Background: Impaction of the maxillary second molar is uncommon, particularly when caused by an overlying third molar. This case highlights a rare presentation involving a severely dilacerated maxillary second molar (UR7) impacted due to the presence of an unerupted third molar (UR8), requiring multidisciplinary management.Case Report: A 13-year-old female was referred for the extraction of unrestorable UR6 and UL6 under general anaesthesia. Clinical examination revealed missing UR7. Radiographic evaluation (OPG and CBCT) showed a vertically impacted and dilacerated UR7 located buccal and superior to a developing UR8. Surgical extraction of UR7 was planned to facilitate the potential eruption of UR8. The procedure was successfully completed under general anaesthesia without complications. The patient is currently under orthodontic review for UR8 eruption.Discussion: This case illustrates the diagnostic and surgical challenges posed by dilacerated impactions and emphasizes the importance of CBCT in treatment planning. Delayed intervention in such cases may result in infection, resorption, malocclusion, or cyst formation. Multidisciplinary collaboration between oral surgery and orthodontics was critical to achieving a favourable outcome.Conclusion: Early detection and a carefully coordinated treatment approach are essential in managing complex impactions involving root dilacerations. Advanced imaging and surgical precision play a vital role in optimizing both functional and developmental outcomes.
