Etiology, Classification and Management of Ectopic Eruption of Permanent First Molars.

Ectopic eruption of a permanent tooth involves abnormal resorption of a portion or all of the adjacent primary tooth. Among the most commonly ectopically erupted teeth are the permanent first molars. Ectopically erupting molars may require intervention to allow for full eruption, or they may spontaneously self-correct and erupt into occlusion. Decisions regarding the necessity of intervention, its ideal timing, and intervention type are multifactorial. Treatment options for the ectopically erupting permanent first molar include the elastomeric separator, brass wire, pre-fabricated clip separator, custom made appliances (Humphrey appliance, Halterman appliance), or extraction of the primary molar. Early intervention when indicated can ensure proper full eruption of the permanent first molar and prevent mesial angulation, arch perimeter loss, tooth impaction and ankylosis. Two cases are described that manage ectopic eruption of the permanent first molar.

Restorations Versus Stainless Steel Crowns in Primary Molars: A Retrospective Split-Mouth Study.

Purpose: The purpose of this study was to evaluate the treatment outcomes of multisurface caries in primary molars treated with intracoronal restorations versus stainless steel crowns (SSCs) through a retrospective split-mouth study. Methods: Dental records were screened for patients who had treatment of one primary molar with a multisurface restoration and one primary molar with an SSC. Teeth were followed until a loss to follow-up, exfoliation, or failure. Results: A total of 988 primary molars were evaluated, with a mean follow-up time of 22 months. The survival probabilities for: SSCs were 95.5 percent at one year of service and 92.8 percent at two years of service; and for intracoronal restorations were 92.0 percent at one year of service and 80.0 percent at two years of service. Overall survival analysis showed SSCs to be significantly more successful than restorations (P<0.001), particularly in children treated at ages four years and younger (P<0.001). No statistically significant difference (P=0.10) was found for children treated at ages five years and older. Conclusions: Stainless steel crowns have a higher survival probability versus restorations for multisurface caries. In children ages four years and younger, more aggressive treatment of multi-surface caries with SSCs should be considered, as conservative treatment leads to an increased need for retreatment.