Submerged Primary Molar — ORE Part 1 MCQ

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ModeratePaediatric DentistrySubmerged Primary MolarORE Part 1

A child has a submerged (infraoccluded/ankylosed) primary second molar. A radiograph confirms that the premolar successor is present. What is the most appropriate management?

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Correct answer: C — Review clinically and radiographically, extracting if infraocclusion becomes severe or eruption is obstructed

**A is correct.** When a premolar successor is present, an ankylosed primary molar that is mildly or moderately infraoccluded is usually monitored, with clinical and radiographic review. Extraction is indicated if infraocclusion becomes severe, adjacent teeth tip, or the eruption path of the successor is compromised. This avoids unnecessary early extraction while preventing later occlusal disturbance, space loss, bony defects or impaction of the successor. **B** is over-treatment because not every submerged molar requires immediate removal. **C** is unsafe because progression and eruption disturbance can occur without symptoms. **D** may be considered only in selected situations and does not address progressive ankylosis or obstruction of the successor. **E** is inappropriate: an ankylosed tooth is fused to bone and will not be orthodontically extruded.

Reference: Tieu LD, Walker SL, Major MP, Flores-Mir C. Management of ankylosed primary molars with premolar successors: a systematic review. Journal of the American Dental Association. 2013;144(6):602-611. https://pubmed.ncbi.nlm.nih.gov/23729457/