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Dolphine Oda, BDS, MSD
Case and images contributed by Drs. Rick Crinzi, Gregory Ogata, & Camran Zafarnia
Bellevue, Washington

Case Summary
An otherwise healthy14-year-old female reports non-eruption of a maxillary right molar. Panoramic imaging reveals delayed eruption of tooth #3. The patient was referred for evaluation and treatment.
History of Present Illness
Unknown.
Medical History
Non-contributory. The patient is in excellent health and not taking medication.

Clinical and Radiographic Findings
The clinical examination reveals erupted first and second molars in the maxillary left and bilateral mandibular quadrants but missing from the maxillary right quadrant. There is no evidence of bony expansion or soft tissue swelling. The patient denies 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.