Late developing supernumerary teeth in the mandible

Clinical features of non-syndromic late developing supernumerary teeth: a sign of the third dentition?

OBJECTIVES

This study aimed to summarize the clinical features of non-syndromic late developing supernumerary teeth (LDST) and comparisons with common supernumerary teeth (ST) and explore the association between LDST and the third dentition.

MATERIALS AND METHODS

This study retrospected cone-beam computed tomography (CBCT) and medical history of 41,903 consecutive patients from January to December 2021. Comparisons between ST and LDST were evaluated by Chi-square test or Fisher exact test. Correlation between chronological age and dental stage age was evaluated by Spearman's rank correlation coefficient. Binary logistic regression analysis was used to explore the features of LDST originating from the third dentition.

RESULTS

Sixty patients with 126 non-syndromic LDST and 1602 patients with 1988 non-syndromic ST were identified. The prevalence of ST and LDST was 3.82% and 0.14%, respectively, with a male-female ratio of 1.78:1 and 1.31:1. LDST patients mainly had LDST in multiple (58.33%) and bilaterally (41.67%), with an average of 2.1/patient. Most LDST were normal-shaped (84.13%), vertically oriented (71.43%), located in the mandible (80.16%), and distributed in the premolar region (82.54%). The study also indicated that the development of LDST was correlated with permanent teeth, with LDST developing 6.48 to 10.45 years later. In this study, 72.22% of LDST met the clinical criteria for the third dentition.

CONCLUSIONS

LDST manifested different clinical features from common ST. LDST might be closely related to the third dentition.

CLINICAL RELEVANCE

This work would help to comprehend LDST from a clinical perspective, and may be complementary to the criteria of the third dentition.

Multiple Nonsyndromic Unerupted Supernumerary Teeth: A Report of a Rare Case

Introduction

The prevalence of nonsyndromic multiple supernumerary teeth is less than 1% of all hyperdontia cases which themselves have a rather small prevalence. Cases with 10 impacted nonsyndromic supernumerary teeth are extremely rare. This report presents such a case of nonsyndromic multiple impacted supernumerary teeth.

Case

A 17-year-old boy with a completely orthodontic chief complaint attended our center. He had no systemic complaints and no signs or symptoms. Oral examination showed no abnormalities. On routine pretreatment panoramic radiography, numerous impacted supernumerary teeth appeared. A CBCT showed 10 impacted vertically aligned supplementary supernumerary teeth with incomplete roots: In the maxilla, the bilateral canine-premolar areas were involved, each having 2 supernumerary teeth palatal to the permanent teeth. In the mandible, the right premolar area included 2 supernumerary teeth. The left premolar-molar area contained 3 supernumerary teeth lingual to the permanent teeth. And in the right mandibular molar area, there was a distomolar tooth distal to the third molar. No bony ankyloses, root resorptions, or fusions were observed. The surrounding bone had become thinner and the mandibular alveolar canal was involved. Interventions. All supernumerary teeth except a mandibular distomolar were extracted carefully before beginning the orthodontic treatment. No complications were seen after the extraction, after orthodontic treatment, and 2 years after treatment.

Conclusions

The possibility of completely hidden unerupted supernumerary teeth without any signs and symptoms might highlight the value of some radiographic screenings.

Phenotypic heterogeneity of non-syndromic supernumerary teeth: genetic study

BACKGROUND

Numerical dental anomalies, through their phenotypic diversity and etiological complexity, represent a very topical chapter in dental practice. In Romania, there is no recent complex genetic study, regarding supernumerary teeth (ST), as a whole.

PATIENTS, MATERIALS AND METHODS

In this research, through the specific genetic study of the phenotypic variability of ST, completed with clinical examinations and paraclinical investigations, to which statistical determinations were added, we performed a complex genetic-clinical and statistical analysis of ST, within a representative group, consisting of 574 patients, who came for specialized dental treatment, between 01/01/2018-05/30/2019, at the private dental offices (Lucky Dental), in Bucharest, Romania.

