What question should be asked to the parents of this young lady?
Do you remember having a tooth extracted that was bigger than the others? Because this anomaly is often hereditary.
Differential diagnosis of macrodontia?
Dental fusion or dental partial duplication, in which the general morphology (crown, pulp, root) is not conserved, nor is the general number of teeth.
OPG technique has its limitations that can have consequences on proportions. They can lead to misinterpreting the size of an image. What are the limitations of this imaging technique in this regard, in this particular case?
Since OPG is a thick tomographic imaging technique: the size of the objects imaged can vary depending on their location inside the section. If an object is located closer to the sensor, meaning buccal, its image will appear relatively smaller. Conversely, if an object is located further away from the sensor, meaning lingual, it will appear as an image relatively bigger. In this case, the images of 48 and 38 look actually bigger. Nevertheless, we can count supplementary cuspids and they were seen objectively gigantic after extraction. Hence the conclusion of macrodontia.
Incidental finding of 48 and 38 macrodontia (right and left mandibulary third molars): bilateral and symetrical impaction in coronary mesioversion.