Rare combination of paramolar and distomolar supernumerary teeth in a 15-year-old male adolescent.

To cite: Kariya PB, Mallikarjuna R, Singh S, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2014205000 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. 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. Multiple supernumerary teeth are commonly associated with developmental anomalies such as cleidocranial dysplasia, Gardner’s syndrome, trichorhinophalangic syndrome and cleft lip and palate 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.