Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Mar 15;14(1):5.
doi: 10.1186/s13005-018-0163-7.

Primary failure of eruption (PFE): a systematic review

Marcel Hanisch  1 , Lale Hanisch  2 , Johannes Kleinheinz  3 , Susanne Jung  3
Affiliations

Primary failure of eruption (PFE): a systematic review

Marcel Hanisch et al. Head Face Med. .

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.

Keywords: Eruption disorder; Orthodontics; PFE; PTH1R; Primary failure of eruption; Rare diseases; Systematic review.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The ethical approval for this study was obtained from the ethical review committee (Ref. no. 2017–372-f-N), Ethikkommission der Ärztekammer Westfalen-Lippe und der Westfälischen Wilhelms-Universität, Münster, Germany.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Data analyses of recorded literature for PFE according to PRISMA-Guidelines
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Baccetti T. Tooth anomalies associated with failure of eruption of first and second permanent molars. Am J Orthod Dentofac Orthop. 2000;118(6):608–610. doi: 10.1067/mod.2000.97938. - DOI - PubMed
    1. Proffit WR, Vig KW. Primary failure of eruption: a possible cause of posterior open-bite. Am J Orthod. 1981;80:173–190. doi: 10.1016/0002-9416(81)90217-7. - DOI - PubMed
    1. Frazier-Bowers SA, Koehler KE, Ackerman JL, Proffit WR. Primary failure of eruption: further characterization of a rare eruption disorder. Am J Orthod Dentofac Orthop. 2007;131:578. doi: 10.1016/j.ajodo.2006.09.038. - DOI - PubMed
    1. Raghoebar GM, Boering G, Vissink A. Clinical, radiographic and histological characteristics of secondary retention of permanent molars. J Dent. 1991;19(3):164–170. doi: 10.1016/0300-5712(91)90007-L. - DOI - PubMed
    1. Raghoebar GM, Boering G, Vissink A, Stegenga B. Eruption disturbances of permanent molars: a review. J Oral Pathol Med. 1991;20:159–166. doi: 10.1111/j.1600-0714.1991.tb00913.x. - DOI - PubMed

Publication types