Primary failure of eruption is a genetic partial eruption disorder that leads to an open posterior bite. The clinical severity and manifestation of primary failure of eruption are variable. The correct diagnosis of this eruptive anomaly plays an essential role in treatment planning, which can be prosthetic, orthodontic, surgical or multidisciplinary.
The aim of this study was to determine the extent to which adequate treatment can be derived from the radiologic presentation of the PFE in the orthopantomogram. Preoperative panthomogram images were evaluated in 42 patients with confirmed PFE. The basis for treatment decisions was defined as follows: Evaluation of the affected teeth, evaluation of the bone, occlusal lines in the posterior region.
Treatment can be standardised on the basis of orthopantomogram images in patients with PFE. We were able to derive the following treatment options from the orthopantomogram images: If the teeth are slightly below the occlusal plane, prosthetic treatment is indicated; in the case of a negative occlusal line in the mandible and also in the maxilla, extraction / augmentation / implantation / prosthetics should be selected as a treatment option; if the occlusal plane is displaced caudally in the mandible and cranially in the maxilla, a bimaxillary repositioning osteotomy would be indicated; if the occlusal plane is displaced caudally in the mandible and cranially in the maxilla, distraction or a segmental osteotomy with fixation would be indicated.
The evaluation of orthopantomogram images of confirmed primary failure of eruption patients has shown that criteria can be defined that lead to standardisation and simplification of treatment.