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Rare combination of paramolar and distomolar supernumerary teeth in a 15-year-old male adolescent
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  1. Pratik B Kariya1,
  2. Rachappa Mallikarjuna1,
  3. Sweta Singh2,
  4. Vinay Mulchandani1
  1. 1Department of Pedodontics and Preventive Dentistry, KM Shah Dental College and Hospital, Vadodara, Gujarat, India
  2. 2Department of Public Health Dentistry, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
  1. Correspondence to Dr Rachappa Mallikarjuna, mmrachappa{at}gmail.com

https://doi.org/10.1136/bcr-2014-205000

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    Description

    A 15-year-old boy reported with extra teeth in his upper left and right back region since 4–5 years. Medical and family history did not reveal any related positive findings. On detailed intraoral examination, supernumerary teeth were found distopalatal to the maxillary second premolar bilaterally. The maxillary supernumerary teeth morphologically resembled the premolar on occlusal aspect (figure 1). Another supernumerary tooth was identified on right lingual aspect of the mandibular first molar (figure 2). There was no history of pain, swelling or discomfort to the patient. On orthopantamogram examination the aforementioned three supernumerary teeth were confirmed, in addition to this two other supernumerary molars were also noticed in the left mandibular region (figure 3). One of the left mandibular supernumerary molars was obstructing the eruption of second molar and the other was presenting distal to the third molar. Supernumerary teeth occurring on the buccal or the lingual side are referred to as paramolars and those appearing on the distal surface of the third molar as distomolar or fourth molar.1

    Figure 1
    Figure 1

    Intraoral photograph showing bilateral paramolar supernumerary teeth in the maxillary arch.

    Figure 2
    Figure 2

    Intraoral photograph showing unilateral paramolar supernumerary teeth on the left side of the mandibular arch.

    Figure 3
    Figure 3

    Orthopantamogram of a 15-year-old child showing paramolar and distomolar in the maxillary and mandibular arch.

    A supernumerary tooth can be defined as one that is additional to the normal series and can be found in almost any region of the dental arch.2 Multiple supernumerary teeth are commonly associated with developmental anomalies such as cleidocranial dysplasia, Gardner’s syndrome, trichorhinophalangic syndrome and cleft lip and palate3 but they are rarely seen without any syndromes as in our case.

    The associated complications with these supernumerary teeth are like ectopic eruption, root resorption of adjacent tooth, impaction of adjacent teeth, crowding in the arch and development of cystic lesion.

    Learning points

    • The clinical examination should always be supplemented with orthopantamogram radiographic examination to rule out any additional supernumerary teeth.

    • Multiple supernumerary teeth may be present in absence of any associated syndrome.

    • The presence of supernumerary teeth may hinder the eruption of permanent teeth.

    References

    1. ↵
      1. Bolk L
      . Supernumerary teeth in the molar region in man. Dent Cosmos 1914;56:154–67.
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    2. ↵
      1. Garvey MT,
      2. Barry HJ,
      3. Blake M
      . Supernumerary teeth—an overview of classification, diagnosis, and management. J Can Dent Assoc 1999;65:612–16.
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    3. ↵
      1. Vichi M,
      2. Franchi L
      . Abnormalities of the maxillary incisors in children with cleft lip and palate. ADSC J Dent Child 1995;62:412–17.
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    View Abstract

    Footnotes

    • Competing interests None.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.