Ectopic eruption of permanent first molars: a cross-sectional study in the mixed dentition

INTRODUCTION: Ectopic eruption of permanent first molars can compromise arch development and lead to malocclusion if undetected. Identifying associated occlusal traits may enable early intervention and prevent complications. OBJECTIVE: To determine the frequency and occlusal characteristics associated with ectopic eruption of permanent first molars in children. MATERIALS AND METHODS: A cross-sectional study analyzed 901 orthodontic files of children aged 5-9 years. Twenty-four patients with ectopic eruption of permanent first molars were included as the experimental group, while 23 age- and sex-matched children comprised the control group. Panoramic radiographs were used to assess molar angulation and digital dental models were used to assess arch length, arch perimeter, intercanine and intermolar distances. Data reliability was assessed using paired t-tests and Dahlberg's formula. Statistical analysis included Shapiro-Wilk tests, independent t-tests or Mann-Whitney tests, Chi-square tests, and logistic regression to evaluate predictors of ectopic eruption. RESULTS: Ectopic eruption was observed in 2.66% of children, predominantly in the maxilla. Children with ectopic eruption exhibited significantly shorter and narrower arches compared with control, with maxillary intermolar width emerging as a significant predictor (p < 0.05). Molar angulations and deciduous molar crown size were not significantly associated. CONCLUSION: Ectopic eruption of first permanent molars is associated with reduced arch dimensions, particularly maxillary intermolar width. Early recognition of these occlusal patterns may facilitate timely orthodontic management and prevent space loss and secondary crowding.