Unusual Impaction of a Mandibular Second Premolar: Case Report

Abstract

Aim The aim of this study is to present clinical and radiographic features along the treatment of an unusual impacted mandibular second left premolar of a patient applied to our faculty. Case Report A 23-year-old female patient was referred to our clinic with pain and mild swelling that is localized at mandibular left area. We examined her panoramic radiography and we noticed that her mandibular second left premolar was impacted vertically and the point of root crossed the cortical bone at the inferior border of mandible. Then, we took a dental volumetric tomography from the patient for a more sensitive assessment of the localization of the impacted tooth and its relationship with the mandibular canal. The tooth was extracted at the Department of Oral Surgery to relieve the pain and the patient was followed up periodically. Discussion In the case of having an impacted tooth, periapical, orthopantomographs or occlusal radiographs are used to detect it. The images obtained with these conventional techniques are 2-dimensional and not sufficient for determining of the exact localization and the relation of the tooth with adjacent structures. Latest research shows that instead of conventional radiographies, Cone beam computed tomography is more successful in defining the localization of impacted teeth. Conclusion In the treatment of impacted teeth, orthodontic treatment or tooth extraction can be applied according to the age of the patient and the condition of the dental arch.

Keywords

• Cone-beam computed tomography
• Dentistry
• Impacted teeth
• Mandible
• Tooth

Supporting Institution

Nil

Project Number

Nil

Thanks

Nil

References

1. Alamri A, Alshahrani N, Al-Madani A, Shahin S, Nazir M. Prevalence of Impacted Teeth in Saudi Patients Attending Dental Clinics in the Eastern Province of Saudi Arabia: A Radiographic Retrospective Study. Scientific World J Vol 2020; Article ID 8104904, pp. 1-6.
2. Bhat M, Hamid R, Mir A. Prevalence of impacted teeth in adult patients: A radiographic study. IJADS 2019; 5(1): 10-12.
3. Hartman B, Adlesic AC. Evaluation and Management of Impacted Teeth in the Adolescent Patient. Dent Clin N Am 2021; 65(4): 805-814.
4. Patil S, Doni B, Kaswan S, Rahman F. Prevalence of dental anomalies in Indian population. J Clin Exp Dent 2013; 5(4): e183-186.
5. Ayrancı F, Ölmezli MM, Sivrikaya EC, Rastgeldi Z. Prevalence of Third Molar Impacted Teeth: A Cross-Sectional Study Evaluating Radiographs of Adolescents. J Clin Exp Inv 2017; 8(2): 58-61,
6. Alberto PL. Surgical Exposure of Impacted Teeth. Oral Maxillofacial Surg Clin N Am 2020; 32(4): 561-570.
7. Vitria EE, Tofani I, Kusdhany L, Bachtiar EW. Genotyping analysis of the Pax9 gene in patients with maxillary canine impaction. F 1000 Research 2019; 8:254.
8. Becker A, Chaushu S, Casap-Caspi N. Cone-beam computed tomography and the orthosurgical management of impacted teeth. JADA 2010;141(suppl 3):14S-18S.

9. Arabion H, Gholami M, Dehghan H, Khalife H. Prevalence of Impacted Teeth among Young Adults: A Retrospective Radiographic Study. JDMDT 2017; 6(3): 131-136.
10. Manjunatha BS, Chikkaramaiah S, Panja P, Koratagere N. Impacted maxillary second premolars: a report of four cases. BMJ Case Rep 2014: bcr2014205206.
11. Shekhar MG, Pavankumar PS, Chowdary VS, Shivappa AS. Bucco-lingual impaction of mandibular second premolar: case report and review of literature. Eur J Dent 2020; 1(6): 1-4.
12. Siotou K, Kouskouki MP, Christopoulou I, Tsolakis AI, Tsolakis IA. Frequency and Local Etiological Factors of Impaction of Permanent Teeth among 1400 Patients in a Greek Population. Dent J 2022; 10(8):1-10.
13. Biswas A, Babu SG, Rao K, Sakthivel S, Madiyal A, Castelino R. Application of 3-D imaging in a familial case of Cleidocranial dysplsia.
14. Shastri D, Tandon P, Singh GP, Singh A. Management of impacted 2nd premolar impaction by buccal approach: a case report. J Interdiscipl Med Dent Sci 2014;2(3): 1-4.
15. McNamara C, Mc Namara TG. Mandibular Premolar Impaction: 2 Cases report. J Can Dent Assoc 2005; 71(11):859–863
16. Bae SM, Hung BQ, Lee YG, Kyung HM. Treatment of an impacted and inverted upper premolar. J Clin Orthod 2017; 51(3):171-178.
17. Pippi R, Sfasciotti RL, Perfetti G. Extraoral extraction: a very rare surgical approach to tooth impaction. Minerva Stomatol 2005; 54(3): 171-177.
18. Göçmen G, Varol A, Basa S, Göker K. Extraoral Extraction of an Impacted Molar Using Bone Lid Technique. Marmara Dent J 2013; 1: 42-43.
19. Smędra A, Wochna K, Neskoromna-Jędrzejczak A, Berent J. Extraoral tooth 48 extaction- a sequence of medical errors and complications. J Stoma 2018; 71(5): 439-443.
20. Deliverska EG, Petkova M. Complications after extraction of impacted third molars-literature review. JIMAB 2016; 22(3): 1202-1211.