Eruption guidance of horizontally angulated, distally displaced mandibular second premolars: Three case reports

An improperly positioned tooth germ can lead to tooth impaction, damage to adjacent teeth, and loss of arch integrity. This report describes three cases of eruption guidance of developing mandibular second premolars (MnP2) that were horizontally angulated and displaced to the distal side of the roots of the second primary molars.

The primary second molars were extracted when root formation of the succeeding premolar began. Surgical exposure was performed to accelerate eruption. These two procedures led to spontaneous eruption of all premolars. In the last case, however, a displaced second premolar disturbed the eruption of the first molar into the occlusal plane.

Several factors should be considered for an optimal treatment approach, including the clinical eruption status, development of the root MnP2, and effect on the mandibular first molar.