INTRODUCTION
Tooth impaction is a pathological process in which the tooth does not
erupt into its functional position due to physical or genetic
factors.1 The most commonly affected teeth are the
mandibular third molars having a prevalence of between 16% to 68%
while the least common are the mandibular second molars whose prevalence
is a mere 0% to 2.3%.2-4 The ‘kissing molar’
(occlusal surfaces contacting each other with their roots pointed in
opposite directions) relationship of these teeth is extraordinarily
sparse with only eleven cases of bilateral pathology having been
reported to date.5,6 The etiopathogenesis of this
condition unknown, however, some authors implicate arch length
deficiency and metabolic diseases in an attempt to explain the
finding.5,7,8
Abnormal root morphology of the maxillary premolars, although uncommon,
have been reported previously in literature involving relatively rare
cases such as presence of a third root of the first maxillary premolar
and a two-rooted second maxillary premolar in about 25% of
cases.9,10 There are scarce reports on the occurrence
of a three-rooted second maxillary premolar whose incidence was reported
to be 0.3% to 2% with no reports so far on a bilateral occurrence of
this phenomenon.11,12
We hereby report a unique combination of two rare dental findings in the
same individual which could pose future treatment challenges: bilateral
kissing molar impactions and bilateral three-rooted second maxillary
premolars. In addition, we discuss the relationship of the molar apices
to the mandibular neurovascular bundle and to the inferior border of
mandible, its surgical implications and the endodontic considerations of
a three-rooted second maxillary premolar.