Case report
A 20-year-old male presented to Glasgow Dental Hospital in August 2011 following a referral from a general dental practice in London. He presented with a dull ache, present for the past 12 months arising from the left angle. The patient brought with him an Orthopantomograph (OPG) taken in Christmas 2010. Medically the patient was fit and well, with no known drug allergies and taking no regular medications. He had a 1 pack year smoking history (10 cigarettes on a daily basis for the past 2 years) and consumed approximately 14 units of alcohol per week.
Clinical examination did not reveal any facial asymmetry or significant extra-oral findings. Intra-orally, the soft tissues were normal. There were 7 unerupted teeth in total (UR7, UR8, UL8, LL7, LL8, LR7, LR8). The upper left second premolar was found to be missing.
The Orthopantomograph (Figure 1) shows presence of bilateral ‘kissing molars’ in the lower quadrants associated with cystic lesions encompassing the molar crowns. An ectopic UR8 was also noted with an associated mass in the right maxillary antrum.