Macho-Lopez Sara, Montes-Carmona Jose-Francisco, Garcia-Perla-Garcia Alberto, Martinez-De-Fuentes Rafael, Infante-Cossio Pedro
Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, School of Medicine, University of Seville, Seville, ESP.
Department of Prosthodontics, School of Dentistry, University of Seville, Seville, ESP.
Cureus. 2025 Aug 7;17(8):e89557. doi: 10.7759/cureus.89557. eCollection 2025 Aug.
The presence of a fourth supernumerary molar in the mandible represents a rare anomaly of dentofacial development. Here, we describe an exceptional, previously unreported case of a 33-year-old man with a solitary ectopic supernumerary fourth molar located in the sigmoid notch, which was associated with a dentigerous cyst. In addition, a review of the literature related to this uncommon and atypical clinical presentation is provided. The patient presented with persistent pain and intermittent swelling on the ipsilateral side of his face. Previous radiographs revealed that, over a 10-year period, the fourth molar had migrated from a position distal to the third molar to the mandibular notch. Surgical extraction of the supernumerary tooth and enucleation of the associated cyst via an intraoral approach averted the cyst recurrence and other complications. This clinical report highlights the importance of early detection and surgical intervention to prevent cyst formation and the atypical migration of supernumerary teeth. It also emphasises the need for periodic follow-up to avoid associated complications.
下颌出现第四颗额外磨牙是牙颌面发育中一种罕见的异常情况。在此，我们描述一例特殊的、此前未报道过的病例，一名33岁男性，其下颌乙状切迹处有一颗孤立的异位额外第四磨牙，并伴有含牙囊肿。此外，还对与这种不常见且非典型临床表现相关的文献进行了综述。患者面部同侧出现持续性疼痛和间歇性肿胀。既往X线片显示，在10年时间里，第四磨牙已从第三磨牙远中位置迁移至下颌切迹处。通过口内入路手术拔除额外牙并摘除相关囊肿，避免了囊肿复发及其他并发症。本临床报告强调了早期检测和手术干预对于预防囊肿形成及额外牙非典型迁移的重要性。它还强调了定期随访以避免相关并发症的必要性。
