A combination of kissing molars, maxillary bilateral supernumerary teeth and macrodontia: a rare case report

Abstract

Background: Supernumerary teeth (ST) is defined as an additional number of teeth compared to the normal dental formula. The prevalence rate of ST varies from 0.5 to 3.8% in the permanent dentition. When ST located distal to the third molar is acclaimed as distomolar. Moreover, kissing molar is an extremely scarce condition of distomolars, pointed in the opposite direction in a single follicular space. Meanwhile, macrodontia is also a rare shape anomaly characterized by a large crown and tapering root. Case presentation: A 22-year-old Chinese man presented a combination of kissing molars, maxillary bilateral supernumerary teeth and macrodontia. Radiographically, two maxillary bilateral distomolars located at the buccal side of adjacent third molars. One mandibular distomolar with the adjacent third molar was contacted by occlusal surfaces while roots were pointed oppositely, which could be diagnosed as KM. Furthermore, the left mandibular third molar can be inferred to be a macrodontia, characterized by a large crown and tapering root. After a thorough investigation, we excluded the possibilities of systemic diseases and genetic inheritance. However, the etiology of this rare combination deserves to be further explored. Conclusion: The combination of kissing molars, maxillary bilateral supernumerary teeth and macrodontia is very rare, especially presented in the patient with no syndromes. As there were no complications with these conditions, long-term observation has been recommended for the patient. In addition, the true etiology need a further exploration.

A Case Report of Kissing Molars Class III

“…The causes and characteristics of KMs are mysterious. There are some reported cases of KMs in patients with mucopolysaccharidosis, supernumerary teeth, and macrodontia [11] [12]. However, our patients had no significant systemic findings.…”

Impacção dentária do tipo “Kissing Molars”: uma revisão narrativa da literatura/ "Kissing Molars" Dental Impaction: a narrative review of the literature

“…O tratamento cirúrgico envolvendo a extração ambos os dentes de KMs é o protocolo de tratamento mais comum (4, 5, 7-10, 13-15, 17-19, 25, 27, 28, 31, 34-37). Outras opções de tratamento compreendem a terapia ortodôntica ( 16) quando há possibilidade de alinhamento dos dentes envolvidos, acompanhamento e proservação do paciente em casos sem sintomatologia e sem espessamento do folículo (8,17,31,33), ou ainda tratamentos combinados, como cirúrgicoortodôntico (17,(38)(39)(40).…”

“…O tratamento conservador é possível em casos assintomáticos e sem dilatação cística do folículo dental que envolve KMs (10,26), desde que seja aliado ao controle periódico clínicoradiográfico para revisão e avaliação de desenvolvimento de quaisquer patologias relacionadas (40).…”

“…Além disso, deve-se atentar ao risco de compressão e reabsorção de raízes adjacentes, o que contraindicaria o tratamento conservador (40).…”

A Rare Case of Concrescence of Mandibular Third Molar and Supernumerary Fourth Molar

“…Such cases were frequently noted in maxillary molars, but were rarely found in the mandible, especially in a third molar and a supernumerary fourth tooth [ 2 ]. Previous research studies reported that the incidence of supernumerary fourth molar is 0.32%, not significantly different between the sexes [ 4 ], and the concrescence of teeth shared similar anatomic morphology with normal molars; usually it might not be erupted [ 5 ]. For clinical applications, it is important to establish a normative diagnosis so that proper treatment can be provided at the earliest time possible.…”