Retained Root Case Reports
Adults with Baby Teeth: Understanding Retained Primary Teeth in Adults
Retained Primary Teeth in Adults: Causes, Treatments & What You Need to Know
Children typically develop their first primary teeth around 6 months old. These 20 "baby teeth" play a vital role in speech development and chewing, naturally shedding as permanent teeth erupt. But what happens when a primary tooth lingers past its expected time? This is called retained primary teeth, affecting some adults.
What are Retained Primary Teeth?
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By age 21, most people have a full set of 32 permanent teeth. However, some individuals retain one or more primary teeth into adulthood. This condition, also known as "adults with baby teeth," can arise from various causes.
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
This case study explores a complex dental situation involving retained primary teeth and the treatment plan devised to address them.
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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.
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Specific Dental Concerns:
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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.
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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).
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Tooth #22: Peg-shaped Tooth #22 presented aesthetic concerns.
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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.
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To effectively diagnose and plan treatment for these interconnected issues, a Cone-Beam Computed Tomography (CBCT) scan was utilized. This advanced imaging technique provides detailed 3D views of the jawbone and teeth, allowing dentists to precisely assess the position and condition of impacted teeth and surrounding structures.
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Treatment Recommendations:
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Removal and Bone Grafting:
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Retained Tooth #85
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Buried Tooth #45, with bone grafting to ensure optimal healing.
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Supra-erupted Teeth #18 and #28.
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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:
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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.
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Procedure:
The dental team meticulously addressed the impacted tooth (#45) with a minimally invasive surgical approach. This involved an incision and flap reflection for precise access. After careful bone reshaping (guttering) and tooth sectioning, the impacted tooth was successfully removed. The extraction site was thoroughly cleaned and prepared for optimal healing with biocompatible bone grafting material.
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For the retained primary tooth (#85) and the supra-erupted tooth (#18), comfortable extractions were performed using local anesthesia (LA XAP).
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A follow-up Cone-Beam CT scan (CBCT) confirmed the successful removal of the impacted tooth with no remaining fragments. This advanced imaging technique provided valuable post-surgical confirmation. Importantly, the surgery preserved the integrity of the inferior dental nerve (IDN) and the maxillary sinus, highlighting the precise and skilled approach of the dental team.
The patient experienced minimal recovery time and left feeling confident and happy with their transformed oral health.
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Conclusion:
This case study highlights the importance of early diagnosis and treatment for retained primary teeth in adults. Advanced imaging techniques like CBCT scans can aid in precise surgical procedures, ensuring successful outcomes like improved function and aesthetics. Understanding this condition and seeking professional dental care is crucial for maintaining optimal oral health throughout life.
