History of Present Illness

This is a healthy 14-year-old female who presented at Dr. Camran Zafarnia’s dental office for non-eruption of a maxillary right molar. She was referred to Dr. Gregory Ogata, an orthodontist, for evaluation of this condition. At the time of her evaluation with Dr. Ogata, a panorex radiograph was performed. The radiograph revealed the delayed eruption of tooth #3 (Fig 1). The patient was referred to Dr. Crinzi for evaluation and treatment. The clinical examination revealed erupted first and second molars in the maxillary left and bilateral mandibular quadrants; these were missing from the maxillary right quadrant. There was no evidence of bony expansion or soft tissue swelling. The patient denied any symptoms associated with this area.

Figure 1. Panoramic view at first presentation demonstrating missing right posterior second and third molars with an impacted first molar. The latter is associated with a well-demarcated, radiolucency with radiopacity and three tooth-like structures. Notice the normal eruption and development of teeth in the other three quadrants.