Multiple PFE: A Case Report With 5-Year Follow-Up

Primary failure of eruption(PFE) is a kind of rare disorder, which usually caused by malfunction in the eruption mechanism. It defined as incomplete tooth eruption despite the presence of a clear eruption pathway. Orthodontic extrusion is not feasible in these cases because it usually causes ankyloses of teeth. Only a few teeth involve in most cases. Here we report a rare case of adult male patient with PFE disorders involving 21 permanent teeth in four quadrants, whose occlusal function was lost. Multidisciplinary treatment was conducted and a fixed-removable combined prosthesis were used to rehabilitate a stable jaw position and occlusal relationship. The teeth and restorations were complete, no endodontic and periodontal disease occurs during the 5-year follow-up period, stable occlusal relationship was achieved by prosthetic rehabilitation. It is necessary to distinguish PFE from other eruption disorders, mechanical failure of eruption(MFE),ankylosis or systemic disorders must be excluded. If a patient is suspected of having PFE but the diagnosis is uncertain, genetic test for mutations must be recommended for comfirming PFE. The treatment of extensive PFE disorders is very difficult. For adult patients, extensive multiple PFE are usually accompany by severe lost of alveolar bone. Removable partial denture is usually the only feasible option when there is no indication for dental implants. In this case, a stable occlusion and jaw position was reconstructed by using the fixed-removable combined restoration program, and the clinical outcomes were satisfactory during the 5 years of follow-up.