• L.F. Kaskova Poltava State Medical University, Poltava, Ukraine
  • N.V. Yanko Poltava State Medical University, Poltava, Ukraine
  • A.V. Artemyev Poltava State Medical University, Poltava, Ukraine
Keywords: supernumerary teeth, retention, distomolar, anthropology


Supernumerary teeth in humans are considered as those in addition to the normal series of deciduous or permanent dentition. Distomolars or the forth molars that erupt behind wisdom teeth are found in 0,18–3,8% of the modern population, but are quite rare compared to other supernumerary teeth. Odontologic studies of ancient and contemporary populations allow not only evaluate health state, life style and diet of people, but explain etiology, clinic manifestations and treatment of dentomaxillary abnormalities. The forth molars mostly are mostly described in people over the period of the XIX-XXІ centuries and only few researchers presented this variant in ancient people.

The aim of the study was to estimate a case of supernumerary teeth in human remains, which represented by Chernyachov archarological culture artefacts. Sex and death age were established by methods widely accepted in anthropology. The method of analysis of dento-maxillary region developed by the authors and orthopantomography were used for dental examination.

An undamaged skeleton was found during archaeologic expedition nearby the town of Shyshaki, Poltava region (burial No 112) in 2016 and now are kept at Archaeological Site Preservation and Research Centre (Poltava). Archaeologists defined the remains dated by the end of the IV c. AD. The skeleton belonged to 1820 years` women was in a good state; no pathological changes of the skeleton were found. Maxilla of the skeleton had supernumerary forth molar (tooth 19) and alveolar sockets of teeth 13, 12, 21, 22, 25, 27, 28 and 29 recorded as being lost anteand postmortem. Teeth presented neither enamel hypoplasia nor tooth wear. Root of tooth 19 was immature.

Etiology of supernumerary teeth is still unclear yet, but there are no data supporting atavistic theory. Bilateral distomolars could be a symptom of systemic abnormalities of dentofacial region, but the skeleton studied had no pathological changes, so this abnormality could not be characterized as systemic. Supernumerary teeth could be described as a congenital anomaly associated with chromosome, autosome or dominant transmission, but the authors do not have enough evidence to prove such nature of this anomaly. This studied case is more likely related to the theory of hyperactivity of dental lamina during follicle development that dominates nowadays.

According to morphological classification, supernumerary teeth in our case are of premolar shape.

Сlinical manifestations of distomolars can be different. Distomolars can be asymptomatic and rarely found erupted; they may provoke no problems or hurt buccal mucosa. Also a retained distomolar may cause retention and pericoronaritis of the third molar, development of keratoand paradental cysts, localized periodontitis, decompression of lower alveolar nerve, or manifests itself in jaw fracture. Oral signs of retained distomolar are mobility of the third molar, discomfort feeling in retromolar area, bulging of mandible. Supernumery and retained teeth are mostly found by X-ray examinations usually taken for non-related dental problems. The distomolars investigated were retained and the mosy likely caused no problems.

Basic methods of the treatment of the fourth molars are extraction and observation, however, choice of the treatment method depends on clinical manifestations and estimation of individual risk factors.

Supernumerary retained fourth molars in the studied woman are non-systemic distomolars with premolar shape. Taking into account that most of the fourth molars are detected by X-ray examination, dentists should be careful not to miss this abnormality.


Download data is not yet available.


1. Kurt H, Berkay ST, Şenel B, Avsever H. A retrospective observational study of the frequency of distomolar teeth in a population of 14,250 patients. J Cumhuriyet Dental. 2015; 14 (4): 335-42.

2. Bamgbose BO, Okada S, Hisatomi M, et al. Fourth molar: A retrospective study and literature review of a rare clinical entity. Imaging Sci Dent. 2019;49(1): 27-34. doi:10.5624/isd.2019.49.1.27.

3. Cassetta M, Altieri F, Giansanti M, Di-Giorgio R, Calasso S. Morphological and topographical characteristics of posterior supernumerary molar teeth: an epidemiological study on 25,186 subjects. Med Oral Patol Oral Cir Bucal. 2014;19(6):545-9.

4. Cholakova R. Clinical and Epidemiological Study of Supernumerary Teeth in Patients from Plovdiv Region. Acta Medica Bulgarica. 2020;47(2): 22-6.

5. Arandi NZ. Hyperdontia: Exploring the Developmental Abnormality. J Pre Clin Clin Res. 2020;14(4):178-183. doi:10.26444/jpccr/130372.

6. Van der Merwe AE, Steyn MA report on the high incidence of supernumerary teeth in skeletal remains from a 19th century mining community from Kimberley, South Africa. South African Dental Journal. 2009; 64(4): 162–6.

7. Ceperuelo D, Lozano M, Duran-Sindreu F, Mercadé M. Supernumerary fourth molar and dental pathologies in a Chalcolithic individual from the El Mirador Cave site (Sierra de Atapuerca, Burgos, Spain). Homo. 2015 Feb;66(1):15-26. doi: 10.1016/j.jchb.2014.05.007.

8. Kaskova LF, Artemiev AV. Skhema vyvchennia stanu zuboshchelepnoi dilianky u davnikh liudei (za antropolohichnymy materialamy). Svidotstvo pro reiestratsiiu avtor. prava na tvir № 44677. 2012 lyp 11. (Ukrainian).

9. Standards for data collection from human skeletal remains. Edited by Jane E. Buikstra and Douglas H. Ubelaker. Fayetteville: Arkansas Archeological Survey Research Series No. 44, 1994. 272 p. (Ukrainian).

10. Phillips ELW, Irish JD, Antoine D. Ancient anomalies: Twinned and supernumerary incisors in a medieval Nubian. Int J Osteoarchaeol. 2021; 31: 456–461.

11. Sacks L. Multiple supernumerary teeth in a likely syndromic individual from prehistoric Illinois. Arch Oral Biol. 2018; 93:100-6.

12. Khambete N, Kumar R. Genetics and presence of non-syndromic supernumerary teeth: A mystery case report and review of literature. Contemp Clin Dent. 2012;3(4):499-502. doi:10.4103/0976237X.107455.

13. Cassetta M, Altieri F, Giansanti M, Di-Giorgio R, Calasso S. Morphological and topographical characteristics of posterior supernumerary molar teeth: An epidemiological study on 25,186 subjects. Med Oral Patol Oral Cir Bucal. 2014; 19(6): 545–9.

14. Arslan A, Altundal H, Ozel E. The frequency of distomolar teeth in a population of urban Turkish adults: A retrospective study. Oral Radiol. 2009; 25: 118-22.

15. Tkachenko PY, Dmytrenko MY, Cholovskyi NA. Sopostavlenye ynformatyvnosty y эffektyvnosty luchevыkh metodov obsledovanyia u detei s retenyrovannыmy zubamy. Myr medytsynы y byolohyy. 2019; 15(3): 158-62. (Russian).

16. Yan L, Yu LW, Bhandari K, Shan CL. Report of a case with 19 supernumerary teeth in a nonsyndromic patient. Indian J Dent. 2014; 5(2):92-5.

17. Gomez-Sosa JF, Goncalves PJ. Endodontic treatment of a rare case of fusion between a right mandibular third molar and a distomolar. ENDO (Lond Engl). 2014; 8 (3): 223-7.
How to Cite
Kaskova, L., Yanko, N., & Artemyev, A. (2022). CASE REPORT: THE FORTH MAXILLARY MOLARS IN WOMAN LIVING IN THE IV CENTURY A.D. Ukrainian Dental Almanac, (1), 50-54.

Most read articles by the same author(s)