Premaxillary predicament: managing a rare case of triple impacted supernumerary teeth

Background. An 11-year-old boy presented with missing permanent maxillary central incisors (#11 and #21) and a history of multiple dental extractions. Clinical examination revealed mild gingival inflammation and the presence of several carious lesions. Methods. Initial radiographic imaging revealed three impacted supernumerary teeth obstructing the eruption pathway of the maxillary central incisors. Following a consultation with a maxillofacial surgeon, cone beam computed tomography (CBCT) was recommended to precisely localize the supernumerary teeth and assess their relationship with adjacent structures. Results. After discussing the diagnostic findings with the patient’s parents, it was decided to proceed with the surgical extraction of the supernumerary teeth under general anesthesia due to procedural complexity. Postoperative follow-up, both clinical and radiographic, was initiated to monitor the spontaneous eruption of the permanent incisors. Conclusion. Supernumerary teeth can lead to eruption disturbances and other complications if not identified early. Thorough clinical and radiographic evaluation is essential for accurate diagnosis and effective treatment planning. Although rare, paramolars should be considered in differential diagnosis to prevent delayed or mismanaged dental development.