Author: Dr Shaun Goh
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Treatment Indications & Timings
Clinical Assessment & Presentations
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Description
Ectopic premolar
“An ectopic premolar can erupt palatally, lingually or buccally in the alveoloar ridge. Their eruption may be delayed or prevented due to the lack of space.”
– Proffit et al. 2013
Upper palatally ectopic premolar
Lower lingually ectopic premolars
Ectopic premolars occur mostly due to crowding or loss of arch space. Their presence can usually be detected radiographically. An ectopic premolar can be anticipated due to the loss of arch length because of factors like early loss of deciduous molars and drifting of the permanent molars.
Treatment Indications & Timings
Early treatment indications:
➤ Early loss of deciduous molars
➤ Over-retained deciduous molar or obstruction
➤ Radiographic signs of an ectopic premolar
Comprehensive treatment indications:
➤ Damage to adjacent teeth and structures
➤ Crowding due to ectopic teeth
➤ Aesthetic concerns of ectopic teeth
➤ Trauma to soft tissues
Clinical Assessment & Presentations
Intraoral Features
Loss of leeway space
Loss of leeway space
Ectopic eruption of premolar
Ectopic eruption of premolar
Radiographic signs
Radiographic signs
Diagnosis & Considerations
Diagnosis
- Maxillary or mandibular ectopic premolars
- Palatal/lingual, midalveolar, buccal ectopia
Clinical Considerations
- Ideal timing for interceptive treatment
Treatment Options
Click a treatment category to explore.
➤ Interceptive orthodontics
➤ Comprehensive orthodontics
➤ Surgical removal without orthodontics
➤ Leave premolar in-situ
Associated Problems
Early loss of deciduous teeth | Crowding