A case of supernumerary maxillary molar placed in a pterygopalatine fossa

The removal of impacted maxillary third molars is one of the most common procedures performed in oral and maxillofacial surgery clinics with low rates of complications and morbidity. A few cases of placement of third molars into adjacent anatomical spaces, such as the infratemporal fossa, the pterygomandibular space, the maxillary sinus, buccal space, or the lateral pharyngeal space, during surgical interventions have been reported. Objective: To report a clinical case of an unerupted supernumerary third molar in the upper left maxilla. Case history: A male patient, 41 years of age, was referred by his dentist to evaluate the third molars. The clinical exam revealed no visible third molars. The computed tomography (CT) exam showed the presence of a supernumerary tooth in the region of the pterygopalatine fossa, on the left side, and impaction of the third molar, which was causing root resorption on the second molar, thus making it impossible to remain in the buccal cavity. The preferred option, therefore, was to remove both third molar and the supernumerary tooth. CONCLUSION: A pterygopalatine fossa accommodated third maxillary molars is a rare occurrence in the everyday dental practice. If symptomatic, surgical removal has to be planned as earlier as possible rather than late complications