Incidental finding of erupted distomolars with bilateral maxillomandibular localization: report of an unusual clinical case of nonsyndromic hyperdontia

Abstract

Introduction: Hyperdontia is a numerical developmental anomaly of the dentition with a multifactorial etiology. Distomolars, or fourth molars, have a low prevalence, and their bilateral and bimaxillary occurrence in nonsyndromic patients represents an uncommon clinical finding. Objective: To characterize the incidental finding of erupted distomolars using a diagnostic protocol based on advanced imaging and 3D biomodeling to guide therapeutic planning. Case presentation: A 42-year-old systemically healthy male attended the Diagnostic and Admission Clinic of the Faculty of Dentistry at Universidad Mayor de San Andrés for a general dental evaluation, reporting food impaction in the left posterior mandibular region. Clinical examination identified dysmorphic and rudimentary supernumerary teeth located distal to teeth 1.8 and 3.8. Cone-beam computed tomography (CBCT) and three-dimensional biomodels produced with Elegoo Standard White resin made it possible to rule out dental fusion and analyze their spatial relationship with the third molars in greater anatomical detail. Conclusions: Erupted distomolars located in both the maxilla and mandible in nonsyndromic patients are uncommon. CBCT allowed precise assessment of their morphology, position, relationship with the third molars, and possible associated root alterations. Three-dimensional biomodeling complemented the diagnosis by providing a clear spatial representation of the structures involved and supporting interpretation of the case. The integration of clinical examination, CBCT, and 3D biomodeling enabled an accurate diagnosis and supported an individualized therapeutic approach consistent with the anatomical findings observed.