Pulp treatment in a second primary molar for preservation due to agenesis of the lower second premolars “clinical case”

Abstract

Dental agenesis is characterized by the congenital absence of one or more teeth in the deciduous or permanent dentition, and is considered the most frequent dental anomaly. It can occur in isolation or associated with genetic syndromes and is classified as hypodontia, oligodontia, or anodontia, according to the number of missing teeth. This condition results from alterations in the dental lamina, which prevent the formation of the dental germ. This case report aims to describe the therapeutic approach for a second lower deciduous molar without a permanent successor, based on cephalometric analysis and the individual needs of the patient. A 10-year-old male patient was evaluated in a pediatric dentistry clinic, and agenesis of teeth 35 and 45 was diagnosed through clinical and radiographic examination. Tooth 75 presented a carious lesion with pulpal involvement. After cephalometric analysis, it was decided to preserve the deciduous tooth to favor occlusal development. Pulp treatment was performed with MTA and glass ionomer, followed by clinical and radiographic follow-up, which demonstrated therapeutic success. This case highlights the importance of early diagnosis and interdisciplinary planning in dental agenesis.