Background: Sagittal root position (SRP) and thickness of buccal plate were of clinical guiding significance in implant treatment planning. The study was to classify the SRP and angulations of the maxillary and mandibular premolar to each osseous housing, and to measure the thickness of buccal plate by cone beam computed tomography (CBCT) in order to estimate the distributions and provide clinical decision support. Methods: CBCT images was reviewed on 150 patients who fulfilled the inclusion criteria. The sagittal root position and angulations of the maxillary and mandibular premolars to their respective osseous housing were evaluated and classified using CBCT images. The thickness of buccal plate at 1 mm, 3 mm, 5 mm apical to the alveolar crest was also measured. Results: The frequency distribution of SRP types indicated that, 41.67%, 51.83%, 3.67%, and 2.83% of maxillary premolars; 84.33%, 15%, 0%, and 0.67% of mandibular premolars were classified as type B, M, L, and N. The frequency distribution of angulation classifications indicated that, 20.83%, 46%, 32.17%, and 1% of maxillary premolars; 2%, 5.33%, 36.67%, and 56% of mandibular premolars were classified as class 1, 2, 3, and 4. The buccal bone thickness in most locations of premolar sites was less than 1 mm. Conclusions: The classification of clinical relevance of SRP and angulation of the premolar root to osseous housing would help for treatment planning and improving interdisciplinary communication of immediate implant placement (IIP) in the premolar region.