Primary Failure of Eruption (PFE): a Systematic Review

Overview

Journal Head Face Med

Publisher Biomed Central

Specialties Dentistry
General Medicine
Orthopedics

Date 2018 Mar 17

PMID 29544499

Citations 30

Authors

Marcel Hanisch

Lale Hanisch

Johannes Kleinheinz

Susanne Jung

Affiliations

Soon will be listed here.

Abstract

Background: Primary failure of eruption (PFE) is a rare disease defined as incomplete tooth eruption despite the presence of a clear eruption pathway. Orthodontic extrusion is not feasible in this case because it results in ankylosis of teeth. To the best of our knowledge, besides the study of Ahmad et al. (Eur J Orthod 28:535-540, 2006), no study has systematically analysed the clinical features of and factors associated with PFE. Therefore, the aim of this study was to systematically evaluate the current literature (from 2006 to 2017) for new insights and developments on the aetiology, diagnosis, genetics, and treatment options of PFE.

Methods: Following the PRISMA guidelines, a systematic search was performed using the PubMed/Medline database for studies reporting on PFE. The following terms were used: "primary failure of tooth eruption", "primary failure of eruption", "tooth eruption failure", and "PFE".

Results: Overall, 17 articles reporting clinical data of 314 patients were identified. In all patients, the molars were affected. In 81 reported cases, both the molars and the premolars were affected by PFE. Further, 38 patients' primary teeth were also affected. In 27 patients, no family members were affected. Additional dental anomalies were observed in 39 patients. A total of 51 different variants of the PTH1R gene associated with PFE were recorded.

Conclusions: Infraocclusion of the posterior teeth, especially if both sides are affected, is the hallmark of PFE. If a patient is affected by PFE, all teeth distal to the most mesial tooth are also affected by PFE. Primary teeth can also be impacted; however, this may not necessarily occur. If a patient is suspected of having PFE, a genetic test for mutation in the PTH1R gene should be recommended prior to any orthodontic treatment to avoid ankylosis. Treatment options depend on the patient's age and the clinical situation, and they must be evaluated individually.

Citing Articles

Syndromic and Non-Syndromic Primary Failure of Tooth Eruption: A Genetic Overview.

Modafferi C, Tabolacci E, Grippaudo C, Chiurazzi P Genes (Basel). 2025; 16(2).

PMID: 40004475 PMC: 11855040. DOI: 10.3390/genes16020147.

A novel PTH1R mutation causes primary failure of eruption via the cAMP-PI3K/AKT pathway.

Lu K, Qian Y, Gong J, Li Z, Yu M, Wang H Prog Orthod. 2025; 26(1):7.

PMID: 39988614 PMC: 11847765. DOI: 10.1186/s40510-025-00555-5.

Single-Nucleotide Polymorphisms in MMP3, TIMP1, and MTR Genes are Associated With Delayed Deciduous Tooth Eruption.

Fonseca B, de Oliveira Fernandes T, de Moura D, Reis C, Kuchler E, Baratto-Filho F Biochem Genet. 2025; .

PMID: 39776370 DOI: 10.1007/s10528-024-11016-9.

The Diagnosis and Management of Infraoccluded Deciduous Molars: A Systematic Review.

Dipalma G, Inchingolo A, Meme L, Casamassima L, Carone C, Malcangi G Children (Basel). 2024; 11(11).

PMID: 39594950 PMC: 11592876. DOI: 10.3390/children11111375.

Orthodontic treatment for substitution of impacted mandibular second molars with their adjacent wisdom teeth.

Chen D, Cheng J, Chen J, Huang H J Dent Sci. 2024; 19(4):2377-2380.

PMID: 39347081 PMC: 11437297. DOI: 10.1016/j.jds.2024.05.026.

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