Ectopic Supernumerary Fourth Molar in the Mandibular Notch: A Report of an Atypical Case With Literature Review.

The presence of a fourth supernumerary molar in the mandible represents a rare anomaly of dentofacial development. Here, we describe an exceptional, previously unreported case of a 33-year-old man with a solitary ectopic supernumerary fourth molar located in the sigmoid notch, which was associated with a dentigerous cyst. In addition, a review of the literature related to this uncommon and atypical clinical presentation is provided. The patient presented with persistent pain and intermittent swelling on the ipsilateral side of his face. Previous radiographs revealed that, over a 10-year period, the fourth molar had migrated from a position distal to the third molar to the mandibular notch. Surgical extraction of the supernumerary tooth and enucleation of the associated cyst via an intraoral approach averted the cyst recurrence and other complications. This clinical report highlights the importance of early detection and surgical intervention to prevent cyst formation and the atypical migration of supernumerary teeth. It also emphasises the need for periodic follow-up to avoid associated complications.