Penatalaksanaan impaksi gigi premolar kedua bawah kiri tanpa exposure bedah pada perawatan ortodonti cekatNon-surgical exposure management of impacted lower left second premolar in orthodontic treatment

Introduction: Impacted lower second premolars are typical cases in the third rank after third molars and upper canines. There are several ways to treat impacted teeth. The choice of treatment plan depends on the position, distance to the occlusal plane, developmental stage, relationship of the impacted tooth to adjacent teeth, orthodontic treatment needs, patient age, and the healing response of hard and soft tissues after surgery. The patient was treated without surgical exposure. Tooth 34 was extracted, which blocked the eruption path of tooth 35, followed by fixed orthodontic treatment to open space for tooth 35 and pull tooth 35 into the occlusal plane. This case report aims to present the management of impacted orthodontic treatment of the left lower second premolar without surgical exposure. Case report: A 20-year-old female patient with skeletal class II division 1 malocclusion, bimaxillary dentoalveolar protrusion, brachyfacial facial type, convex profile, and impacted tooth 35. MBT bracket insertion of 0.22” slot was performed after teeth 14, 24 and 34 were extracted. The space for the eruption of tooth 35 was maintained by placing an open coil spring between teeth 33 and 36. Once there was sufficient space for tooth 35, tooth 35 was pulled into the dental arch. The total treatment time was 21 months. The impacted tooth 35 had entered the occlusal plane, the patient’s soft tissue profile improved, the upper lip became more competent, and a lip seal was created due to reduced overjet. Conclusion: Management of patients with impacted lower second premolars without adequate surgical exposure and the patient’s smile is more aesthetically pleasing with the position of the anterior teeth in a well-corrected profile.