RESULTS

Following this study, it was possible to characterize the phenotypic variability of ST, to analyze the pattern of abnormality genetic transmission in the families of investigated patients, to identify people at risk, and specify the therapeutic conduct of choice, specific to each case.

CONCLUSIONS

We consider this paper to be of interest for medical practice by bringing new, recent data on the current prevalence of non-syndromic ST, their clinical phenotypes, and the specifics of their genetic determinism in the studied population group.

A Review of Supernumerary Teeth in the Premolar Region

Supernumerary teeth in the premolar region, unlike other supernumeraries, occur more often in the mandible where they are generally of the supplemental type. Occasionally, they are conical or smaller than normal, particularly in the upper premolar regions. They might occur singly or in multiples, be erupted or impacted, but the majority have been found to be unerupted and asymptomatic. The prevalence of supernumerary teeth in the premolar region has been demonstrated to be between 0.01 and 1 percent depending on the population studied. Interestingly, populations from the East or Africa are known to be the most affected. Various theories have been suggested to explain the etiology of supernumerary teeth in general including both genetic and environmental factors. Furthermore, it has been suggested that supernumerary premolar teeth belong to a third (postpermanent) series, developing from extensions of the dental lamina. Several consequences can result from the presence of supernumerary premolars, especially in the mandible, such as cyst formation, transposition, and other clinical scenarios.

Investigation of impacted supernumerary teeth: a cone beam computed tomograph (cbct) study

Purpose:

The purpose of this study was to investigate the impacted supernumerary teeth which were initially detected on panoramic radiographs by using cone beam computed tomography (CBCT).

Materials and Methods:

In this retrospective study, supernumerary teeth diagnosed on panoramic radiographs taken from patients who had admitted for routine dental treatment were evaluated using CBCT. Patients’ age, gender, systemic conditions as well as number of supernumerary teeth, unilateral-bilateral presence, anatomical localization (maxilla, mandible, anterior-premolar-molar, mesiodens-lateral-canine, parapremolar-paramolar-distomolar) shape (rudimentary, supplemental, tuberculate, odontoma), position (palatal-lingual-buccal-labial-central), shortest distance between the tooth and adjacent cortical plate, complications and treatment were assessed.

Results:

A total of 47 impacted supernumerary teeth in 34 patients were investigated in this study. Of these, 33 (70.2%) were unilateral and 14 (29.8%) were bilateral. Only 1 supernumerary tooth was found in 27 patients (79.4%) whereas 7 patients (20.6%) had 2 or more supernumerary teeth. Most of the teeth located in the anterior region (74.4%) of the jaws and maxilla (74.4%). Twenty teeth (42.5%) were mesiodens, 11 (23.4%) were lateral or canine, 14 (29.7%) were parapremolar and 2(4.4%) were distomolar. Twenty-seven teeth (57.4%) were rudimentary, 15 (31.9%) were supplemental and 5 (10.7%) were odontoma in shape. The shortest distance between the supernumerary tooth and adjacent cortical plate varied between 0 to 2.5 mm with a mean of 0.66 mm. The most common clinical complaint was the non-eruption of permanent teeth (42.5%). All supernumerary teeth were removed under local anesthesia. Orthodontic traction was performed for those impacted permanent teeth if necessary.

Conclusion:

Impacted supernumerary teeth are usually in close proximity to cortical bone. Although this may facilitate surgical access, there is a risk of damaging surrounding anatomical structures. Therefore, CBCT evaluation of impacted supernumerary teeth for accurate planning is recommended.

