Zangoei Booshehri Maryam, Pakshir Hamid Reza, Fasihinia Hamed, Hamedani Shahram
Dentomaxillofacial Radiologist, Private Practice, Shiraz, Iran.
Orthodontic Department, Dental School, Shiraz Azad University, Shiraz, Iran.
BMC Oral Health. 2025 Jan 2;25(1):10. doi: 10.1186/s12903-024-05416-x.
Molariform second premolar is a rare dental anomaly where the second premolar resembles a molar in size and shape. This condition is often linked to macrodontia, a rare enlargement of teeth that disrupts dental proportions and can manifest in isolated, relative, or generalized forms. Although mandibular second premolars are more prone to morphological variability, the occurrence of bilateral molariform premolars, induced by a unique form of gemination, is exceptionally uncommon and infrequently documented, thus making this case clinically significant.
This case report illustrates a rare bilateral presentation of molariform second premolars in the mandibular arch of a young patient. Both premolars displayed exaggerated mesiodistal dimensions, molar-like occlusal morphology with multiple cusps, and disproportionate faciolingual dimensions. Diagnosis was established through detailed clinical examination and radiographic evaluations. The report explores the treatment challenges posed by the enlarged tooth size and abnormal morphology, including their impact on orthodontic alignment and restorative planning. The patient was scheduled for reshaping of the macrodont premolars after finishing orthodontic treatment, which was planned for correction of overjet, overbite, as well the deep curve of spee.
Molariform premolars, though uncommon, have a profound impact on dental alignment and treatment outcomes. Their morphological uniqueness might potentially be ignored; therefore, dental professionals should remain vigilant for such anomalies during routine examinations to prevent complications like crowding, malocclusion, and caries. Early diagnosis and strategic intervention are crucial for prevention and interdisciplinary management of unexpected complications during dental procedures. This case emphasizes the importance of routine examination and interdisciplinary collaboration in identifying and treating such anomalies.
磨牙状第二前磨牙是一种罕见的牙齿异常，其中第二前磨牙在大小和形状上类似于磨牙。这种情况通常与巨牙症有关，巨牙症是一种罕见的牙齿增大，会破坏牙齿比例，可表现为孤立、相对或普遍形式。虽然下颌第二前磨牙更容易出现形态变异，但由一种独特的双生形式引起的双侧磨牙状前磨牙的发生极为罕见，且鲜有记录，因此该病例具有临床意义。
本病例报告展示了一名年轻患者下颌牙弓中罕见的双侧磨牙状第二前磨牙表现。两颗前磨牙均显示出过大的近远中尺寸、具有多个牙尖的磨牙样咬合形态以及不成比例的颊舌尺寸。通过详细的临床检查和影像学评估得以确诊。该报告探讨了牙齿增大和异常形态所带来的治疗挑战，包括它们对正畸排齐和修复计划的影响。患者计划在完成正畸治疗后对巨牙前磨牙进行重塑，正畸治疗旨在矫正覆盖、覆合以及Spee曲线过深。
磨牙状前磨牙虽不常见，但对牙齿排齐和治疗结果有深远影响。它们的形态独特性可能会被忽视；因此，牙科专业人员在常规检查时应保持警惕，以防出现拥挤、错颌和龋齿等并发症。早期诊断和策略性干预对于预防牙科手术期间意外并发症以及跨学科管理至关重要。本病例强调了常规检查和跨学科协作在识别和治疗此类异常中的重要性。
