Molariform macrodont bilateral second premolars

OBJECTIVES: Macrodontia is a rare morphoanatomical anomaly that has been used to describe dental gigantism when the body of the tooth is enlarged and roots are smaller. The aim of the present artiche was to present the clinical and radiographic findings of isolated bilateral macrodontia of mandibular second premolars. Because of apical prolongation, the affected teeth have proportionately shortened roots, and enlarged pulp chambers. Although its aetiopathogenesis remains largely unclear, genetic and acquired factors may play a role in the onset of this condition. In spite of mandibular second premolar showing an elevated variability of crown morphology, macrodontia of premolars is extremely rare and may be confused with fusion or gemination of adjacent teeth to form
a single tooth.
Depending on the size and morphology of the affected teeth, macrodontia is a dental condition that may create several functional and esthetic problems that may require endodontic, prosthetic, surgical, and/or orthodontic treatment to allow adequate formation of the dental arches.

MATERIALS AND METHODS: A 16-year-old boy visited the outpatient department of the Division of dentistry with a chief complaint of irregular teeth in oral cavity and pain in correspondence of the tongue. The patient’s medical history was unremarkable, and there was no family history of any genetic or dental anomalies.

RESULTS AND DISCUSSION: Intraoral examination revealed the crowding in the mandibular arch, with the presence of unusually bulbous mandibular second premolars bilaterally which had molar- like appearances. The treatment plan included surgical extraction of the macrodontic premolars as well as preparation for consequent orthodontic therapy. The teeth were surgically removed in 2 consecutive sessions under local anesthesia.

CONCLUSIONS: Dental practitioners should be familiar with macrodontia with regard to not only clinical complications but also its management.

CLINICAL SIGNIFICANCE: Isolated bilateral macrodontia of the mandibular second premolars is an extremely rare dental anomaly, which requires an early diagnosis and multidisciplinary-treatment approach to favor the adequate formation of the dental arches.

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