Supernumerary molars are relatively rare entities in the oral and maxillofacial region. These are an odontostomatologic anomalies characterized by the existence of an excessive number of teeth in relation to the normal dental formula. Usually, these supernumerary teeth occur singly and unilaterally, but very rarely do they occur bilaterally. Even more unique is the occurrence of both paramolar and distomolar together. Such a condition is commonly seen with several congenital genetic disorders, including cleft lip and palate, Gardner's syndrome, and Cleidocranial Dysostosis. Other uncommon disorders which may lead to such an anomaly include Ehlers-Danlos syndrome, Fabry Anderson’s syndrome, and chondroectodermal dysplasia. However, in this case, the patient as well as his twin was asymptomatic and non-syndromic. The presence of hyperdontia causes complications which include dental impaction, delayed eruption, and relapse after orthodontic treatment. This paper reports an unusual occurrence of a combination of paramolar and distomolar in the maxillary arch of a twin male patient, which was an incidental finding.We will also discuss the prevalence and treatment options for paramolars and distomolar as relevant to our case.
 

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