Primary failure of eruption (PFE): a systematic review

Area of Science:

• Dental Science
• Genetics
• Orthodontics

Background:

• Primary failure of eruption (PFE) is a rare condition characterized by incomplete tooth eruption despite a clear eruption pathway.
• Orthodontic extrusion is often not feasible due to the risk of ankylosis.
• Limited systematic analysis of PFE's clinical features and associated factors exists.

Purpose of the Study:

• To systematically evaluate the literature on PFE from 2006 to 2017.
• To gain new insights into the aetiology, diagnosis, genetics, and treatment of PFE.
• To update understanding of this rare dental anomaly.

Main Methods:

• A systematic literature search was conducted following PRISMA guidelines.
• The PubMed/Medline database was searched using specific terms for PFE.
• Studies reporting clinical data on PFE were included.

Main Results:

• 17 articles with data from 314 patients were analyzed.
• Molars were consistently affected, with premolars and primary teeth also impacted in some cases.
• 51 different variants of the PTH1R gene were associated with PFE, and additional dental anomalies were noted in 39 patients.

Conclusions:

• Infraocclusion of posterior teeth, particularly bilateral, is a hallmark of PFE.
• Genetic testing for PTH1R gene mutations is recommended for suspected PFE cases before orthodontic intervention to prevent ankylosis.
• Treatment strategies for PFE require individualized evaluation based on patient age and clinical presentation.