A rare case of impacted mandibular distomolar: Identification and management at a remote high altitude location

Planning the surgical extraction of an impacted supernumerary tooth poses a very peculiar problem for a dental professional. The management of this unique clinical situation is quite challenging and requires meticulous preparation, especially in a remote high altitude regions. Supernumerary teeth are those which are present in excess of the normal permanent or deciduous dentition in the oral cavity. A distomolar, also commonly known as the fourth molar, is a supernumerary tooth located distal to the third molars. The occurrence of supernumerary teeth is much more frequently observed in the maxillary arch as compared to the mandible. While the distomolar is quite infrequently observed, its occurrence in the mandible is even rarer. In this article, we present an overview of distomolars along with a case report on the management of a symptomatic mandibular distomolar at a remote setup in Tangtse region of the Union Territory of Ladakh.