Introduction
Hyperdontia involving the premolar teeth can be single or multiple or
even related to a syndrome. Their occurrence has ranged between 0.09 to
0.64% in the general population1,2. A 21-year-old
patient with a non-contributory history reported to the clinic with a
complaint of spacing in the anterior teeth. On radiographic examination,
eumorphic supernumerary premolar crowns were found located between the
roots of the mandibular first and second premolars (Figure 1). The
patient was completely asymptomatic and had no knowledge regarding the
presence of these accessory teeth. A Neumann full-thickness flap was
utilized to remove these during the course of orthodontic treatment. A
lingual approach is preferred during their removal over the buccal
method as it poses less risk of root trauma. The shortcoming of this
approach is that although it is better for visualization, it poses a
high risk of trauma to the adjacent teeth or nerves. As the premolar was
being removed on the right side, there was a fracture of the root apex.
On follow-up over the next 1 year, no other complications or secondary
tooth germs were observed, and following a period of bone formation, the
bone in the affected area normally formed again (Figure 2).