Complications resulting from the lack of prevention in deviations of permanent tooth eruption

Abstract

Orthodontic prevention is a fundamental component of modern dental medicine, playing a key role in the normal development of the craniofacial complex during childhood and adolescence. The timely diagnosis of deviations in the eruption of permanent teeth enables the prevention of functional disorders, aesthetic discrepancies, and complications that could result in severe orthodontic deformities, more invasive treatment and long-term deterioration of oral health. This clinical case study aims to demonstrate the consequences of failing to take timely orthodontic preventive measures, in cases involving an ectopically positioned permanent tooth germ and a persistent primary tooth. The case of a 13-year-old girl with orthodontic anomalies and a persistent primary tooth (85) is presented. A clinical examination and radiographic investigations were performed, including panoramic radiography, lateral cephalometric radiography and CBCT, to evaluate the position and development of tooth 45, as well as the occlusal and skeletal relationships. Following a multidisciplinary consultation, a treatment plan involving surgical and orthodontic treatment was established. The absence of timely preventive measures in cases of deviated permanent tooth eruption has led to resorption and loss of the adjacent permanent first molar due to the migration of the tooth germ of tooth 45. Early radiographic monitoring, accurate interpretation of findings and timely referral to an orthodontist are crucial to ensure proper eruption and preservation of the dental arch, as well as stable occlusion. This will help to maintain craniofacial function and the patient’s quality of life, while minimising the need for complex therapeutic interventions at a later stage.