Case report: A.J. Premolar autotransplantation--eight years later

Congenitally missing premolars often present a diagnostic concern to the orthodontist. Arch crowding, facial profile and the existing malocclusion must be evaluated to diagnose and establish treatment objectives and a treatment plan. When premolars are missing bilaterally in the arches, diagnosis and treatment mechanics can often be straightforward. The choices are (1) to close all spaces so that natural teeth contact each other or (2) to maintain the primary tooth in the missing tooth area with the possibility that a replacement tooth might be needed once the primary tooth exfoliates. The compromises of maintaining the primary tooth can include the periodontal and occlusal concerns due to the size and shape of the crown and root both occlusal-gingivally and mesio-distally.