title: Deep submersion: severe phenotype of deciduous-molar infraocclusion with biological associations.
abstract: OBJECTIVE
  To evaluate the clinical manifestation of and treatment modalities for this severe phenotype of infraocclusion and to examine relationships between deep submersion and the occurrence of other dental anomalies.
  
  
  METHODS
  The experimental sample consisted of 25 orthodontic patients with at least one deciduous molar in infraocclusion greater than 5 mm. Dental records were used to assess severity of infraocclusion, treatment modality, and presence of other dental anomalies (tooth agenesis, small maxillary lateral incisors, palatally displaced canines, and distal angulation of mandibular second premolars).
  
  
  RESULTS
  The sample included 14 females and 11 males, age 7 to 14 years (mean age 10.1 years). The mean infraocclusion depth was 9 mm, with a range of 5-18 mm. The crowns of the adjacent teeth were severely tilted toward the infraoccluded tooth, space was lost in the dental arch, and the successor premolars were impacted in all cases. Treatment consisted of space regaining, surgical extraction of the deciduous molar, and space maintenance. The impacted premolar erupted spontaneously in 95% of the cases. There was a significant increase in prevalence of dental anomalies in the deep-submersion sample compared with that of reference values (P < .001).
  
  
  CONCLUSIONS
  The treatment modality used in this sample resulted in spontaneous eruption of the impacted premolar in most cases. Markers for early diagnosis of deep submersion include other dental anomalies, severe tilt of adjacent teeth, and local space loss. The increased prevalence of other dental anomalies supports a shared genetic etiology.
authors.affiliation: a  Clinical Lecturer and Director of Postgraduate Program, Department of Orthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
authors.forename: Miriam
authors.initials: M
authors.lastname: Shalish
authors.forename: Gilad
authors.initials: G
authors.lastname: Har-Zion
authors.forename: Avraham
authors.initials: A
authors.lastname: Zini
authors.forename: Doron
authors.initials: D
authors.lastname: Harari
authors.forename: Stella
authors.initials: S
authors.lastname: Chaushu
mesh_terms: D000293:Adolescent; D000848:Anodontia / Q000150:complications; D001641:Bicuspid / Q000002:abnormalities / Q000473:pathology; D002648:Child; D003481:Cuspid / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000002:abnormalities; D008297:Male; D008963:Molar / Q000473:pathology* / Q000601:surgery; D010641:Phenotype; D012189:Retrospective Studies; D013027:Space Maintenance, Orthodontic; D020254:Tooth Ankylosis / Q000145:classification / Q000150:complications* / Q000628:therapy; D019228:Tooth Crown / Q000002:abnormalities / Q000473:pathology; D014078:Tooth Eruption / Q000502:physiology; D014079:Tooth Eruption, Ectopic / Q000150:complications; D014081:Tooth Extraction; D014087:Tooth Movement Techniques / Q000379:methods; D014094:Tooth, Deciduous / Q000473:pathology* / Q000601:surgery; D014095:Tooth, Impacted / Q000209:etiology / Q000503:physiopathology