Surgical removal of trans-alveolar mandibular 2[nd] premolar impactions by lingual approach

There is an abundance of literature on impacted teeth but only a few papers have addressed impacted premolars. A case of a young female with bilaterally impacted mandibular 2[nd] premolars in trans-alveolar position with their crowns facing lingually and roots buccally is reported. The patient was under orthodontic treatment for correction of malocclusion with an orthodontic plan for surgical removal of impacted mandibular 2[nd] premolars. Due to lingual position of crowns of these impacted teeth, it was decided to adopt lingual surgical approach rather than conventional buccal approach for their removal. The surgical approach with discussion on the various management options for management of impacted premolars is described here