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Retained temporary teeth (Persistent primary teeth)
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Introduction
  • Temporary tooth remaining after eruption of permanent tooth, canines and incisors most commonly affected.
  • If not removed, affect direction of eruption of permanent tooth causing malocclusions and gingivitis.
  • Mandibular canines: permanent tooth erupts medial to temporary. Retention of temporary mandibular canines causes permanent tooth to tip laterally and impinge on hard palate/gingiva/other teeth causing pain on closure of mouth.
  • Maxillary canines: permanent tooth erupts rostral to temporary. Retention of temporary maxillary canines permanent tooth erupts into space for mandibular canine when mouth closed. May result in:
    • Impaction of mandibular or maxillary canine.
    • Maxillary lateral incisor and/or canine pushed laterally by mandibular canine (often with impaction of mandibular canine).
    • Mandibular canine pushed medial relative to maxillary canine impinging on hard palate.
  • Incisors: permanent tooth erupts caudal to temporary - retention may affect scissor bite resulting in local soft tissue trauma.
  • Treatment: extraction under general anesthesia.


Presenting signs
  • Presence of both permanent and temporary teeth.


Age predisposition
  • Young: 4-12 months.
Pathogenesis Top

Etiology
  • Hereditary.


Predisposing factors
General
  • Hereditary predisposition to retention of temporary teeth.


Pathophysiology
  • Retention of temporary tooth alters direction of eruption of permanent tooth right_arrow malocclusion.
  • Retention of plaque between permanent and temporary tooth right_arrow localized gingivitis and periodontitis.

Diagnosis Top

Presenting problems
  • Local gingivitis Gingivitis and stomatitis/periodontal disease Periodontal disease.
  • Malocclusion Crowding of teeth.


Clinical signs
  • Presence of both permanent and temporary tooth Teeth: retained temporary canine.

Definitive Diagnostic features
  • Oral examination.
  • Radiography (sometimes suspected retained tooth is a supernumerary permanent tooth).

Treatment Top


Standard treatment
  • Extraction of temporary tooth Dental extraction.
    TIP.jpg Take care not to disturb permanent tooth and not to fracture temporary tooth root.
  • Do not put elevator between temporary and permanent teeth but loosen temporary tooth on other three sides: do not use dental forceps: use sharp elevator, luxator, size 11/15 scalpel blade to cut periodontal ligament, be very patient.
  • If tooth root fractures; less damaging to remain in situ, monitor with radiograph after 2 months to assess situation (absorption).


Subsequent management

Monitoring
  • Check direction of eruption of permanent tooth; if deviating from normal encourage better direction of eruption by digital pressure < 2 hours daily.

Sequelae Top

Sources Top


Vetstream contributor(s)
  • D A Crossley BVet Med FAVD MRCVS, Animal Medical Centre, 511 Wilbraham Road, Charlton, Manchester M21 0UB, UK. Tel: 0161 881 3329; Fax: 0161 861 8553.

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Crowding of teeth
Dental extraction
Gingivitis and stomatitis
Periodontal disease
Teeth: retained temporary canine Link
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