Rare Case of Paramolar Cusps on Bilateral Maxillary First Permanent Molars

Abstract

Occurrence of a paramolar cusp is relatively uncommon, though is more frequently seen in the second and third permanent molars, while it is relatively rare in the first permanent molars. Affected patients are usually presented with one unilateral cusp in permanent dentition. A 10-year-old girl visited our clinic for examination of dental caries. The maxillary first permanent molars showed delayed eruption, while paramolar cusps were observed on the buccal surface of the bilateral erupted first permanent molars. Fenestration was performed to accelerate eruption of the maxillary left first molar. Notably, two markedly well-developed independent cusps were seen on the buccal surface on the left side. Therefore, it is assumed that this is a relatively rare case. An abnormal tooth crown shape, as well as complicated root and root canal morphologies in cases with a paramolar cusp may pose problems for endodontic management and periodontal therapy. Therefore, strict oral hygiene is imperative for preventing recurrence of dental caries and maintaining periodontal health in affected patients.