Histological Evaluation and Management of Rare Case of Supernumerary “Ghost” Teeth

Supernumerary teeth are teeth that exceed the normal dental formula. Their prevalence in the permanent dentition is 1–14% and they occur more frequently in maxilla with a sex ratio of 2 : 1 in favor of males. They are often associated with syndromes but there are examples of nonsyndromic multiple supernumerary teeth reported in the literature. CBCT is usually the best exam for radiographic diagnosis and treatment planning, because it provides 3D information about location and morphology of supernumerary teeth. This paper reports a rare case of four supernumerary teeth in a nonsyndromic 9-year-old boy. The peculiarity of this case is that two more exceeding teeth were found during surgical procedure. After extraction, all the teeth underwent a histological undecalcified processing for light microscopical examination. The two “ghost” supernumerary teeth seemed to be primordial dental germs, possibly resulting from an altered odontogenic process. After supernumerary teeth extraction, X-rays and exfoliation monitoring are recommended, since permanent retained teeth often erupt naturally or, at least, improve their condition. Radiographic follow-up is also useful in order to assess the formation of further teeth due to the hyperactivity of the dental lamina.

Late-Developing Supernumerary Premolars: Analysis of Different Therapeutic Approaches

This case series describes the different potential approaches to late-developing supernumerary premolars (LDSP). LDSP are supernumerary teeth (ST) formed after the eruption of the permanent dentition; usually they develop in the premolar region of the upper and lower jaw. The choice to extract or to monitor the LDSP depends on many factors and has to be carefully planned due to the several risks that either the monitoring or the extraction could provoke. These four cases of LDSP showed different treatment plan alternatives derived from a scrupulous assessment of the clinical and radiographic information.

The prevalence and distribution of nonsyndromic hyperdontia in a group of Qatari orthodontic and pediatric patients

OBJECTIVE

There is no data specific to the Qatari population on the prevalence and distribution of hyperdontia. The aim of this study was to investigate the prevalence and distribution of hyperdontia in the permanent teeth among a group of Qatari sample and to compare the present results with findings from other populations.

MATERIALS AND METHODS

Records of 1269 Qatari patients (674 females; mean age 11.8 ± 2.3 and 595 males; mean age 11.4 ± 2.2 years) which included panoramic radiographs were examined to identify hyperdontia in the permanent dentition. Supernumerary teeth were assessed for their location, morphology, number, and whether impacted or not.

RESULTS

The prevalence of hyperdontia was 1.6% (females 0.7% and males 0.9%; P < 0169). The most common type of supernumerary teeth was the supplemental (45.5%), followed by the conical (40%). Of the supplemental teeth, the mandibular incisor was the most prevalent (60%), followed by the premolar (20%). No significant difference in the prevalence was found between the maxilla and mandible. More than half of supernumerary teeth identified were impacted (54.5%).

CONCLUSIONS

The prevalence of hyperdontia in a group of Qatari population was within the normal range of the majority of published studies in the literature. Although not significant, hyperdontia cases were more prevalent in male patients.

Late developing supernumeraries in a case of nonsyndromic multiple supernumerary teeth

Objective. This case report presents 3-year follow-up of a case of nonsyndromic multiple supernumerary teeth (NSMST) with 11 supernumerary teeth, 2 of which showed subsequent formation. Case Report. A 10-year-old girl was referred to the dental clinic with the chief complaint of delayed eruption. Radiographic examination showed 9 retained supernumerary teeth. The treatment plan consisted of extraction of the supernumerary teeth and associated primary teeth in order to allow the permanent teeth to erupt. After 2 years of follow-up, 2 additional supernumerary teeth were observed. Conclusion. Regular follow-up for late forming supernumeraries is crucial for NSMST cases.

A multi-centre evaluation of multiple supernumerary premolar prevalence

Aim

The occurrence of multiple supernumerary teeth is rare and often found in association with syndromes such as cleidocranial dysplasia, Gardner's syndrome or cleft lip and palate. Few examples of non-syndromal multiple supernumerary teeth have been reported. The aim of this multi-centre study was to investigate the prevalence of supernumerary premolar teeth in non-syndromic patients and to investigate the association between the presence of supernumerary premolar teeth and malocclusion type in a Turkish population.

