Retained and impacted teeth are two common dental anomalies involving the failure of tooth eruption. Although often used interchangeably, they differ in etiology, pathology, and management.
馃搶 Recommended Article :
Dental Article 馃斀 Normal Tooth Eruption vs. Ectopic Eruption in Children: Key Differences and Clinical Management ... This article compares normal dental eruption with ectopic eruption in children, highlighting diagnostic features, clinical implications, and treatment strategies.This article explains their clinical distinctions, contributing factors, implications, and treatment approaches in modern dentistry.
Advertisement
✅ Introduction
Tooth eruption is a physiological process that guides developing teeth into their functional positions within the oral cavity. However, disturbances in eruption may lead to retention or impaction, conditions frequently encountered in dental practice. Understanding the difference between a retained and an impacted tooth is essential for accurate diagnosis, prevention of complications, and planning effective treatment.
馃搶 Recommended Article :
Dental Article 馃斀 Radicular Cyst, Dentigerous Cyst, and Odontogenic Tumor: Etiology, Diagnosis, and Treatment ... This article explores three common odontogenic pathologies: radicular cyst, dentigerous cyst, and odontogenic tumor. Their etiology, clinical features, differential diagnosis, and treatment options are discussed in detail.✅ Defining Retained vs. Impacted Teeth
▪️ A retained tooth refers to a tooth that fails to erupt within the expected time, yet has no physical obstruction preventing its eruption. This may be due to developmental delay or lack of eruptive force.
▪️ An impacted tooth, by contrast, is prevented from erupting due to a physical barrier, such as bone, soft tissue, or adjacent teeth. Impaction commonly involves third molars and maxillary canines.
In summary, retention is related to eruption delay, whereas impaction involves mechanical obstruction.
馃搳 Frequently Retained Teeth
| Tooth | Common Causes | Clinical Implications |
|---|---|---|
| Maxillary Canine | Lack of eruption space, ectopic eruption path | Aesthetic alteration, root resorption of adjacent teeth |
| Third Molar (Wisdom Tooth) | Insufficient arch space, mesioangular impaction | Pericoronitis, caries, cystic lesions |
| Second Premolar | Prolonged retention of primary molars | Malocclusion, delayed eruption sequence |
| Supernumerary Tooth (Mesiodens) | Developmental anomaly | Prevents eruption of adjacent permanent teeth |
Several biological and environmental factors influence tooth retention and impaction:
▪️ Genetic predisposition and syndromic associations (e.g., cleidocranial dysplasia).
▪️ Local causes such as lack of space, crowding, or early loss of deciduous teeth.
▪️ Abnormal tooth position or eruption pathway.
▪️ Trauma or infection in the developing dentition.
▪️ Endocrine or nutritional disorders affecting dental maturation.
馃搶 Recommended Article :
Video 馃斀 What is pericoronitis? Causes, symptoms and treatment ... By partially erupting, the soft tissue can accumulate food and bacteria that are difficult to remove. When the soft tissue becomes inflamed, it causes pain when chewing.✅ Clinical Implications
Both retained and impacted teeth can lead to functional, aesthetic, and pathological consequences, including:
▪️ Malocclusion and spacing anomalies.
▪️ Cyst formation (dentigerous cysts) around impacted teeth.
▪️ Root resorption of adjacent teeth.
▪️ Infection and inflammation (especially in impacted molars).
▪️ Altered occlusal balance and aesthetic disharmony.
馃搶 Recommended Article :
PDF/Video 馃斀 Ameloblastoma in a pediatric patient - Characteristics, treatment and clinical case ... Ameloblastoma is an odontogenic tumor, non-malignant but locally aggressive, with high recurrence, and is evidenced as a facial swelling, or sometimes as a radiographic finding.✅ Diagnosis
Diagnosis requires clinical examination and radiographic evaluation, including:
▪️ Panoramic radiographs to assess position and angulation.
▪️ Cone-Beam Computed Tomography (CBCT) for three-dimensional localization.
▪️ Evaluation of eruption patterns, occlusal relationships, and space availability.
✅ Treatment Approaches
➤ Retained Teeth
▪️ Treatment depends on the cause and age of the patient:
▪️ Observation if physiological eruption is still possible.
▪️ Surgical exposure and orthodontic traction to guide eruption.
▪️ Extraction if the tooth is non-functional or causes malocclusion.
➤ Impacted Teeth
Management varies according to the degree and position of impaction:
▪️ Surgical removal is indicated in cases of pain, infection, or risk to adjacent structures.
▪️ Orthodontic repositioning may be considered for strategic teeth (e.g., canines).
▪️ Regular monitoring if asymptomatic and no pathology is evident.
馃搶 Recommended Article :
PDF 馃斀 Syndromes of the First and Second Branchial Arches - Clinical and radiographic characteristics ... For correct treatment, a diagnosis must be made based on the clinical finding and the results of imaging studies (computed tomography and magnetic resonance imaging).馃挰 Discussion
Although both conditions involve eruption failure, their pathophysiological mechanisms differ significantly. Retention reflects delayed eruption without obstruction, while impaction involves physical blockage. Early diagnosis through clinical and radiographic assessment is crucial to prevent complications such as resorption, cystic lesions, or occlusal disturbances.
Advancements in orthodontic and surgical techniques allow for conservative management, preserving function and aesthetics.
✍️ Conclusion
Retained and impacted teeth represent distinct clinical entities with overlapping manifestations. Recognizing their differences in etiology, diagnosis, and management allows for precise treatment planning and better long-term outcomes. Multidisciplinary collaboration between orthodontists, oral surgeons, and pediatric dentists ensures optimal care.
馃搶 Recommended Article :
Video 馃斀 What are the symptoms of pericoronitis? ... If it is not treated, it can lead to more serious problems for general health, for example: forming abscesses, or spreading the infection or inflammation to the lymph nodes.馃攷 Recommendations
▪️ Include eruption assessment in routine pediatric and orthodontic evaluations.
▪️ Use CBCT imaging for accurate localization of impacted teeth.
▪️ Intervene early to prevent root resorption or cyst formation.
▪️ Implement patient education regarding potential eruption complications.
馃摎 References
✔ Becker, A. (2012). The orthodontic treatment of impacted teeth (3rd ed.). Wiley-Blackwell.
✔ Bishara, S. E. (1992). Impacted maxillary canines: A review. American Journal of Orthodontics and Dentofacial Orthopedics, 101(2), 159–171. https://doi.org/10.1016/0889-5406(92)70008-X
✔ Dachi, S. F., & Howell, F. V. (1961). A survey of 3,874 routine full-mouth radiographs: II. A study of impacted teeth. Oral Surgery, Oral Medicine, Oral Pathology, 14(10), 1165–1169. https://doi.org/10.1016/0030-4220(61)90204-4
Peterson, L. J. (2013). Contemporary Oral and Maxillofacial Surgery (6th ed.). Elsevier.
馃搶 More Recommended Items
► Is there a relationship between headache and temporomandibular disorder?
► Can Malocclusion and Stress Cause Headaches and Dizziness?
► Indications and Contraindications of Serial Extractions in Pediatric Dentistry: Updated Clinical Guide