18. Retention of the teeth. Etiology, pathogenesis, clinical features, diagnosis, differential diagnosis, treatment. Complications and prevention

Question 1

Etiology of tooth retention

Answer 1

• Rickets
• Devitalized deciduous teeth=> delay root resorption preventing normal eruption of permanent teeth
• Dystopia (incorrect positioning) or partial anodontia (lack of a germ of the respective permanent tooth)=>
• Deciduous tooth to remains in the alveolar process longer than usual.
• Genetic factors

Question 2

Clinical features of retained teeth

Answer 2

• No symptoms
• Absence of one or more teeth
• Presence of persistent deciduous teeth.
• Slight deformities or a convex bone contour in the area of the missing tooth.
• Dense consistency in the area where the tooth is retained

Question 3

Differential diagnoses for tooth retention

Answer 3

• Delayed eruption due to nutritional deficiencies or systemic conditions like rickets.
• Presence of supernumerary teeth which might prevent the eruption of permanent teeth

Question 4

Treatment options for retained teeth

Answer 4

• Operative Treatment: Extraction if the retained tooth causes complications=>
• such as cysts or infections.
• Surgical-Orthodontic Treatment: (e.g., canines),
• Bone above the tooth is removed and the tooth is gradually moved to proper position

Question 5

Complications that can arise from retained teeth

Answer 5

• Infections and cyst formation around the retained tooth.
• Displacement or crowding of adjacent teeth.
• Resorption of roots of adjacent teeth.
• Formation of dental abscesses.
• Potential impact on the development of the dental arch and occlusion problems

Question 6

Prevention of tooth retention

Answer 6

• Early diagnosis and monitoring of deciduous and permanent teeth development
• Timely extraction of devitalized deciduous teeth that may obstruct the eruption of permanent teeth
• Orthodontic evaluation and intervention
• Nutritional and health management => rickets