Epidemiology of Supernumerary Teeth in 5000 Radiography Films: Investigation of Patients Referring to the Clinics of Ardabil in 2015-2020

Extraction of an ectopic supernumerary tooth through nasal cavity with piezosurgery under local anesthesia: A case report

Key Clinical Message

The ectopic supernumerary teeth (ST) commonly occur in the oral cavity. Ectopic ST in the maxilla can be extracted not only through an intraoral approach but also through a nasal approach.

Abstract

The ectopic supernumerary teeth (ST) commonly occur in the oral cavity. We are reporting a case of a 23-year-old female patient with one ectopic ST in the anterior midmaxillary region. We extracted the ectopic ST under local tissue anesthesia through the nasal cavity using piezosurgery and minimally invasive extraction tools. During the operation, the adjacent structures remained intact, and the patient discomfort. This case indicates that ectopic ST in the maxilla can be extracted not only through an intraoral approach but also through a nasal approach.

Exploring the potential of artificial intelligence in paediatric dentistry: A systematic review on deep learning algorithms for dental anomaly detection

BACKGROUND

Artificial intelligence (AI) based on deep learning (DL) algorithms has shown promise in enhancing the speed and accuracy of dental anomaly detection in paediatric dentistry.

AIM

This systematic review aimed to investigate the performance of AI systems in identifying dental anomalies in paediatric dentistry and compare it with human performance.

DESIGN

A systematic search of Scopus, PubMed and Google Scholar was conducted from 2012 to 2022. Inclusion criteria were based on problem/patient/population, intervention/indicator, comparison and outcome scheme and specific keywords related to AI, DL, paediatric dentistry, dental anomalies, supernumerary and mesiodens. Six of 3918 initial pool articles were included, assessing nine DL sub-systems that used panoramic radiographs or cone-beam computed tomography. Article quality was assessed using QUADAS-2.

RESULTS

Artificial intelligence systems based on DL algorithms showed promising potential in enhancing the speed and accuracy of dental anomaly detection, with an average of 85.38% accuracy and 86.61% sensitivity. Human performance, however, outperformed AI systems, achieving 95% accuracy and 99% sensitivity. Limitations included a limited number of articles and data heterogeneity.

CONCLUSION

The potential of AI systems employing DL algorithms is highlighted in detecting dental anomalies in paediatric dentistry. Further research is needed to address limitations, explore additional anomalies and establish the broader applicability of AI in paediatric dentistry.

Imaging analysis of 1 138 supernumerary teeth by using cone-beam computed tomography

OBJECTIVES

This study aims to analyze and summarize the characteristics of supernumerary teeth by using cone-beam computed tomography (CBCT).

METHODS

A total of 718 patients with 1 138 supernumerary teeth were retrospectively collected. Age, gender, number, location, morphology, eruption status, and accompanying symptoms of the supernumerary teeth were statistically analyzed. The relationship relative to jaws, gender, and eruption status were analyzed and discussed.

RESULTS

The average age of the patients was 9.54±5.32 years, and the male to female ratio was 2.88∶1. About 77.02% of the patients sought medical advice during the mixed dentition period, and 50.70% had one supernumerary tooth. These supernumeraries were most commonly conical in shape, and 85.76% of them were in the incisor region, 92.09% in the upper jaw, 46.75% in inverted position, and 86.20% unerupted. Overall, 65.29% of them had fully developed roots, and 60.63% had an impact on adjacent structures. Significant differences were found in eruption status, morphology, zoning, direction, root development, and impact on adjacent structures between the supernumerary teeth located in the upper and lower jaws (P<0.05). Significant differences were also detected in gender, morphology, zoning, orientation, root development, and impact on adjacent structures between erupted and unerupted teeth (P<0.05). The incidence of supernumerary teeth in the incisor region was higher in males than that in females. Moreover, the root of supernumeraries was more completely developed in males than in females (P<0.05).

CONCLUSIONS

For supernumerary teeth, CBCT images can provide accurate three-dimensional radiographic data and are valuable for clinical diagnosis and treatment planning.

