An abnormally oriented tooth germ causes root resorption of adjacent teeth, and root curvature and abnormal direction of eruption have also been reported. The present report describes three patients with four abnormally oriented tooth germs treated by surgical rotation. All of the patients were girls, with an average age of 11.3 years at treatment. One upper second premolar and three lower second premolars were treated, and the degrees of tooth development were Ri-R 1/4 according to Moorrees. Axial inclinations of the crowns of the impacted teeth were -92° for the upper premolar and 56° to 78° for the lower premolars. Axial inclination after the operations ranged from 12°to 48°. Natural eruption occurred in three teeth, and one tooth is erupting. However, a constricted pulp cavity was seen in two teeth, and root curvature was seen in one tooth. Our results suggested that surgical rotation of abnormally oriented tooth germs at the initial stage can lead to natural eruption with natural root formation, although abnormalities of pulp cavities and root shape were seen in some of our patients.
