonte-Caro R., Albuso-Andrade C., Torres-Lagares D., Gutierrez-Perez JL. 2016. Kissing molars extraction: case series and review of the literature. J Clin Exp Dent, 8 (1): e97-101.
Reddy S. K., Uloopi K. S., Vinay C., Subba Reddy V. V. 2008. Orthodontic uprighting of impacted mandibular permanent second molar: a case report. J Indian Soc Pedod Prevent Dent, 26 (1): 29-31.
Barros S. E., Janson G., Chiqueto K., Ferreira E., Rösing C. 2018. Expanding torque possibilities: a skeletally anchored torqued cantilever for uprighting “kissing molars”. Am J Orthod Dentofacial Orthop, 153: 588-98.
Kurol J. 2006. Impacted and ankylosed teeth: why, when, and how to intervene. Am J Orthod Dentofacial Orthop, 129: 86–90.
Browse journals by subject