Complications associated with the surgical removal of non-syndromic supernumerary premolar tooth buds in the mandible

Hyperdontia involving the premolar teeth can be single or multiple or even related to a syndrome. These are frequently encountered in permanent dentition, but their occurrence has ranged between 0.09 and 0.64% in the general population. These are commonly found between the permanent canines and first premolars but rarely between the first and second premolars. These are usually eumorphic and can be easily identified as they follow the conventional tooth morphology. These are usually asymptomatic and not easily palpable unless they are very close to eruption. A lingual approach is preferred during their removal over the buccal method as it poses less risk of root trauma. In this case, bilateral accessory premolar tooth buds were present between the first and second premolars. Since the patient was undergoing orthodontic treatment, she was advised to remove these accessory teeth. For their removal, a Neumann flap with a buccal approach was used, which led to fracturing the root apex of the mandibular right second premolar root. 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 formed normally again.