1 Department of Pedodontics and Preventive Dentistry, Government Dental College and Hospital, Hyderabad, India

2 Department of Orthodontia, Government Dental College and Hospital, Hyderabad, India

3 Department of Public Health, Benedictine University, Lisle, United States


Introduction: Macrodontia or Megadontia or Megalodontia is simple enlargement of all tooth structures. Most of the literature regarding this condition belongs to 1970’s and 80’s and very recent clinical case reports in different ethinic groups are lacking. The etiology of unilateral versus bilateral macrodontia of premolars is unexplained till date. The prevalence of macrodontia of premolars in mandible is higher than in the maxilla. Isolated macrodontia of second premolars has been known by many synonyms like “Macrodont molariform premolars” and “Megadonts”.
Case Presentation: A 16 year old male adolescence patient had reported with a complain of forwardly placed upper front teeth. Routine clinical examination revealed a uniquely-appearing second premolar on the right side of the mandibular arch. The surface area of the crown was two to three times greater than that of normal premolars. There was crowding of the lower anterior teeth with labial placement of lower canines. The intraoral periapical radiograph showed a huge premolar tooth with a single, short, stunted and tapering root. The Model analysis favours expansion of the mandibular arch and extraction of the premolar teeth in maxillary arch for contraction of the arch.
Conclusions: For proper space management, any developmental anamoly involving the shape of the tooth such as a macro premolar or an erupted odontome has to be extracted as early as possible, as part of the orthodontic treatment plan and fixed appliance therapy initiated. Treatment of macropremolars is a challenging task for the orthodontist, as it requires accurate space analysis and space management.