Impaction of teeth is more commonly noticed with permanent dentition compared to primary dentition. Impaction of deciduous teeth can result in a variety of consequences including effects on the succedaneous teeth. Here we present a unique incidental finding on a panoramic radiograph of a 19-year-old male who had an unerupted mandibular right second premolar with the deciduous second molar being significantly off positioned against the lower border of the mandible. Inversion of the intraosseous positions of the primary molar and its succedaneous premolar is a very rare phenomenon. Various factors, such as lack of space in the dental arch, obstruction caused by supernumerary teeth, infectious process in the path of eruption or displacement of the tooth bud due to traumatic facial injury, have been implicated in the causation of impaction of teeth. Hence, disturbances in the eruption of the primary tooth could result in non-eruption of the succedaneous tooth.
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