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  • Writer's pictureQuek And Me Dental Surgery

Adults with Baby Teeth: Understanding Retained Primary Teeth in Adults

Updated: Dec 19, 2023

The journey of dental development is a fascinating aspect of human growth. Typically, children begin to grow their primary teeth, commonly known as baby teeth, around six months of age. These 20 primary teeth play a crucial role in oral development and are expected to shed naturally as permanent teeth take their place. However, there are instances where this natural process encounters a unique scenario—retained primary teeth in adults.

What are Retained Primary Teeth?

By the age of 21, most individuals have experienced the eruption of 32 permanent teeth, replacing their primary teeth. Nevertheless, some people may retain their primary teeth into adulthood. This condition is known as "retained primary teeth." AKA Adults with Baby Teeth. One such case, documented as Tooth #45, exemplifies a complex scenario involving a primary tooth buried completely in bone, impacted with Tooth #46.

X-Ray for Retained Primary Teeth
X-Ray for Retained Primary Teeth

Case Study: Retained Tooth #45 and Treatment Plan: The patient presented with multiple dental concerns, including buried and impacted Tooth #45, retained Tooth #85 with significant root resorption, a peg-shaped Tooth #22, and issues related to median diastema and supra-eruption of Teeth #18 and #28. A Cone-Beam Computed Tomography (CBCT) was conducted to assess the complexities of the situation.

Specific Dental Concerns:

  1. Tooth #45: The CBCT revealed that Tooth #45 was buried and impacted with the mesial root of Tooth #46. The inferior dental nerve (IDN) was positioned buccally of Tooth #45.

  2. Tooth #85: Retained Tooth #85 showed over 50% root resorption. Additionally, a prior removal of Tooth #48 left a retained root remnant, marked as Keep in View (KIV).

  3. Tooth #22: Peg-shaped Tooth #22 presented aesthetic concerns.

  4. Orthodontic Treatment (Ortho Tx): The patient expressed a desire for orthodontic treatment to address issues such as median diastema, crowding, and an edge-to-edge bite associated with Tooth #22.

Treatment Recommendations:

  1. Removal and Bone Grafting:

    • Retained Tooth #85

    • Buried Tooth #45, with bone grafting to ensure optimal healing.

    • Supra-erupted Teeth #18 and #28.

Ortho Tx Consideration: To close the median diastema, relieve crowding, and correct the edge-to-edge bite associated with Tooth #22. Aesthetic Correction: Crown or veneer application to correct the peg-shaped Tooth #22.

2. Supra-erupted Teeth #18 and #28:

  • Removal of supra-erupted Teeth #18 and #28.

Orthodontic Solution: Consideration for CR Veneer to close the median diastema and crown or veneer application to correct the peg-shaped Tooth #22.

Procedures: The dental team, with meticulous precision, executed the planned procedures. For Tooth #45, an incision was made, and buccal and lingual flaps were raised. Bone guttering and tooth sectioning were performed, resulting in successful removal. The space was carefully cleaned, irrigated, and bone grafting with EthOss artificial bone grafting material was carried out.

Tooth #85 was successfully extracted with LA XAP, ensuring a thorough and atraumatic procedure. The team then performed LA XAP for Tooth #18, addressing the supra-eruption concern.

X-Ray for Retained Primary Teeth removed
X-Ray for Retained Primary Tooth removed

Outcome: Postoperative CBCT verified the success of the procedures, with no tooth remnants noted. Importantly, the inferior dental nerve (IDN) and the maxillary sinus remained intact, showcasing the precision and expertise involved in the surgery. The patient left reassured and with a transformed oral condition.

Conclusion: The case of retained primary teeth in adults is a captivating aspect of dentistry, requiring a tailored and meticulous approach. This case study demonstrates how advanced techniques, such as CBCT, coupled with precise surgical procedures, can address complex scenarios, providing patients with both functional and aesthetic improvements.

Understanding retained primary teeth and their treatment is pivotal in ensuring optimal oral health and well-being, emphasizing the importance of comprehensive dental care throughout an individual's life.

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