Radiographic finding of supernumerary tooth: Fourth molar. Clinical case report

Abstract

The fourth molar or “distomolar” is a supernumerary tooth whose formation may be related to alterations in odontogenesis. Although it is considered a rare developmental anomaly, its understanding is essential due to potential associated pathologies, such as the Dentigerous Cyst. This study aims to describe the clinical case of an 18-year-old patient, in a retention stage after orthodontic treatment, presenting with a fourth molar. During a general check-up, the clinical examination did not reveal significant findings, but the radiographic examination showed semi-erupted upper third molars, absence of lower third molars, and a right upper fourth molar. Maxillofacial surgery was recommended for extraction; however, due to the patient’s travel plans, the procedure could not be performed
within a year. Periodic radiographic monitoring was chosen for follow-up. There are two main treatment modalities for the fourth molar. The first is surgical extraction, and the second is periodic radiographic monitoring every six months. Additionally, there are two secondary options: orthodontically repositioning the molar so it can function within the dental arch, and preventive extraction, more commonly used in young patients to avoid future complications. The choice of the optimal treatment will depend on the fourth molar’s location and the patient’s commitment to follow-up and clinical recommendations.