Multiple Dental Impactions and Agenesis: A Case Report

Case Report

J Dent & Oral Disord. 2020; 6(5): 1142.

Multiple Dental Impactions and Agenesis: A Case Report

Penido FO1, Barbosa FI2, Oliveira BJ2, Aguiar TR3 and Consani RLX4*

1Post-graduate Student, University of Itauna, Brazil

2Professor, University of Itauna, Brazil

3Specialist in Buccomaxillofacial Surgery and Traumatology, University of Vale do Rio Verde, Brazil

4Professor, State University of Campinas, Piracicaba Dental School, Department of Prosthodontics and Periodontology, Brazil

*Corresponding author: Consani RLX, Piracicaba Dental School, Department of Prosthodontics and Periodontology, Brazil

Received: June 05, 2020; Accepted: July 01, 2020; Published: July 08, 2020


Like the agenesis of the first molars, simultaneous impaction of second and third molars are uncommon events. This case report aims to expose and discuss the surgical treatment of a second and third molars impacted bilaterally and simultaneously associated with agenesis of all first molars involving with bone cement dysplasia.

Keywords: Tooth impacted; Anodontia; Oral surgical procedures; Dentistry; Maxillofacial abnormalities


The tooth to be classified as retained should not have been erupted in the oral cavity according to the normal chronology of eruption [1]. Beyond that it must be evident that the spontaneous eruption will not occur [2]. This condition represents a predisposition for the advent of several pathologies such as dental caries, periodontal problems, root resorption of the adjacent tooth and even the development of cysts and tumors [3].

Among the dental groups, third molars are the ones with the highest prevalence of retention and impaction. This is due, among other factors, as ectopic position, lack of space, late maturity and angulation variation [3]. However, the occurrence of impacted permanent second molars is a rare phenomenon, recently became more prevalent occurring mainly in the mandibular region (0,2%) [4].

Under these circumstances, the treatment includes four possible maneuvers: extraction, intervention, transfer and observation. Extraction refers to removal the dental organ, while observation is the follow-up of the case without application of any therapy. Another option would be the intervention, an orthodontic or surgical attempt to remove the factor that prevents the eruption, while the transfer tries to reposition the tooth in the árcade [5].

The choice of treatment will depend on the specific characteristics of each case, making the exact location of the tooth crucial, with a critical analysis of the anatomical structures nearby and the tooth position. Classical radiology does not provide the necessary precision for the event while the tomography would be a better option [6].

The congenital absence of teeth accompanies the evolution of the human species. In the posterior segment of the arch, agenesis of the third molars is normal. It is normal the agenesis of the third molars in the posterior segment of the arch, which can lead to several occlusal disturbances and dental migrations [7].

The present article aims to present an uncommon case of agenesis of the first four molars associated with simultaneous impaction of maxillary and mandibular in both sides of the second and third molars with concomitant presence of bone cement dysplasia. Besides, to expose the treatment proposed.

Case Presentations

Female, melanoderma 29 years old, sought dental care owing to non-eruption of the second and third permanent molars. Dental history revealed the ectopic eruption of a maxillary central incisor tooth on the anterior third of the palate, requiring orthodontic treatment. Was also reported the mutual impaction of the second and third molars in maxilla and mandible in both sides, associated with the congenital absence of the first molars. The others teeth erected conventionally.

The patiente did not report having any systeic disease and family history did not reveal significant changes in relation to this dental problem.

In the pre-surgical procedure, radiographic and tomographic examinations were performed (Figure 1), revealing the horizontal position of the impacted teeth, which presented complete rhizogenesis. A hyodense bone mass and an anatomical alteration in the mandibular region close to the dental elements 37 and 47 were also observed.