Multiple Distomolar Non-sindromik pada Tiga Kuadran Rahang: Temuan Radiografis dan Pertimbangan Klinis

Distomolar is a rare type of supernumerary tooth located distal to the third molar and, being usually asymptomatic, is commonly detected incidentally on panoramic radiographs. This report describes the radiographic findings of nonsyndromic multiple distomolars involving three dental quadrants that were detected incidentally on a panoramic radiograph, and discusses their clinical considerations. A 20-year-old male was referred for panoramic radiography because of intermittent pain in the left mandibular third molar region. The patient had no history of systemic disease or congenital abnormality and showed no clinical features suggestive of a syndrome. The panoramic radiograph revealed three impacted distomolars distal to teeth 18, 28, and 48, impaction of all four third molars, and a diffuse pericoronal radiolucency distal to tooth 38 suggestive of pericoronal inflammation. The findings were explained to the patient, who was referred back to the referring dentist with the radiographic report for definitive diagnosis and treatment planning. Cone-beam computed tomography (CBCT) is recommended as a further examination if surgical treatment is planned. Multiple distomolars may be detected incidentally on panoramic radiographs obtained for other complaints. Systematic radiographic interpretation is essential to identify these rare developmental anomalies and to support appropriate clinical decision-making.