Korean J Orthod.  2012 Apr;42(2):94-98. 10.4041/kjod.2012.42.2.94.

Late development of a mandibular second premolar

• Bicakci AA
• Doruk C
• Babacan H

• KMID: 2273262
• DOI: http://doi.org/10.4041/kjod.2012.42.2.94

Abstract

In this report, we present the case of a girl with delayed odontogenesis of a lower second premolar for which she was followed up for 8.5 years. Congenital absence of permanent mandibular second premolars was observed at the initial radiographic examination at 8 years and 1 month. One year later, during the treatment period, an unexpected odontogenesis of a right second premolar was diagnosed on follow-up radiography. The original treatment plan was revised and a new plan was successfully implemented. Th is unusual case showed that the orthodontist's clinical philosophy must be flexible because unexpected situations can arise, especially when treating growing patients.

Keyword

Agenesis; Dentofacial anomalies; Diagnosis and treatment planning; Pediatric dentistry

MeSH Terms

Bicuspid
Follow-Up Studies
Humans
Odontogenesis
Pediatric Dentistry
Philosophy

Figure

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  Figure 1 Panoramic radiograph of the patient aged 8 years and 1 month showing the absence of mandibular permanent second premolars.

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  Figure 2 Panoramic radiograph of the patient aged 9 years and 6 months indicating mandibular right second premolar formation 17 months after initial diagnosis.

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  Figure 3 Panoramic radiograph of the patient showing no sign of mandibular left second premolar tooth formation, while calcification of the contralateral premolar had progressed.

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  Figure 4 Panoramic radiograph of the patient demonstrating that mineralization of 3 third molars had begun while the forth one was in the germ phase; therefore, agenesis diagnosis for the left premolar was given and the deciduous molar was extracted.

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  Figure 5 Panoramic radiograph of the patient showing that two-thirds of the late-developing premolar root formation was completed and the tooth was about to be exposed in the oral cavity.

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  Figure 6 Panoramic radiograph of the patient aged 16 years and 6 months demonstrating that the mandibular right second premolar reached the occlusal plane at 8 years and 6 months after initial diagnosis. Note that the root formation was almost complete; however, the apex was still open.

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