Completely submerged primary molars

Two mixed dentition cases have been presented which became quite complicated because of ankylosed and submerged primary second molars. These cases demonstrate the need for an early orthodontic evaluation and interceptive orthodontics. The orthodontic and surgical procedures required for these two patients could have easily been avoided by removing the ankylosed primary molars and placing space maintainers. (Of course this depends upon the parents responding to their dental recall notices.) If a submerging primary molar is retained too long, the second premolar may become displaced superiorly and the permanent first molar may migrate mesially as it erupts. Both of these problems can be prevented by extracting the ankylosed primary second molar before it submerges below the mesial height of contour of the permanent first molar. A fixed space maintainer then becomes necessary to prevent loss of arch length by mesial migration of the permanent molar.