Abstract
Eruption disturbance of the second permanent molar is rare in clinical pediatric dentistry. In the present case, the patient had four cystic lesions adjacent to the upper and the lower bilateral permanent second molars at 13 years 10 months of age. Out of them, three molars were delayed in erupting. In the mandible, the left second permanent molar impacted horizontally and the crown was included in the cystic lesion. Fourteen months after surgical exposure of the impacted molar and the lesion, the radiolucent area of the cyst was abolished and replaced by new bone. Thereafter, the second molar was guided for eruption and aligned properly within the dentition. On the other side, the cystic legion adjacent to the erupted right second permanent molar was surgically exposed and healed 3 months later. In the maxilla, cystic legions were detected bilaterally over the crowns of the unerupted second molars. Although the right second molar erupted spontaneously at the age of 14 years 9 months, the left one was surgically exposed at the age of 16 years 1 month because of non-eruption and swelling.
The main causes for the eruption disturbance of the three permanent second molars were presumed to be pressure of the cystic lesion and/or abnormal eruptive direction of the tooth germ. It seems to be quite rare for the four cystic lesions to occur adjacent to all of the second molars. Although the present patient is not suspected to have a basal cell nevus syndrome, careful observation will be important in her case to be carried out from puberty to around 35 years of age when the disease often appears.
