From Impaction to Eruption: Management of an Impacted Mandibular Second Premolar with an Open Coil Spring in a Pediatric Patient – A Case Report

Abstract

Mandibular premolar impaction in children is rare but may cause space loss, crowding, and eruption disturbances. Early detection and interceptive orthodontic treatment help regain space and guide eruption. A 9-year-old girl presented with delayed eruption of the mandibular right second premolar (45). Clinical and radiographic evaluation revealed inadequate space and impaction. A fixed orthodontic appliance with an open coil spring was placed between teeth 44 and 46 to regain space. Regular follow-up over 10 months showed progressive space opening and favorable eruption of 45. The appliance was well tolerated, and sufficient space was achieved for spontaneous eruption without complications. An open coil spring is an effective, well-tolerated, and predictable space regainer for managing impacted teeth in children. Early mixed-dentition intervention can simplify later orthodontic treatment and prevent complex malocclusion.