If a premolar is impacted sideways and located below a retained primary molar, what is the recommended action?

• A. Monitor the teeth
• B. Extract the primary molar
• C. Perform orthodontic treatments to move the premolar
• D. Use extraction of both the premolar and primary molar

Answer: (B)

The recommended action to extract the retained primary molar in the context of a sideways-impacted premolar situated beneath it is based on several clinical considerations. When a permanent tooth is impacted, its position can lead to complications such as potential tooth resorption of adjacent teeth, pathological changes, or developmental problems if left untreated.

Extraction of the retained primary molar can facilitate the eruption of the impacted premolar, improving the chances for its optimal eruption path. By removing the obstructing primary molar, the space becomes available for the impacted tooth, which can allow it to assume a more favorable position within the dental arch. This approach can prevent future complications that could arise from the impaction or crowding of teeth.

Furthermore, monitoring without intervention might lead to the worsening of the situation as the primary tooth may not exfoliate naturally, and the impacted tooth could stay submerged or move further into an undesirable position, complicating future treatment options. Performing orthodontic treatments without extraction could also be inappropriate since the presence of the retained primary molar can lead to difficulties in aligning the other teeth and addressing the impaction effectively. Similarly, extracting both teeth may not be necessary if the primary molar can be removed to allow the premolar to erupt properly.

Thus,