The conservative approach to managing unerupted lower premolars – two case reports

Abstract

General dental practitioners frequently refer patients with unerupted premolars for specialist management. The frequency of unerupted lower second premolars in 15-year-old children has been cited as high as 9.7%. Two cases are discussed involving unilateral unerupted premolars, which initially appear to be in unfavourable positions. The first patient was referred at 16 years of age and presented with an unerupted lower left first premolar positioned along the lower border of the mandible. The second patient presented with an unerupted distally inclined, horizontally positioned second premolar impacting on the roots of the first permanent molar. Both cases were reviewed without any treatment, and both premolars erupted into excellent positions. This raises important questions concerning the possible treatment options for such teeth as well as the timing of any interceptive treatment. In cases where premolars are unerupted or impacted, a multidisciplinary approach is indicated involving orthodontics, paedodontics and oral surgery to establish the optimal treatment plan.

The Prevalence of Impacted Premolars in the Anatolian Population

“…Thus, we consider that, although premolar impaction is infrequent, early diagnosis is important. In addition, unerupted and impacted premolars can be a problem for orthodontists and oral surgeons, and the approach to managing these teeth are still an area of controversy (8,22). Orthodontic treatment options should be considered (23).…”

“…Observation involves no treatment other than monitoring the patient clinically and radiographically (19). Assessment of all the clinical and radiographic findings is fundamental when deciding upon a suitable treatment plan (8). In this study, we recorded cystic lesions in 7 (6.93%) impacted premolars, and 61.30% of the impacted premolars were extracted.…”

“…These impacted teeth can cause problems in clinical dentistry (8). Although they are mostly asymptomatic, they are sometimes discovered when a patient presents with pericoronitis or pathologies such as a cystic lesion in an adjacent tooth.…”

“…Although they are mostly asymptomatic, they are sometimes discovered when a patient presents with pericoronitis or pathologies such as a cystic lesion in an adjacent tooth. Thus, the discovery of an impaction usually occurs during a routine visit, and this leads to a late diagnosis (8)(9)(10). There are insufficient studies about impacted premolar prevalence in the literature.…”

Incidence of Mandibular and Maxillary Impacted Canines Transmigration:a Retrospective Study

“…The incidence of impacted teeth has been reported between 6.9% and 76.6% [1][2][3][4][5][6] . The most frequently impacted teeth are third molars, upper canines, upper central incisors and upper premolars, respectively [7][8][9] . Although many impacted teeth are asymptomatic, they can cause movement or external root resorption of the adjacent teeth, cystic lesions, and especially in partial eruption cases, infection, pain and trismus 10 .…”