Mandibular premolar migration: two case reports

Premolar migration is an infrequent and unusual phenomenon. Although several cases of distal premolar migration have been reported in the literature, the management of these cases is often challenging and to date, there are no agreed guidelines regarding best practice. This report describes two cases of distal migration of a lower second permanent premolar with sequential panoramic imaging mapping the progress of the teeth as they migrated distally. Cone Beam Computerised Tomography was subsequently used in one case to locate the migrated premolars' precise position. We report on one case which was managed with the surgical removal of the migrated premolar and one case which has been managed conservatively to date, largely due to patient wishes. Alternative treatment strategies are also discussed in the following case report.