International Journal of Case Reports and Images, Vol. 9, 2018. ISSN: 0976-3198

Int J Case Rep Images 2018;9:100967Z01MA2018. www.ijcasereportsandimages.com

Alsuwaida MM 1

CASE REPORT PEER REVIEWED | OPEN ACCESS

Unilateral maxillary impacted distomolar

Majed Mansour Alsuwaida

ABSTRACT

Introduction: Hyperdontia is considered as one of the important anomalies that can be found in the mouth. It is also known as supernumerary teeth or extra teeth. It can be defined as having a higher amount of teeth than the normal number in primary or permanent dentition. Case Report: A 26-year-old patient with maxillary left impacted molar (distomolar) impinging on the third molar and causing it to be carious. Treatment consisted of surgical extraction of the supernumerary tooth. Conclusion: Hyperdontia considered as one of the important anomalies that can be found in the mouth, it is also called supernumerary teeth, and it is defined as having greater amount of teeth than the normal number in both primary and permanent dentition.

Keywords: Dental Anomalies, Distomolar, Hy-perdontia, Supernumerary teeth

How to cite this article

Alsuwaida MM. Unilateral maxillary impacted distomolar. Int J Case Rep Images 2018;9:100967Z01MA2018.

Article ID: 100967Z01MA2018

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doi: 10.5348/100967Z01MA2018CR

Majed Mansour AlsuwaidaAffiliation: Saudi Arabia, Jeddah.Corresponding Author: Dr. Majed Mansour Alsuwaida, Saudi Arabia, Jeddah; Email: Drmajedmj@gmail.com

Received: 15 September 2018Accepted: 23 October 2018Published: 14 November 2018

INTRODUCTION

Hyperdontia is considered as one of the critical anomalies that can be found in the mouth [1]. Hyperdontia can be present anywhere in dental arches. Hyperdontia can be found single or multiple and classified according to the site in the dental arches as paramolar, distomolar, mesiodens and according to the shape as normal shape and abnormal [1, 2].

Hyperdontia is an increased number of teeth than the usual number of teeth which is 20 deciduous in the primary dentition and 32 teeth in the permanent dentition [3].

The actual cause of hyperdontia is unknown, but there is some evidence of association of hyperdontia with syndromes such as Down’s syndrome, Apert syndrome, cleft lip and palate, theories such as evolutionary theory and dental lamina hyperactivity theory which is the most reasonable one and there are hereditary factors associated with it [4, 5]. Supernumerary teeth are asymptomatic (painless) [6]. Diagnosis of supernumerary teeth depending on a proper clinical and radiographic examination to avoid a lot of problems will be caused by it such as malocclusion, Teeth rotation, Diastema and ectopic eruption of teeth [5, 6]. Hyperdontia happens in males twice more than females [7]. Hyperdontia classified according to the shape and the site in the dental arches into Supplementary which is Solo normal morphology like the nearest tooth, Tuberiferous has multiple roots with barrel-shaped tooth, conical is a wedge-shaped or pig shaped supernumerary tooth, and it is found in permanent dentition as a mesiodens. Compound Odontoma is multiple small teeth like, grows next to each other and Complex Odontoma is an area of teeth like shaped tissue that grows in deranged matter [1, 2, 6, 7]. While classified according to the site into mesiodens the most common type of hyperdontia, it is found in the maxillary anterior region between the central incisors, they grow single, multiple, unilateral, bilateral, impacted or erupted. Paramolar is a small molar hyperdontia, and it can be found between second and third molar, labial or lingual regarding maxillary molar. Distomolar is a small tooth located distal to the third molar [1, 2, 6, 7].

Causes of hyperdontia have been discussed into numerous theories, factors, and have been associated with syndromes. Dental lamina hyperactivity is the

International Journal of Case Reports and Images, Vol. 9, 2018. ISSN: 0976-3198

Int J Case Rep Images 2018;9:100967Z01MA2018. www.ijcasereportsandimages.com

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most reasonable theory, and it is about independent hyperactivity of dental lamina. Another theory is evolutionary theory which talks about the evolution of the number of teeth from a more significant amount into lesser amount in our generation and there is a hereditary factor it shows a substantial role in hyperdontia growth [1, 2, 6, 7].