Digital Laser-Sintered Expander in Adolescent Patient with Hyperdontia and Molar Impaction

Supernumerary teeth can have normal or abnormal morphologic structure and characteristics, and their impacted form is diagnosed usually during X-ray examinations. In this case report, the presented patient is a 16-year-old female with anterior and right posterior open bite and bilateral posterior crossbite, upper right supernumerary paramolar, and impacted second and third molars. The paramolar development was the reason for the asymmetric growth of the alveolar bone in the upper jaw. The development of the bone is connected with the development of the teeth, and one additional tooth leads to extensive development in the maxilla. There is a risk of gingival recession occurrence when leveling the lower incisors due to the thin gingival biotype. A combined surgical-orthodontic treatment was done according to the following plan: extraction of supernumerary paramolar, germectomy of the upper right third molar (18) and at the same time periodontal graft in the lower anterior segment. A digitally three-dimensional (3D) printed appliance for rapid maxillary expansion was used for the transverse insufficiency of the upper jaw. The upper dental arch expander was designed with distal extension in the area of the upper right second molar (17). The extension was used as an anchorage during the orthodontic traction of the second molar. The treatment continued with a fixed orthodontic appliance-braces in the upper and lower jaw. With the extraction of the impacted and supernumerary teeth in the right maxillary segment, the eruption of 17 was stimulated and a change in the height of the alveolar bone was achieved. This favored the vertical changes and normalization of the occlusion. The maxillary expansion was also a significant factor in normalizing the occlusion. Observations on paramolar behavior showed that more often they develop in the bone and do not erupt. Each clinical case is highly individual, and patients seek orthodontic treatment at different stages of dentition development and corresponding development of the supernumerary teeth.

Clinical and imaging analysis of 22 cases of supernumerary teeth in the mandibular region

PURPOSE

This study aimed to describe clinical and imaging analysis of supernumerary teeth in the mandibular region of 22 cases.

STUDY DESIGN

Retrospective study METHODS: : This study enrolled patients diagnosed with supernumerary teeth who underwent cone beam computed tomography (CBCT) at Stomatology Hospital of Xi'an Jiaotong University from August 2016 to September 2022. Participants included individuals aged 7-29 years of both genders. The following variables were examined: number of supernumerary teeth, location, shape, direction, length, relationship with adjacent teeth and surrounding anatomical structures, and secondary effects RESULTS: : Out of 236 subjects, 22 (6.02%) were found to have supernumerary teeth in the mandibular region, with a total of 62 teeth identified. The male-to-female ratio was 5:6. Most supernumerary teeth were located in the lingual side of the mandibular region, particularly in the 34-35 tooth area (21.66%), followed by the 44-45 tooth region. The vast majority of supernumerary teeth (96.77%) were impacted, and more than half (51.67%) were located near the mental nerve canal. The average length of the supernumerary teeth was 10.5 mm. While no primary complications were observed, some secondary symptoms were noted, such as the ectopic eruption of adjacent teeth and crowding of permanent teeth.

CONCLUSION

The supernumerary teeth in the mandibular area have regional characteristics, which can provide for clinical diagnosis and treatment. CBCT can accurately analyze the location of supernumerary teeth and their secondary effects, and provides the treatment plan on that basis.

The Role of Artificial Intelligence in the Accurate Diagnosis and Treatment Planning of Non-Syndromic Supernumerary Teeth: A Case Report in a Six-Year-Old Boy

Hyperdontia can cause numerous aesthetic and functional problems. The diagnosis is made radiologically, and the most commonly used radiological method is orthopantomography, while CBCT is also used. CBCT has the advantage of being three-dimensional. Artificial Intelligence is widely used in medicine and dentistry, and it can create a specific algorithm to aid in diagnosis and suggest therapeutic procedures. In a case report, a 6-year-old boy was diagnosed with a supernumerary tooth between the upper central incisors. Orthopantomography revealed another impacted supernumerary tooth, and the patient was referred for CBCT. A platform for analyzing dental images, based on artificial intelligence, Diagnocat (Diagnocat Inc., San Francisco, CA, USA), was used for analysis and the AI system identified the supernumerary teeth and provided a complete plan for treatment. The use of AI in dentistry allows for faster and more accurate diagnosis and treatment planning.

Tooth number abnormality: from bench to bedside

Tooth number abnormality is one of the most common dental developmental diseases, which includes both tooth agenesis and supernumerary teeth. Tooth development is regulated by numerous developmental signals, such as the well-known Wnt, BMP, FGF, Shh and Eda pathways, which mediate the ongoing complex interactions between epithelium and mesenchyme. Abnormal expression of these crutial signalling during this process may eventually lead to the development of anomalies in tooth number; however, the underlying mechanisms remain elusive. In this review, we summarized the major process of tooth development, the latest progress of mechanism studies and newly reported clinical investigations of tooth number abnormality. In addition, potential treatment approaches for tooth number abnormality based on developmental biology are also discussed. This review not only provides a reference for the diagnosis and treatment of tooth number abnormality in clinical practice but also facilitates the translation of basic research to the clinical application.