[Tooth movement of an impacted lower 2nd premolar in the root developmental stage--a follow-up radiographic observation on the root formation].

Abstract

A 9 year old girl presented an impacted lower right 2nd premolar which not only was in horizontal position, but its crown was directed lingually. As a lower right 2nd premolar was in such a position that normal eruption was impossible, the deciduous predecessor was extracted at 9 years of age, and then sufficient space had been created for the lower right 2nd premolar to be erupted, and the eruption of it was observed for about 2 years. 2 years later, radiographic indication showed that no spontaneous eruption of a lower right 2nd premolar was to be expected. At 11 years of age, surgical exposure and traction of a lower right 2nd premolar was attempted. When the lower right 2nd premolar was upright, its root formation was in the 1st stage of root developmental stages according to Moorrees et al. Follow up radiographic observations on surgical exposure and traction of a lower right 2nd premolar 3 years later revealed the following results: 1. The root development went on to amount to about 90 percent of the root formation of the other tooth concerned without the curvature of the root. 2. Lamina dura and periodontal space were normal. The continued root formation was narrowing the root apex and the pulpal tissue of apical foramina was continuous with the periodontal space surrounding the root. 3. Bone deposition occurred at the alveolar crest and the latter was recontoured normally. The interdental and inter-radicular trabecula were good. As based on these results, normal development of the root of a lower right 2nd premolar with normal periodontium can be anticipated. Clinically, the lower right 2nd premolar had completely erupted and was in normal position on the arch and in occlusion. Color, vitality and mobility were normal. Periodontal support was good. The above-mentioned findings give support to the possibility that "early treatment" enables the impacted tooth to correct.