International Journal of Paediatric Dentistry

2003;

13:

204207

204

2003 BSPD and IAPD

Blackwell Publishing Ltd.

The role of magnets in the management of unerupted teeth
in children and adolescents

B. O. I. COLE

1

, A. J. SHAW

1

, R. S. HOBSON

1

, J. H. NUNN

1

,
R. R. WELBURY

1

, J. G. MEECHAN

2

& N. J. A. JEPSON

3

1

Department of Child Dental Health,

2

Department of Oral Surgery, and

3

Department
of Restorative Dentistry, Dental School & Hospital, Richardson Road, Newcastle upon
Tyne, UK

Summary.

This case report describes the use of magnets in the management of teeth
that fail to erupt. Eight children aged between 10 and 15 years were treated. Magnetic
traction was applied to two premolars and six molars. Seven teeth (one premolar and six
molars) erupted successfully (mean treatment time with magnetic traction: 75 months).
One premolar failed to erupt; serial radiographic assessment over a 9-month period
revealed no evidence of movement and so the magnetic xture was removed. Histological
evaluation of tissue samples taken from around the xture revealed no evidence of
abnormal pathology.

Introduction

Magnets have been used in dentistry to retain dentures
[13] and maxillofacial prostheses [4]. Development
and availability of rare earth magnetic alloys (cobalt-
samarium alloys or neodymium-iron-boron) have
led to their increased use in orthodontics [5,6].
Several clinical applications have been described,
including the treatment of unerupted teeth [7,8], arch
expansion [9], xed retention [10] and anterior open
bite correction [11].
This case report describes the use of magnets in
the management of unerupted premolars and molars
and considers the advantages and limitations of the
technique.

Case report

Eight children, mean age 115 years (range 1015
years), were selected. Each child had a single tooth
that had failed to erupt and that was considered
beyond the scope of conventional orthodontic techniques.
Treatment was undertaken in a Hospital Paediatric
Dental Unit following a standard clinical protocol
(illustrated in Figs 15).

Clinical protocol

1

Radiographs (panoramic or periapical views) were
taken to ascertain the cause of eruption failure and
severity of tooth impaction (Fig. 1).

2

A removable appliance was tted prior to surgical
tooth exposure (magnet placement) to ensure that

Correspondence: B. O. I. Cole, Department of Child Dental
Health, Dental School & Hospital, Richardson Road, Newcastle
upon Tyne NE2 4AZ, UK. E-mail: B.O.I.Cole@ncl.ac.uk
Fig. 1. Panoramic view showing distally inclined and unerupted
UR7 prior to treatment.
Moving impacted teeth with magnets

205

2003 BSPD and IAPD,

International Journal of Paediatric Dentistry



13:

204207

patients had the necessary compliance to undergo
their postoperative orthodontic treatment (Fig. 2).

3

Paralene coated NdFeB magnets (Magnet Devel-
opments Ltd, Swindon, UK) were encased in ortho-
dontic composite (Transbond, 3M, Unitek, Monrovia,
CA, USA).

4

Teeth were surgically exposed and encased
magnets (3 mm

3 mm



2 mm) were cemented
in place using orthodontic adhesive (Transbond, 3M,
Unitek) (Fig. 3).

5

Patients were reviewed 12 weeks after surgery
and their removable appliances modied to accept
an encased magnet (5 mm

5 mm



3 mm). The
magnet was carefully orientated to ensure the at
attractive surface was as near parallel as possible
to the rst magnet bonded to the tooth.

6

Post-operative radiographs (panoramic or peri-apical
views) were taken to conrm correct magnet orientation
and as a baseline reference for monitoring tooth
movement.

7

Patients were seen for a further review at 1 month
and then at 3-monthly intervals until the magnets
were removed or, between these reviews if problems
occurred.

8

Final arch alignment was undertaken with xed
appliances if necessary (Fig. 5).

