Introduction
Hyperdontia involving the premolar teeth can be single or multiple or even related to a syndrome. Their occurrence has ranged between 0.09 to 0.64% in the general population1,2. A 21-year-old patient with a non-contributory history reported to the clinic with a complaint of spacing in the anterior teeth. On radiographic examination, eumorphic supernumerary premolar crowns were found located between the roots of the mandibular first and second premolars (Figure 1). The patient was completely asymptomatic and had no knowledge regarding the presence of these accessory teeth. A Neumann full-thickness flap was utilized to remove these during the course of orthodontic treatment. A lingual approach is preferred during their removal over the buccal method as it poses less risk of root trauma. The shortcoming of this approach is that although it is better for visualization, it poses a high risk of trauma to the adjacent teeth or nerves. As the premolar was being removed on the right side, there was a fracture of the root apex. On follow-up over the next 1 year, no other complications or secondary tooth germs were observed, and following a period of bone formation, the bone in the affected area normally formed again (Figure 2).