What is Diagnosis?

A 37-year-old man complains of food impaction between #14 and 15, which may be related to mesioangular impaction of #16 (Fig.1 ^ (* a supernumerary premolar; #20 asymptomatic after RCT retreatment)).  When the third tooth is removed, it is smaller than expected.  Intraop X-ray reveals a normal sized 3rd molar in situ (Fig.2 ^).  Therefore the microdontia removed is a supernumerary tooth.  The tooth #16 is then extracted.  The diastema appears to persist 2 years 7 months postop (Fig.3), although gingival swelling and pain reduces.  There is a significant increase in PARL at #20, supported by 2 PAs (Fig.4,5).  The tooth has no mobility with normal periodontal pockets.  There is no paresthesia of the lower left lip.

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Xin Wei, DDS, PhD, MS 1st edition 05/16/2020, last revision 05/16/2020