114 PROF. DR. L. BOLK 



a conical crown, as shown in figure 9. Sometimes it was of an 

 increased size, as in figure 8. I have never found it with more 

 than a single root. 



So far we have only discussed the occurrence of a sujjer- 

 immerary molar as an entirely independent tooth outside of or 

 behind the row of teeth. We shall now consider these anomalies 

 from quite another standpoint, as these supernumerary teeth, 

 paramolars as well as distomolars, occur more frequently co- 

 alesced with one of the molars, and for the sake of a well-founded 

 judgment respecting the phylogenetical significance of the super- 

 numerary elements in the molar region of man, it is necessary to 

 examine more closely the occurrence of coalesced paramolars. 

 Some points hitherto dark will be cleared up by this examina- 

 tion, and unexpected new facts will be brought to light. We 

 shall discuss the concrescence of the paramolars and of the dis- 

 tomolars, separately, beginning with the former, treating the 

 upper first and thereafter the lower molars. 



In case of the coalescence of a paramolar with a molar it is 

 obvious that the supernumerary element unites with the buccal 

 surface of the normal tooth, and appears as an additional tubercle 

 at this side. Such supernumerary tubercles are mentioned in 

 literature frequently, but their identity with independent, free 

 paramolars has never been suggested. De Terra alone, calling 

 such supernumerary tubercles at the buccal side of the molar- 

 crown simply buccal cusps, considered them as a small super- 

 numerary tooth, united with the normal molar. In order to 

 express their developmental significance, I shall distinguish these 

 tubercles as 'para-molar cusps.' 



This tubercle shows very different degrees of development. 

 In case of the most complete development it appears as an 

 appendage to the normal tooth with a small free crown and a 

 proper root, being attached to the molar only by means of its 

 neck, as illustrated in figure 10. Such cases, in which the primi- 

 tive features of the paramolar are wholly recognizable, are very 

 evidently intermediate forms between a free paramolar and a 

 simple paramolar tubercle. Such cases however are very rare. 



c 



