Treatment planning in the presence of congenitally absent second premolars: a review of the literature.

One of the most common dental anomalies encountered by the pediatric dentist is the congenital absence of second premolars. Once diagnosed, the appropriate treatment necessitates the formulation of a comprehensive treatment plan, which is dependent upon a number of factors. Considerations include: the condition of the deciduous molar, dental and skeletal relationships, dental age of the patient, willingness of the patient to undergo extensive dental treatment and financial considerations. Approaches to the management of congenitally missing premolars have been described in the literature, including the more recently available option of dental implant placement. The objective of this paper is to present a review of the literature with emphasis on the considerations needed for appropriate treatment planning when the practitioner is confronted with this diagnostic challenge.