343 - Implications of Retained Primary Dentition: a Multispecialty Approach

Abstract:

Purpose: Retained primary teeth may result in impaction of the permanent dentition and treatment such as surgical extrusion of the impacted teeth and prolonged comprehensive orthodontic treatment. The purpose of this presentation is to highlight the many implications of retained primary teeth and emphasize the importance of vigilant supervision of exfoliation of primary dentition within the pediatric patient population.



Methods: Multiple series of radiographs were reviewed and comprehensive intraoral examinations were conducted for a series of patients, all of whom possessed retained primary teeth. Each of these patients received an initial comprehensive exam by the pediatric dentist, followed by referrals to both the oral surgery and orthodontic departments for multispecialty care.



Results: Every patient within this case series received either extraction of the retained primary teeth, surgical extrusion of the impacted permanent tooth/teeth, or both. Each patient subsequently received an orthodontic workup to determine the most optimal orthodontic treatment sequelae.

Conclusions: The presence of all primary teeth should be examined during every visit, with age of the patient considered. Adequate and comprehensive series of radiographs should be captured for every patient, starting at age six, so that the biological and positional development of the permanent dentition can be seamlessly reviewed. When a patient is suspected to have either a retained primary tooth/teeth and/or a bilateral asymmetry of permanent dentition eruption, a swift referral should be made to both the orthodontist and oral surgeon to ensure further complications to the alignment and occlusion of the existing dentition do not occur.

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