Diagnosis and treatment planning for unerupted premolars

Premolars rank third in frequency after third molars and maxillary canines in impacted or unerupted teeth. Failure to detect and analyze the problem may lead to unnecessary space loss, crowding, or collapse of the dental arch. A diagnostic scheme is presented to facilitate diagnosing and treating unerupted premolars. Important observations include: Diagnosing congenitally missing permanent teeth. Whether the condition is generalized or localized. Whether the succedaneous tooth has a viable form, eruptive potential, and viable orientation Whether the delayed eruption is due to over-retained primary molars such as ankylosis and incomplete root resorption. The amount of space available for the succedaneous tooth to erupt The presence of overlying soft tissue or bone. Space management and proper management of primary molars will frequently facilitate uneventful eruption of premolars. Orthodontic guidance of eruption is rarely indicated if problems can be detected early and managed properly. Four case reports elucidate the recommended treatment methods for these commonly occurring unerupted premolars.