An Unusual Case of Double Mandibular Parapremolars: A Cone Beam Computed Tomography Assessed Case Report

Abstract

Background: Extra teeth number in the patient’s mouth is scientifically known as supernumerary teeth. Multiple supernumerary teeth are frequently seen in patients with developmental disorders. Cone-Beam Computed Tomography (CBCT) is a three-dimensional imaging tool that can provide a precise case planning. The purpose of this paper is to present a rare case of double parapremolars in on single quadrant and investigate these teeth by using Cone-Beam Computed Tomography (CBCT). Case Description: A 28-year-old, Filipino female patient came to PNU dental clinics. She was medically fit, not on medications and no allergies were detected. Intraoral examination revealed presence of two supernumerary teeth at the area between #35 and #36. The Parapremolars located in quadrant three, both are with normal shape and color. Regarding the position, the first supernumerary has erupted lingually, the second is in the arch line but slightly tilted to the lingually. As a result of the extra teeth number, moderate crowding found in the area. The patient denied any family history of similar findings. Discussion: Extraction of the first supernumerary tooth was carried out after radiographic analysis using CBCT, to facilitate proper oral hygiene, to prevent food impaction, and to eliminate its possible effects on the adjacent teeth. Extraction was performed cautiously without causing any damage to the anatomical structures. Regarding the anatomical position of the tooth, we prepared splint for teeth stabilization in case of adjacent teeth mobility. Extraction was done under local anesthesia. The patient was followed up after the extraction, no complications were reported. Conclusion: Double parapremolar teeth were found in a non-syndromic patient. CBCT precisely locate malposed supernumerary teeth and help in getting proper treatment plan without complications.