Conservative Approach in Management of Unerupted Second Premolar Teeth: A Case Report

Impaction of premolar teeth is a common dental problem. Timelyandappropriatetreatmentof theseteethis important in preventingthe risk ofpossible problems, such as effectsonadjacent structuresand thepossibility ofpathological manifestation. Treatment of these teeth includes conservative orthodontic and/or surgical interventions. Few reports about management of impacted or unerupted second premolar are available. Case report: The patient was a 12-year-old girl with four unerupted second premolars. In radiographic examination, the right maxillary second premolar was in horizontal buccolingual direction and the mandibular second premolars were distoangular. All second primary molars were extracted and space-maintainers were placed in both jaws. After eight months, the maxillary second premolar teeth and mandibular right second premolar erupted spontaneously. In subsequent visits, due to worsening of eruptive position of the left second premolar, bone mass covering the crown and refusing surgical exposure and orthodontic repositioning treatment, by the patient and her parents, this tooth was removed surgically. Conservative approach should be considered as a non-invasive treatment option before surgical ororthodontic treatment plan in management of impacted second premolar teeth. However, factors such as the developmental disturbance of other permanent teeth, oral hygiene and patient compliance should be considered in planning an appropriate treatment approach for each patient.