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Peer-reviewedCC BYProgress in orthodontics

Infraoccluded permanent first molars and their effect on dentoalveolar and root development: a two-center retrospective split-mouth cross-sectional study.

  • Avi Leibovich1
  • Zehava Geller Fishman2
  • Gabriel Nahmias3
  • Heli Rushinek4
  • Nardi Casap4
  • Letizia Perillo5
  • Miriam Shalish2
  • Cristina Grippaudo6,7
  • Ludovica Nucci8
  • Stella Chaushu2
8 affiliations
  1. 1Department of Orthodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. [email protected].
  2. 2Department of Orthodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
  3. 3Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
  4. 4Department of Oral and Maxillofacial Surgery, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
  5. 5Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy.
  6. 6Dipartimento Universitario testa collo ed organi di senso, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
  7. 7UOC Clinica Odontoiatrica, Dipartimento di Neuroscienze, Organi di senso e Torace, Fondazione Policlinico universitario A. Gemelli, IRCCS, 00168, Rome, Italy.
  8. 8Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
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Abstract

Background

Infraocclusion of a permanent first molar, frequently due to ankylosis, can disrupt occlusal development and generate asymmetries. This study aimed to evaluate dental developmental differences caused by infraoccluded permanent first molars.Methodology

A retrospective, two-center, split-mouth cross-sectional study analyzed panoramic radiographs of 45 patients (9-25 years) with a single, unilateral, infraoccluded permanent first molar. The contralateral molar served as control. Measurements included infraocclusion severity, teeth position within the arch, adjacent-tooth tipping and spacing, root length, presence and degree of root dilaceration.Results

Infraoccluded permanent first molars were positioned 5.6(3.3) mm (95% CI, 5 to 7; p < 0.001) lower than controls and were significantly more distal within the arch (p < 0.001), with adjacent teeth also displaced distally. Adjacent teeth tipped toward the infraoccluded molar: second premolars were 8(12)° more distally angulated (95% CI, 5 to 12; p < 0.001) and second molars 6(19)° more mesially angulated (95% CI, 0.6 to 15; p = 0.003). Posterior spacing was more frequent on the affected side (OR = 15.5; 95% CI 4 to 133; p < 0.001). Infraoccluded molars had roots that were 2.8(5.4) mm shorter than controls (95% CI, 1.2 to 4.4; p < 0.001) and a markedly higher prevalence of root dilaceration (OR = 18.5; 95% CI 5 to 158; p < 0.001). Infraocclusion severity was linearly associated with dilaceration severity (r = 0.69; p = 0.0001). Adjacent teeth showed a similar trend toward higher prevalence and severity of dilacerations on the affected side.Conclusions

Unilateral infraoccluded permanent first molars are strongly associated with shortened roots, increased root dilaceration, and significant distal displacement of the affected and adjacent teeth. Other effects include tipping and spacing of the adjacent teeth.

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Cite

BibTeXRIS
BibTeX
@article{leibovich2026infraoccluded,
  title = {{Infraoccluded permanent first molars and their effect on dentoalveolar and root development: a two-center retrospective split-mouth cross-sectional study.}},
  author = {Avi Leibovich and Zehava Geller Fishman and Gabriel Nahmias and Heli Rushinek and Nardi Casap and Letizia Perillo and Miriam Shalish and Cristina Grippaudo and Ludovica Nucci and Stella Chaushu},
  journal = {Progress in orthodontics},
  year = {2026},
  month = oct,
  doi = {10.1186/s40510-026-00650-1},
  url = {https://europepmc.org/article/MED/42955197},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Infraoccluded permanent first molars and their effect on dentoalveolar and root development: a two-center retrospective split-mouth cross-sectional study.
AU  - Avi Leibovich
AU  - Zehava Geller Fishman
AU  - Gabriel Nahmias
AU  - Heli Rushinek
AU  - Nardi Casap
AU  - Letizia Perillo
AU  - Miriam Shalish
AU  - Cristina Grippaudo
AU  - Ludovica Nucci
AU  - Stella Chaushu
PY  - 2026
DA  - 2026/10/29
JO  - Progress in orthodontics
DO  - 10.1186/s40510-026-00650-1
UR  - https://europepmc.org/article/MED/42955197
AB  - Background  Infraocclusion of a permanent first molar, frequently due to ankylosis, can disrupt occlusal development and generate asymmetries. This study aimed to evaluate dental developmental differences caused by infraoccluded permanent first molars.Methodology  A retrospective, two-center, split-mouth cross-sectional study analyzed panoramic radiographs of 45 patients (9-25 years) with a single, unilateral, infraoccluded permanent first molar. The contralateral molar served as control. Measurements included infraocclusion severity, teeth position within the arch, adjacent-tooth tipping and spacing, root length, presence and degree of root dilaceration.Results  Infraoccluded permanent first molars were positioned 5.6(3.3) mm (95% CI, 5 to 7; p < 0.001) lower than controls and were significantly more distal within the arch (p < 0.001), with adjacent teeth also displaced distally. Adjacent teeth tipped toward the infraoccluded molar: second premolars were 8(12)° more distally angulated (95% CI, 5 to 12; p < 0.001) and second molars 6(19)° more mesially angulated (95% CI, 0.6 to 15; p = 0.003). Posterior spacing was more frequent on the affected side (OR = 15.5; 95% CI 4 to 133; p < 0.001). Infraoccluded molars had roots that were 2.8(5.4) mm shorter than controls (95% CI, 1.2 to 4.4; p < 0.001) and a markedly higher prevalence of root dilaceration (OR = 18.5; 95% CI 5 to 158; p < 0.001). Infraocclusion severity was linearly associated with dilaceration severity (r = 0.69; p = 0.0001). Adjacent teeth showed a similar trend toward higher prevalence and severity of dilacerations on the affected side.Conclusions  Unilateral infraoccluded permanent first molars are strongly associated with shortened roots, increased root dilaceration, and significant distal displacement of the affected and adjacent teeth. Other effects include tipping and spacing of the adjacent teeth.
SN  - 1723-7785
SN  - 2196-1042
ER  -