Results

Seven teeth (one premolar and six molars) erupted
successfully over a 6-month period. The mean
treatment time with magnetic traction was 75 months
(range 312 months). One premolar failed to erupt.
Serial radiographic assessment over a 9-month period
revealed no evidence of tooth movement and so the
magnetic xture was removed. Histological assessment
of soft tissue samples taken from around the xture,
at the time of removal, identied the presence of
granulation tissue with no evidence of abnormal
pathology.
Fig. 2. A lower removable appliance demonstrating embedded
opposing magnet.
Fig. 3. Surgically exposed UR7 with magnet cemented on the
mesial surface.
Fig. 4. Partially erupted UR7 four months post magnetic traction.
Fig. 5. Final alignment of UR7 with xed appliance.
206

B. O. I. Cole

et al.

2003 BSPD and IAPD,

International Journal of Paediatric Dentistry



13:

204207

Discussion

Treatment options available to clinicians for the
management of teeth that fail to erupt include extrac-
tion, transplantation and application of conventional
orthodontic traction [1214]. An alternative option
involves the use of magnetic traction, which is less
traumatic than extraction and transplantation and avoids
the need for direct application of traction forces
through gold chain, ligatures and elastics [13,14].
Case reports have shown the technique to be effective
in the management of unerupted canines and premolars
[7,8]. This case report conrms that magnetic traction
can also be used to treat unerupted molars where the
application of direct traction forces is frequently
restricted.
The failure of one premolar to erupt was attrib-
uted to its unfavourable position. Correct orientation
of magnetic xtures proved difcult and the 10 mm
intermagnet distance achieved for this tooth was
considered too large to generate sufcient attractive
force to produce tooth movement. Previous reports
conrmed that attractive forces generated between
intraoral magnets fall rapidly as intermagnetic
distances increase [7,15] and this can be explained
as the force generated between magnets is inversely
proportional to the square of the distance between
them. In the seven successful cases, the intermagnet
distances did not exceed 8 mm, suggesting that
distances up to this magnitude can produce sufcient
force to induce tooth movement.
The safety and biological properties of magnets
have been thoroughly investigated and current
evidence indicates that coated NdFeB magnets are
acceptable for clinical use [16,17]. Magnets used
in this series were Paralene coated and encased in
orthodontic composite to prevent degeneration in
the oral environment. Failure of one premolar to
erupt gave the opportunity to take soft tissue
biopsies adjacent to the xture at the time of its
removal. No histological evidence of abnormal
pathology was noted in agreement with previous
work [17].
This case report conrms that magnetic traction can
be used in the management of unerupted premolars
and molars and merits further investigation.

Acknowledgements

We are grateful to all the practitioners who contributed
patients to this series.

Rsum.

Cette srie de cas dcrit lutilisation daim-
ants dans le traitement de dents nayant pu faire leur
ruption. Huit enfants ont t traits, gs de 10
15 ans. La traction magntique a t applique
deux prmolaires et six molaires. Sept dents (une
prmolaire et six molaires) ont pu faire leur ruption
(temps moyen de traction magntique 7,5 mois).
Une prmolaire est reste bloque. Lvaluation
radiographique sur une priode de 9 mois na montr
aucune preuve de mouvement. Le systme mag-
ntique a t dpose. Lvaluation des chantillons
de tissus pris autour du systme nont rvl aucune
pathologie.

Zusammenfassung.

Diese Fallserie schildert den Ein-
satz von Magneten in der Behandlung von Zhnen
mit Eruptionsstrungen. Acht Kinder im Alter von
10 bis 15 Jahren wurden behandelt. Magnetische
Befestigungselemente wurden an zwei Prmolaren
und sechs Molaren angebracht. Sieben Zhne (ein
Prmolar und sechs Molaren) konnten daraufhin zur
Eruption gebracht werden (mittlerer Behandlungszeit
mit Magnetzug: 7.5 Monate). Ein Prmolar konnte nicht
mobilisiert werden: Eine Serie von Rntgenaufnahmen
ber einen Zeitraum von 9 Monaten ergab keinerlei
Hinweise auf eine Bewegung, so dass die mag-
netische Apparatur entfernt wurde.
Die histologische Untersuchung von Gewebe aus
der Umgebung der magnetischen Apparatur ergab
keine pathologischen Vernderungen.

