Eruption Sequestrum Of Bilateral Molars: A Rare Case Report

Eruption sequestrum (ES) is a rare anomaly characterized by calcified masses over the occlusal surfaces of erupting molars, which may cause gingival inflammation and delayed eruption. Etiological theories remain controversial, ranging from retained cortical bone fragments to odontogenic hamartomas. A 6-year-old girl presented with discomfort due to food impaction and minor gingival bleeding in the left mandibular region. Clinical examination revealed an irregular calcified mass on the occlusal surface of the left mandibular first molar. Radiographs demonstrated radiopaque masses with enamel density, while histopathological analysis confirmed necrotic compact bone, squamous epithelium, and chronic inflammation. During follow-up, masses with identical characteristics were observed on the erupting right mandibular and maxillary first molars. Sequential removal of masses confirmed recurrent ES, with subsequent normal eruption after intervention. This case is distinguished by its multiquadrant involvement, with histological findings aligning with prior literature supporting etiological hypotheses such as developmental anomalies or chronic inflammation. Bilateral recurrence challenges the conventional paradigm of unifocal ES, suggesting potential systemic or developmental predispositions. The observed recurrent lesions underscore the multifactorial nature of ES pathogenesis and raise unresolved questions about risk factors for recurrence. This rare case highlights the importance of proactive clinical surveillance in pediatric dentistry to prevent gingivitis, pericoronal inflammation or carious lesions over time. Diagnosis was confirmed through combined radiological and histopathological evaluation of soft and hard tissues, enhancing the understanding of ES pathophysiology. The findings advocate for multicenter collaborative research to establish evidence-based management guidelines and further elucidate the underlying etiological mechanisms.