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REVIEW ARTICLE
Abstract
Supraerupted posterior tooth is one of the common clinical findings in dental practice. Delayed replacement
of lost teeth often leads to extrusion of the opposing teeth into the edentulous space, which leads to masticatory
insufficiency and TMJ disorders. When prosthesis is planned on the opposing edentulous area, re-establishing a
functional posterior occlusion requires a comprehensive dental treatment plan. If the dentoalveolar extrusion is not
severe, it is possible to recapture the space by performing Coronoplasty & intentional endodontic treatment of the
supraerupted tooth. When the extrusion is moderate, orthodontic intrusion can be done and the extrusion is great, a
prosthetic rehabilitation is impossible and removal of the teeth is often proposed. This paper gives a brief review of
the various treatment modalities discussed in the literature to manage supraerupted posterior teeth.
Key words: Supraerupted Teeth, Coronoplasty, Intentional Endodontics, Temporary Anchorage Device.
Received on: 07/05/2010 Accepted on: 18/06/2010
Introduction
The partial dentate state may be the fate of to evaluate the size of the pulp and the dento-alveolar
many elderly dentate patients in the future, as the structure,
prevalence of edentulousness decreases in the 1. Enameloplasty can effectively reduce occlusal
population (1). The main positional change to be discrepancy in a moderately extruded tooth.
expected in unopposed teeth, retained root stump and Approximately 1-2 mm of enamel can be
carious teeth is over eruption. Kiliaridis et al (2) removed in many situations. At times the
identified that over eruption >2 mm occurred in 24% reduction of a single cusp improves the occlusal
of unopposed teeth, with 18% having no plane (4).
demonstrable over eruption at all (3). In other words, 2. If the tooth does not lend itself to Enameloplasty,
82% demonstrated some over eruption (1). the placement of an extra coronal cast metallic
If we replace the edentulous area with the restoration is indicated. The degree of reduction
prosthesis, without correcting the supra-erupted teeth, is limited as much or more by the clinical crown
it may lead to inefficiency in the masticatory function length of the tooth as by the size of the dental
due to improper distribution of masticatory force, pulp (4).
deviation in the mandibular movement and problems 3. Intentional Root Canal treatment of tooth with
in the Temporomandibular Joint. perfectly vital pulp may be necessary in cases of
Treatment Modalities: Before we plan the hyper erupted tooth or drifted teeth that must be
different treatment modalities, we should have a reduced so drastically that the pulp is certain to
mounted diagnostic cast and a very good radiograph be involved (5).
1. To direct the occlusal forces along the long axis successfully with orthodontic TADs (Titanium-Alloy
2. To attain simultaneous contact of all teeth in length and 1.2 to 2 mm in diameter, that is fixed to
centric relation. bone temporarily to enhance orthodontic anchorage),
3. To eliminate any occlusal contact on inclined re-establishing a functional posterior occlusion and
planes to enhance the positional stability of reducing the need for prosthetic crown reduction.
maximum inter-cuspation position. location chosen should be the optimal one in terms of
5. To arrive at the occlusal scheme selected for the both the patients safety and biomechanical tooth
Extruded posterior teeth can be intruded Molar intrusion can be achieved by temporary
orthodontically, by other methods, such as (10) anchorage device (TAD) orthodontically. The scope
Inter-maxillary device of orthodontics is expanding. TADs have allowed the
Sectional mechanics orthodontist to overcome anchorage limitations and
Removable appliance perform difficult tooth movements predictably and
Segmental Osteotomy: This is a simple but strict MDS, Department of Prosthodontics, S.Nijalingappa
technique, without which one can achieve a good Institute of Dental Sciences & Research (SNDC), Sedam
Road, Gulbarga, Karnataka, India.
surgical outcome but a poor final occlusion. Some
distortions can occur at any stage of surgery. Thus,
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of upper second molars using the palatal intrusion