Management of congenitally missing second premolars in a growing child

The second premolars have the highest incidence of congenital absence, after the third molars. The problem resides not in the prevalence of congenitally missing premolars but in the selection of a treatment plan that will yield the best results over the long term. The present study reports a case of a 14 year old female patient with bilaterally congenitally missing second mandibular premolars with associated crowding of teeth. The case has been managed using a multi-speciality approach, in which both deciduous mandibular second molars were sectioned and the distal half retained. The retained half was prepared to receive a full coverage restoration which was contoured as a premolar. The space created was then utilized to correct the crowding by fixed orthodontics. A two year follow up shows retained distal half of the deciduous mandibular second molar with correction of crowding and space closure.