Sir, supernumerary molars occur far less frequently compared to other supernumerary teeth.1 While the literature reports on fourth, fifth, sixth and seventh molars, it is extremely rare for patients to have impacted fifth molars bilaterally.2 To the best of our knowledge, the following case is the first of its kind in the literature, which describes bilateral impacted fourth and fifth molars in the maxilla and an impacted fourth molar in the mandible.

A 21-year-old female patient presented to the oral diagnosis clinic for routine dental treatment. There was occlusal and aproximal caries in the permanent molars and following clinical examination, panoramic and periapical radiographs were taken. The panoramic radiograph (Fig. 1) revealed five supernumerary molars with maxillary fourth and fifth molars bilaterally (UR9, UR10, UL9, UL10) and the mandibular fourth molar (LR9) impacted radiographically. The fourth and fifth molars were all present distal to the third molars although one fourth molar on the maxillary right quadrant was smaller in size. A general physician was consulted who confirmed that there was no associated syndrome. Root canal treatment was carried out for the right first mandibular molar while a surgical procedure was considered for the impacted supernumerary teeth and third molars.

Figure 1
figure 1

The panoramic radiograph showing the impacted mandibular fourth molar

Full size image

Supernumerary molars exist bilaterally in almost a quarter of cases2 and dentists should keep this in mind when examining the oral cavity, both clinically and radiographically, when a supernumerary molar is found.