Surgical luxation and elevation as treatment approach for secondary eruption failure of permanent molars

BACKGROUND: Secondary eruption failure of permanent molars is a rare disturbance that usually causes serious clinical problems to the patient. Various treatment approaches have been proposed that depend on the age of the patient, the developmental stage of the root, the position of the tooth, the severity of infraocclusion and the presence of one or more affected teeth. Surgical luxation followed by elevation and stabilization of the luxated tooth has been proposed as a first-step treatment in cases of young patients with incomplete root formation and favourable position of the tooth. CASE REPORT: A boy initially aged 7.5 years old presented with localized secondary eruption failure of the mandibular right first permanent molar (46) and infra-occlusion. The medical and dental history of the child was uneventful, while there was no history of eruption failure or ankylosis in any other family member. TREATMENT: This included surgical luxation of the tooth, followed by elevation to the occlusal plane and immobilization to the adjacent primary molar. The splint was removed after 4 weeks. FOLLOW-UP: Three years follow-up revealed a successful result with no clinical or radiological pathology of the area. Root development of the affected tooth was arrested, but there was no sign of pulp necrosis. CONCLUSION: Favourable treatment outcome using surgical luxation and repositioning of the teeth in the present case of permanent molar with secondary eruption failure was observed.