A continuous process of teeth eruption and shedding replaces the exfoliated deciduous teeth with succedaneous teeth i.e permanent incisors, canine and premolar .
Differential gene expressions by dental follicle needed for osteoclastogenesis, osteogenesis and pressure from underlying succedaneous teeth are responsible for timely shedding and eruption process of succedaneous teeth (3) and several local, systemic causes including syndromes (Cleidocranial dysplasia, Gardner's syndrome) and metabolic or hormonal diseases have been attributed in literature for impacted and embedded teeth.
The present case, reports a patient, with sixteen retained deciduous teeth along with multiple permanent teeth out of which some were erupted, some impacted and embedded succedaneous teeth, and some supernumerary teeth.
After the clinical and radiographic evaluations, a treatment plan was made under which it was advised that all the third molars need to be extracted and orthodontic extrusion of succedaneous teeth will be attempted.
While impaction of tooth is widespread, multiple impacted succedaneous teeth along with multiple retained primary teeth by itself is a rare condition.