# Symmetrically Erupted Upper Fourth Molars and an Impacted Fifth Molar: A Case Report

## TL;DR

A rare case of symmetrically erupted upper fourth molars and an impacted fifth molar is reported, with treatment based on patient symptoms and preferences.

## Contribution

A unique clinical case of bilaterally erupted maxillary fourth molars and an impacted fifth molar is documented.

## Key findings

- Symmetrically erupted maxillary fourth molars were identified in a 38-year-old male.
- An impacted fifth molar was found in the right upper jaw through radiographic imaging.
- Extraction of affected molars was performed, with follow-up care recommended for remaining teeth.

## Abstract

Introduction: Supernumerary teeth are often asymptomatic and impacted within the jawbone, typically identified during routine radiographic examinations. While cases of impacted fourth molars have been reported, bilaterally erupted fourth molars are exceedingly rare. This case report presents a unique instance of symmetrically erupted maxillary fourth molars, along with an impacted fifth molar in the right upper jaw.

Case Presentation: A 38-year-old male presented with food impaction and discomfort in the area of the left maxillary third molar. Clinical examination revealed bilaterally erupted fourth molars, and a panoramic radiograph incidentally uncovered an impacted fifth molar in the right maxilla. Cone beam computed tomography confirmed these findings. The left maxillary fourth molar was diagnosed with periapical periodontitis. Both the left maxillary third and fourth molars were extracted under local anesthesia. Periodic follow-up of the right fourth and fifth molars was recommended based on symptom progression and patient preference. The patient expressed satisfaction with the treatment plan and surgical outcome.

Conclusion: This report documents a rare case of symmetrically erupted fourth molars with an associated impacted fifth molar in the maxilla. The treatment strategy and surgical approach should be tailored to the patient's symptoms and willingness to undergo the recommended procedures.