Materials and methods

The clinical records and panoramic radiographs of 10,700 patients (referred to three different university hospitals) were retrospectively examined for the presence of supernumerary premolars. Age, gender, orthodontic malocclusion type, the number of supernumerary premolars (two or more), the distribution, location, position (vertical, horizontal, inverted, mesio-angular), surgical approach, and related complications (pain, cystic changes, root resorption, or eruption disturbance of adjacent teeth) were recorded.

Results

Forty-two cases (13 Class I, 17 Class II, 12 Class III) of multiple mandibular supernumerary premolars in patients without an associated syndrome were detected. A total of 97 (27 Class I, 41 Class II, 29 Class III) supernumerary premolar teeth were found, with a prevalence of 0.39%. No statistical difference was found related to gender, malocclusion type and supernumerary premolars (p > 0.05). The majority of the extra premolars were located in the mandible, which was statistically significant (p < 0.05).

Conclusion

The present study revealed that the prevalence of multiple supernumerary teeth was 0.39%. The most frequently impacted premolars were found in the mandible and more often associated with Class II malocclusions in the examined Turkish population.

Supernumerary teeth in Nepalese children

Objective. The objectives of the present study were to investigate the prevalence and characteristics of supernumerary teeth in a patient sample of Nepalese children. Study Design. A survey was performed on 2684 patients (1829 females and 1035 males) ranging in age from 6 to 14 for the presence of supernumerary teeth. For each patient with supernumerary teeth the demographic variables (age and sex), number, location, eruption status, and morphology were recorded. Descriptive statistics were performed. Results. Supernumerary teeth were detected in 46 subjects (1.6%), of which 26 were males and 20 were females with a male : female ratio of 1.3 : 1. The most commonly found supernumerary tooth was mesiodens followed by maxillary premolars, maxillary lateral incisor, and mandibular lateral incisor. Of the 55 supernumerary teeth examined, 58.18% (n = 32) had conical morphology, followed by tuberculate (30.90%, n = 17) and supplemental (10.90%, n = 6) forms. The majority of the supernumerary teeth were erupted (56.36%, n = 31). Conclusion. The prevalence of supernumerary teeth in Nepalese children was found to be 1.6%, the most frequent type being mesiodens. Conical morphology was found to be the most common form of supernumerary tooth.

Late developing supernumerary premolars: reports of two cases

This paper presents two cases of late developing supernumerary premolars. Case 1 is a female patient with nonsyndromic multiple supernumerary teeth located in the maxillary right premolar-molar region, maxillary left premolar region, and the mandibular right and left premolar regions. In this patient surgical removal of all supernumerary teeth was carried out to avoid complications during orthodontic treatment. Case 2 is a female aged 19 years in whom formation of a mandibular supernumerary premolar was observed which was not present at age 13. The patient was made aware of the supernumerary tooth presence, and periodic radiographic assessment was planned.

Odontometric evaluation of mandibular premolars with tooth shape deviation: a case-control study

OBJECTIVE

To evaluate the mean dimensions and morphologic characteristics of mandibular premolars that had mesiodistally elongated and faciolingually squeezed tooth shape deviations (MnP-TSD) and determine the population prevalence of this anomaly.

MATERIALS AND METHODS

Clinical photographs and study models were made for all new patients with MnP-TSD teeth who were seen over 20 years. The mesiodistal (MD) and faciolingual (FL) dimensions of the anomalous premolars were measured. MD/FL indices and MD × FL mm(2) occlusal crown areas were calculated and means and standard deviations were derived. Male and female means from the mandibular first and second anomalous premolars (MnP1/MnP2-TSD) were statistically compared against gender-specific means derived from published normative data using Student's t-tests and chi-square tests.

RESULTS

Fifty-six individuals (33 male and 23 female) with MnP-TSD were identified, giving a male to female ratio of 1.4:1, while the prevalence rate in the indigenous British population was estimated to be 0.6%. The MD widths of the MnP1-TSD and MnP2-TSD teeth were approximately 1 mm wider than normal, while the FL diameters were about 0.5 mm and 1.5 mm narrower respectively, for the first and second premolar teeth. The MD/FL indices, instead of being under 90 as usual were above 100, while the mean MD/FL mm(2) crown surface areas were normal.

