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Primary failure of eruption (PFE) is a rare disease in which tooth eruption does not occur despite space in the arch for eruption. Non-eruption of non-ankylosed teeth occurs due to an eruption mechanism that has failed leading to a posterior unilateral/bilateral open bite. [28] Infra occlusion is the primary hallmark of PFE.
Over-eruption of the opposing tooth into the unoccupied space left by the stalled eruption of a tooth is a risk factor to operculum trauma from biting. Teeth that fail to erupt completely (commonly the lower mandibular third molars) are often the result of limited space for eruption, or a non-ideal angle of tooth eruption causing tooth impaction.
[2] [3] This type of failure of eruption has a genetic or familial background precursor as a cause. The prevalence is of PFE is about 0.06% in population. In this type of failure, teeth that are non-ankylosed fail to erupt in the mouth. These teeth do not have a precursor tooth that is blocking their path.
As the cells of the reduced enamel epithelium degenerate, the tooth is revealed progressively with its eruption into the mouth. The degeneration of reduced enamel epithelium also mediates the initial epithelial attachment to the tooth, which is called the junctional epithelium. The reduced enamel epithelium consist of: Inner enamel epithelium
Radiographically, affected teeth have short and narrow roots, and obliterated pulps due to dentine hypertrophy before or shortly after tooth eruption. [2] The severity of these features is variable, with some teeth presenting with total obliteration of the pulp, while other teeth appear to have normal, healthy dentine. [2]
Because of the lack of opposing force and the natural eruptive potential of the tooth there is a tendency for the tooth to erupt out of the line of the occlusion. [citation needed] Not all teeth lacking an opposing tooth overerupt, even in the long term. [2] Unopposed upper jaw molars overerupt more than the unopposed lower jaw molars.
Other events occur during the bell stage. The dental lamina disintegrates, leaving the developing teeth completely separated from the epithelium of the oral cavity; the two will not join again until the final eruption of the tooth into the mouth. [1] Histologic slide of tooth in late bell stage. Note disintegration of dental lamina at top.
Intraosseous eruption is a stage of tooth eruption that directly precedes the baby tooth emerging from the gums. This stage involves the formation of root of a tooth which allows the tooth to erupt from the bone. It precedes the supraosseous eruption phase which consists of infragingival eruption and supragingival eruption.