Prospective assessment of premolar eruption rates following extraction of deciduous predecessors affected by pathological root resorption

Background: Chronic pulpal infection caused by dental caries often leads to the premature loss of primary molars, which can result in significant root resorption and alveolar bone deterioration, potentially disrupting normal premolar eruption. This study aimed to evaluate the eruption rate of premolar tooth buds following the extraction of pathologic primary molars compared to those following physiologic root resorption. Methods: A prospective clinical study included 17 pairs of premolar tooth buds from children aged 6 to 8 years. Each participant had at least one infected primary molar that required extraction (pathological group), with the non-infected antimere serving as the control (physiological group). Pre-extraction bitewing and panoramic radiographs were taken, followed by bitewing radiographs after six months to assess eruption rates. The eruption rate was calculated by measuring the change in the distance of premolar movement toward the occlusal plane between baseline and follow-up radiographs, divided by the number of days between them. Data were analyzed using the Wilcoxon signed-rank test. Information on bone crypt (BC), alveolar bone coverage (ABC), and tooth developmental stage were extracted from panoramic radiographs and identified as variable factors potentially influencing the eruption rate, along with the patient’s age, gender, arch type and premolar type. Results: Results showed a significantly faster eruption rate in the pathological group (mean: 0.54 ± 0.325 mm/month) compared to the physiological group (mean: 0.15 ± 0.163 mm/month) over an average follow-up period of 228.2 ± 43.16 days (p = 0.002). Moreover, a significantly higher absence of BC and ABC was observed in the pathological group compared to controls (p = 0.001). Conclusions: These findings suggested that premolar eruption was significantly accelerated in children aged 6–8 years who had infected primary molars compared to those without prior infections. Clinical Trial Registration: The study was registered with ClinicalTrials.gov as TCTR20220530001.

Root resorption; Premolar; Predecessors; Tooth eruption; Premature loss; Bone crypt; Alveolar bone coverage

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