Scientific Online Resource System

Scripta Scientifica Medicinae Dentalis

Diagnostic approach to the incorrect position of lower second premolars

Zornica Valcheva, Hristina Ivanova Arnautska, Tsvetan Tonchev, Tihomir Georgiev


Abstract: The lower second premolar is regarded as the third most common impacted tooth after lower wisdom teeth and upper canines. The aim of the present study is to apply objective diagnostic methods to help determine the impaction likelihood of lower second premolars and their distal inclination. For the purpose of this study 137 panoramic radiographs (OPGs) have been examined of children aged 8 - 16 years. The methodology used in this study helped measure the inclination and angle between the lower second premolar and the crown and axis of the first permanent molar and the mandibular plane. Prevalence of the distal inclination of lower second premolars was observed. Indicators for the impacted lower second premolar proved to be the germ inclination of the lower fifth tooth in relation to the first molar of more than 30° and the intersection of the crown of the sixth tooth by the axis of premolar as well as the inclination towards the mandibular plane of less than 68°. Early extraction of deciduous molars, reserving or creating space when there is a lack of space, allow for favourable conditions for altering the eruption path of the premolar.


lower premolar; second temporary molar; impacted premolar; disturbed eruption path

Full Text


Collett AR. Conservative management of lower second premolar impaction. Aust Dent J. 2000 Dec;45(4):279-81.

Thilander H, Thilander B, Persson G. Treatment of impacted teeth by surgical exposure. A survey study. Sven Tandlak Tidskr1973;66:519-525.

Andreasen JO. Textbook and color atlas of tooth impactions. Diagnosis, treatment and prevention. Copenhagen: Munksgaard; 1997. 177-195.

Tsukamoto S, Braham RL. Unerupted second primary molar positioned inferior to the second premolar: clinical report. ASDG J Dent CHILD. 1986;53:67-9.

Borsatto M, Sant`Anna A, Niero H, et al. Unerupted second primary mandibular molar positioned inferior to the second premolar: case report. Pediatr Dent. 1999;21:205-8.

Kudo M, Konta K, Oguchi H. Clinical Observation of Unerupted Primary Molars in the Patients of Hokkaido University Pediatric Dental Clinic. Jpn J Ped Dent. 1996;34:824-34.

Bateman R, Emmering TE. Deciduous impaction. Oral Surg. 1976;42:852-3.

Park JK. Submerged impacted primary molar. Oral Surg. 1979;48:383.

Bhasker SN. Orban's Oral Histology and Embryology. St. Louis: Mosby; 1986. 372-3.

Chida R, Chiba K, Saitoh T, Mayanagi H. A case for impacted second deciduous molar caused by anomalies in the position of the tooth germ of succeeding permanent tooth. Jpn J Ped Dent. 1982;20:74-80. Japanese.

Haavikko K. The formation and the alveolar and clinical eruption of the permanent teeth. An orthopantomographic study. Suom Hammaslaak Toim. 1970;66:103-70.

Ooe T. Changes of positions of deciduous molar and premolar germs during development. Okajimas Folia Anat Jpn. 1968;44:83-97.

WassersteinA, BrezniakN, ShalishM, HellerM, and Rakocz M.Angular Changes and Their Rates in Concurrence to Developmental Stages of the Mandibular Second Premolar. The Angle Orthodontist. 2004;74(3):332-36.

Bianchi SD, Roccuzzo M. Primary impaction of primary teeth: a review and report of three cases. J Clin Pediatric Dent. 1991;15:165-8.

McNamara B, McNamara TG. Mandibular Premolar Impaction: 2 Case Reports Clare. JCDA. December 2005/January 2006;71(11):859-63.

Becker A. The orthodontic treatment of impacted teeth. New York: Thieme; 1998. 234.

Baccetti T, Leonardi M, Giuntini V. Distally displaced premolars: A dental anomaly associated with palatallydisplaced canines. Am J Orthod Dentofacial Orthop. 2010;138(3):318-322.

Burch J, Ngan P, Hackman A. Diagnosis and treatment planning for unerupted premolars. Pediatr Dent. 1994 Mar-Apr;16(2):89-95.

Konstat MM, White GE. Ankylosed teeth: a review of the literature. J Mass Dent Soc 1975;24:74-8.

Biederman W. The problem of the ankylosed tooth. Dent Clin North Am. 1968 Jul:409-24.

Andlaw RJ. Submerged deciduous molars: a review, with special reference to the rationale of treatment. J Int Assoc Dent Child. 1974;5:59-66.

Shalish M, Peck Sh, Wasserstein A, Peck L. Increased Occurrence of Dental Anomalies Associated with Infraocclusion of Deciduous Molars. Angle Orthod. 2010 May;80(3):440-5.



About The Authors

Zornica Valcheva
Faculty of Dental Medicine Medical University, Varna

Hristina Ivanova Arnautska
Department of PDM and Orthodontics Faculty of Dental Medicine Medical University, Varna

Tsvetan Tonchev
Faculty of Dental Medicine Medical University, Varna

Tihomir Georgiev
Faculty of Dental Medicine Medical University, Varna

Font Size