“Failure to Erupt Syndrome”: Myth or Reality?
This question was submitted by a general dentist: Three siblings have been diagnosed with “failure to erupt syndrome.” The oldest had removal surgery and implants. How rare is this syndrome and how common for all three to have it?
Dr. Ian McConnachie, pediatric dentist at Woodroffe Pediatric Dentistry, provided the following initial and quick response.
I am unaware of any condition called “Failure to Erupt Syndrome.”
There is a small list of conditions where one finds a failure of at least several teeth to erupt. The one we all remember from our dental student days is cleidocranial dysplasia and the slide of the patient apposing his shoulders together because he lacked collar bones. He also had supernumary teeth and multiple unerupted teeth.
The other syndromes that come up are Gardner’s syndrome with multiple osteomas, osteopetrosis, mucopolysaccharidosis of which there are several types, and GAPO syndrome which is an acronym for growth retardation, alopecia, pseudoanodontia and optic atrophy.
There is also reported a syndrome with amelogenesis imperfecta (AI), failure to erupt and renal problems (nephrocalcinosis). This last one reminds me of one of my cases which was a young lad with multiple unerupted teeth. Those that were erupted had AI. The unerupted teeth when exposed were similarly affected and their adhesion to the overlying gingiva was tenacious. Once exposed, their eruption was variable in success. The mother had similar problems and was edentulous due to them.
In short, at this point, my opinion is that no such syndrome exists but it is being termed as such based on the familial pattern and the symptom of lack of eruption. One would need to know more about the other signs and symptoms that the family experienced to better follow up on true categorization.
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Have had very many families with this problem
This is the first time I hear about “failure to erupt” syndrome too. I also think there are probably underlying factors that have not been fully investigated or understood. To the list of conditions already presented one may also add those causing cranial synchondrosis, such as Apert’s or Crouzon. Furthermore, we still do not understand how ankylosis of an unerupted primary tooth develops. Most of these are solitary and limited to only primary dentition.
It’ll be helpful to place radiographs and photos of these siblings on Oasis so one can get a better idea of what these cases look like.
I have previously encountered a patient with prior history of chemotherapy during early mixed dentition stage. He had no further eruption of adult dentition when I saw him as a late teen. A local pediatric dentist informed me that while it was possible that there could be severely delayed eruption of permanent dentition, it was mostly likely that the no further eruption would occur.
The is a condition termed “Primary Failure of Eruption” where the posterior dentition fails to erupt for no apparent reason. Not sure if it is applicable to the case but it does exist and has a familial background. I was involved in the treatment of a family with PFE and their management is complex and often unsuccessful.
A good summary can be found in seminars of orthodontics:
http://www.ncbi.nlm.nih.gov/pubmed/20830195