CONCLUSIONS

This study supplies odontometric dimensional and morphologic data on MnP-TSD teeth that provide a reference source for future comparisons.

Non-syndromic multiple supernumerary teeth: meta-analysis

BACKGROUND

Non-syndromic multiple supernumerary teeth (NSMST) is a condition with a very low prevalence and which is opportunely described in the literature by case reports or group of cases. This represents a problem when it comes to describing and discussing the characteristics of this disorder.

MATERIALS AND METHODS

A search was conducted in PubMed, Web of Knowledge, Science Direct, and Scopus databases to locate and identify cases and series of cases about articles on multiple supernumerary teeth not associated with syndromes that have been reported so far. The following data were recorded: age, gender, total number of supernumerary teeth, number of teeth in both the maxilla and mandible, respectively, and number of teeth in each dental series (incisor, canine-premolar, and molar). Bilaterality in dental series and its localization in either maxilla or mandible were also determined.

RESULTS

A total of 46 cases including patients of both genders with a mean age of 19 years (SD = 6.826) and a ratio of 2.14:1 were identified. A total of 393 supernumeraries were reported; 43.26% (n = 170) were located in the maxilla and 56.74% (n = 223) in the mandible. No significant differences were found between genders with respect to the total number, involvement of the dental series, or distribution of supernumerary teeth in each of the arches.

CONCLUSION

Although NSMST is a condition that has a higher incidence in the male gender, no differences have been found as to their number and localization in both genders. Bilaterality seems to be a common characteristic of this disorder.

A clinical epidemiologic analysis of a sample of 73 supernumerary premolars

BACKGROUND

The authors conducted a retrospective study to determine the prevalence of supernumerary premolars in sample of patients from Madrid, as well as the possible complications associated with the presence of such supernumerary premolars.

METHODS

The study included a data assessment of all patients seeking dental care at a hospital's department of oral surgery across four years. The authors studied data from patients who had supernumerary premolars.

RESULTS

The authors identified supernumerary premolars in the records of 43 patients (0.32 percent) of the total population studied. These patients had 73 hyperdontic premolars (65 mandibular premolars [89 percent] and eight maxillary premolars [11 percent]).

CONCLUSIONS

Supernumerary premolars usually are diagnosed as a coincidental radiographic finding without an associated pathology. However, the authors found a higher percentage of comorbidity than they initially expected.

CLINICAL IMPLICATIONS

Mechanical or obstructive pathology was associated with 2.7 percent of the premolars, and enlargement of the follicular sac of more than 3 millimeters was present in 26.0 percent of the sample.

A late-forming mandibular supernumerary: a complication of space closure

This case report describes a situation in which a mandibular supernumerary developed during orthodontic treatment and prevented space closure.

The development of supernumerary teeth in the mandible in cases with a history of supernumeraries in the pre-maxillary region

This article presents four cases in which delayed formation and late eruption of supernumerary teeth in the mandible occurred in patients with a history of supernumerary formation in the premaxilla region. In all cases, the premaxillary supernumeraries prevented eruption of the associated permanent incisor(s).

Late forming supernumerary tooth in the premaxilla: a case report

A case of late forming supernumerary tooth in the premaxilla is presented in this report. The patient has been followed-up radiographically from the age of 9 years but the supernumerary tooth could only be detected radiographically when the patient was 11 years old. This emphasises the importance of thorough clinical and radiographic examination of the developing dentition in children.

Apparent hypodontia: a case of misdiagnosis

The case of a 12-year-old girl is reported, whose pretreatment radiograph demonstrated agenesis of two premolars and a canine and slow development of the contralateral premolars. A follow-up radiograph taken 1 year later showed initial mineralization of a tooth germ in the site of one of the apparently missing premolars. The cause, diagnosis, and treatment planning implications of delayed mineralization and slow development of second premolars are discussed with reference to the literature.