Hyperdontia associated with syndromes such as Gardner syndrome, Down’s syndrome, Apert syndrome, and cleft lip and palate. Multiple Supernumerary teeth associated with syndromes are rare. Supernumerary teeth are painless so when we diagnosis we go through an excellent clinical and radiographic diagnosis to avoid a lot of complications and problems. Treatment of dental hyperdontia is determined by the effect on the surrounding teeth and occlusion. There are cases that do not need to interfere, while some cases require interference [1–3].

CASE REPORT

A 26-year-old male patient came to a routine checkup. Clinical examination revealed normal dentition and soft tissues, no carious teeth, multiple restorations in maxillary and mandibular molar region, anterior dental crowding. X-ray examination showed the presence of previously root canal treated maxillary right first molar, and carious maxillary left third molar due to distomolar impinging, impacted supernumerary tooth in the upper left molar area, located distal to the third molar (distomolar) (Figure 1). Treatment consisted of surgical extraction of the supernumerary tooth. We chose to remove this anomaly because of its effect on the third molar causing lack of clearance and caries, so patient referred to an oral surgery clinic for surgical removal of supernumerary tooth (distomolar).

DISCUSSION

Clinical and radiographic diagnosis of all teeth is essential for early detection of dental hyperdontia. Early exposure leads to early management that enhances the

results. However, the control of hyperdontia differs from one case to another, and it depends on the effect of the hyperdontia on the oral cavity and the adjacent teeth and tissues [5, 6].

Hyperdontia etiology is unclear [1, 2]. Multiple theories suggest that there is an association of hyperdontia with syndromes, hereditary factors or theories such as dental lamina hyperactivity theory which is the most acceptable theory [2, 3].

Hyperdontia can be found in primary or permanent dentition in any region in the dental arches. Supernumerary teeth classified according to the site in the dental arches into paramolar, distomolar, mesiodens and according to the shape into normal shape, abnormal [1–3].

In Supernumerary teeth, ninth molar is less commonly seen [7]. Stafne [8] reports that most of the maxillary ninth molars are blunt, multicuspid, and much smaller than the third molars. However, our case report showed presence of impacted ninth molar in the maxillary left side and is seen as bicuspid teeth.

CONCLUSION

Hyperdontia is considered to be one of the important anomalies that are found in the mouth.

REFERENCES

1. Arathi R, Ashwini R. Supernumerary teeth: A case report. J Indian Soc Pedod Prev Dent 2005 Jun;23(2):103–5.

2. Lo Giudice G, Nigrone V, Longo A, Cicciù M. Supernumerary and supplemental teeth: Case report. Eur J Paediatr Dent 2008 Jun;9(2):97–101.

3. Faqeeh MA, Absi ASF, Alrefai MA, Ali FM. A case report of bilateral impacted mandibular fourth molars. International Journal of Contemporary Medical Research 2017;4(11):2306–7.

4. Smith JD. Hyperdontia: Report of case. J Am Dent Assoc 1969 Nov;79(5):1191–2.

5. Oropeza Murillo MP. Dientes supernumerarios. Reporte de un caso clínico. Rev Odontológica Mex 2013;17(2):91–6.

6. Pereira MN, de Almeida LE, Martins MT, da Silva Campos MJ, Fraga MR, Vitral RW. Multiple hyperdontia: Report of an unusual case. Am J Orthod Dentofacial Orthop 2011 Oct;140(4):580–4.

7. Arandi NZ. Distomolars: An overview and 3 case reports. Dent Oral Craniofacial Res 2017;4(1):1–3.

8. Stafne EC. Supernumerary teeth. Dent Cosmos 1935;74:653–69.

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Author ContributionsMajed Mansour Alsuwaida – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising

Figure 1: Panoramic radiograph showing an impacted maxillary left bicuspid distomolar impinging on the third-molar.

International Journal of Case Reports and Images, Vol. 9, 2018. ISSN: 0976-3198

Int J Case Rep Images 2018;9:100967Z01MA2018. www.ijcasereportsandimages.com

Alsuwaida MM 3

it critically for important intellectual content, Final approval of the version to be published

Guarantor of SubmissionThe corresponding author is the guarantor of submission.

Source of SupportNone.

Consent StatementWritten informed consent was obtained from the patient for publication of this case report.

Conflict of InterestDr. Alsuwaida has no competing interests. He has never received financial or non-financial, direct or indirect funding either from institutions or individuals. Dr.

Alsuwaida certifies that he has no commercial associations that might pose a conflict of interest in connection with the submitted article.

Data AvailabilityAll relevant data are within the paper and its Supporting Information files.

Copyright© 2018 Majed Mansour Alsuwaida. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.

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