Maxillary Kissing Molars in a Pediatric Patient: Case Report

Background Kissing molars (KMs) represent a rare pattern of tooth impaction characterized by two molars positioned crown-to-crown within a single follicular space. Although most cases involve the mandible, maxillary occurrence remains exceptional. Case presentation This report describes a case of true maxillary KMs in a 14-year-old systemically healthy patient. Panoramic radiography revealed crown-to-crown impaction of teeth 27 and 28, and cone-beam computed tomography confirmed the inverted position of the third molar and assisted surgical planning. Selective extraction of tooth 28 performed, preserving tooth 27 due to its incomplete root formation and favorable vertical orientation. Spontaneous eruption of the second molar occurred within 12 months, confirming the effectiveness of a conservative approach. Conclusions This case emphasizes the importance of early diagnosis, three-dimensional imaging, and individualized surgical planning to optimize functional outcomes and preserve permanent dentition in pediatric patients presenting with rare impaction patterns.