Clinical management of mandibular permanent premolars with periapical lesion and bilateral supernumerary teeth: A 7-years follow-up case report

Abstract

Objectifs: This 7-years follow-up case report describes two diversified strategies for the management of bilateral mandibular permanent premolars associated with periapical lesion and unerupted supernumerary teeth.

Case Report: A non-syndromic 9 years-old Asian female patient presented pain and swelling of the 35 in anatomical contiguity with an immature and unerupted supernumerary tooth. Clinical examination revealed an intraoral vestibular sinus tract related to the necrotic 35. Periapical radiography and CBCT showed that the 35 had an immature apex associated with a periapical lesion, and a supernumerary tooth in a lingual direction. Endodontic treatment of the 35 was performed by creating an apical plug with ProRoot MTA, while the supernumerary tooth was monitored radiographically with no intervention. Four years later, the 45 developed the same clinical condition of the left arch. Radiographic examination revealed a periapical lesion with massive periapical bone resorption, and a supernumerary tooth in normal alignment. The second premolar was herein extracted to allow for eruption of the supernumerary tooth.

Outcomes: 3-years follow-up revealed continued root maturation and its spontaneous eruption in the dental arch. Proper healing of both mandibular lesions was monitored after 10 months, 3-years and 7-years revealing no recurrence on both sides.