Resumen.

Esta serie de casos describe el uso de
imanes en el tratamiento de dientes que presentan
un fracaso en la erupcin. Se trataron ocho nios
que tenan entre 10 y 15 aos. La traccin magntica
fue aplicada en dos premolares y seis molares. Siete
dientes (un premolar y seis molares) erupcionaron
exitosamente (tiempo promedio con traccin mag-
ntica: 7,5 meses). Un premolar no erupcion y la
serie radiogrca durante un periodo de 9 meses,
revel la falta de movimiento eruptivo por lo que
se retir la jacin magntica. La evaluacin his-
tolgica obtenida del tejido circundante a la jacin,
revel la ausencia de patologa.

References

1 Freedman H. Magnets to stabilise dentures.

Journal of
American Dental Association

1953;

47

: 288289.
2 Thompson IM. Magnetism as an aid to a prosthetic problem.

British Journal of Surgery

1964;

2

: 4446.
3 Behrman SJ. The implantation of magnets in the jaw to aid
Moving impacted teeth with magnets

207

2003 BSPD and IAPD,

International Journal of Paediatric Dentistry



13:

204207
denture retention.

Journal of Prosthetic Dentistry

1960;

10

:
807841.
4 Javid N. The use of magnets in maxillofacial prosthesis.

Journal of Prosthetic Dentistry

1971;

25

: 334341.
5 Blechman AM. Magnetic force systems in orthodontics.

American Journal of Orthodontics

1985;

87

: 201210.
6 Blechman AM, Smiley H. Magnetic force in orthodontics.

American Journal of Orthodontics

1978;

74

: 435443.
7 Darendeliler MA, Friedle JM. Treatment of impacted canines
with magnets.

Journal of Clinical Orthodontics

1994;

28

:
639643.
8 Sandler PJ, Springate SD. Unerupted premolars an
alternative approach.

British Journal of Orthodontics

1991;

18

: 315321.
9 Vardimon AD, Graber TM, Voss LR, Verrusio E. Magnetic
versus mechanical expansion with different force thresholds
and points of application.

American Journal of Orthodontics
and Dentofacial Orthopedics

1987;

92

: 455466.
10 Springate SD, Sandler PJ. Micro-magnetic retainers: an
attractive solution to xed retention.

British Journal of
Orthodontics

1991;

18

: 139141.
11 Dellinger EL. A clinical assessment of the active vertical
corrector a nonsurgical alternative for skeletal open bite
treatment.

American Journal of Orthodontics

1986;

89

:
428436.
12 Marcusson KAM, Lilja-Karlander EK. Autotransplantation of
premolars and molars in patients with tooth aplasia.

Journal
of Dentistry

1996;

24

: 355358.
13 Kokich VG, Matthews DP. Surgical and orthodontic management
of impacted teeth.

Dental Clinics of North America

1993;

37

: 181204.
14 Jones JW, Husain J. Management of the unerupted incisor.

Dental Update

1996;

23

: 3639.
15 Vardimon AD, Graber TM, Drescher D, Bourauel C. Rare earth
magnets and impaction.

American Journal of Orthodontics
and Dentofacial Orthopaedics

1991;

100

: 494512.
16 Noar JH, Evans RD. Rare earth magnets in orthodontics: An
overview.

British Journal of Orthodontics

1999;

26

: 2937.
17 Bondemark L, Kurol J, Larsson A. Long-term effects of
orthodontic magnets on human buccal mucosa a clinical,
histological and immunohistochemical study.

European
Journal of Orthodontics

1998;

20

: 211218.