Supernumerary teeth amongst Iranian orthodontic patients. A retrospective radiographic and clinical survey

Prevalence and Distribution of Dental Anomalies in Schoolchildren in Kuwait

OBJECTIVE

Dental anomalies (DA) can affect paediatric patients' aesthetics, function, and psychological well-being. There is a lack of data about the prevalence of DA in children in Kuwait. This study aimed to investigate the prevalence and distribution of DA amongst schoolchildren aged 8 to 12 years.

METHODS

A retrospective study was conducted using panoramic digital radiographs of children who attended a single dental center. All radiographs were evaluated by 2 calibrated and trained examiners.

RESULTS

DA were present in 110 (20.1%) out of the 546 panoramic radiographs examined: 53.6% in females and 46.4% in males. The mean age of children with DA (9.83 ± 1.29) was similar to that of children with no anomalies (9.96 ± 1.46). The most prevalent anomaly was dental agenesis (9.3%), followed by taurodontism (6.6%) and ectopic eruption (EE, 2%). DA were more common in the maxilla (58.2%) compared to the mandible (41.8%, P = .042). Congenitally missing teeth were significantly more frequent in the mandible (56.9%) than in the maxilla (43.1%, P = .003). EE was significantly more common in the maxilla (90.9%) than in the mandible (9.1%, P = .024). Microdontia and root dilacerations were only present in males, whilst supernumerary teeth, transposition, and impacted teeth were noted in females only.

CONCLUSIONS

The prevalence of DA amongst schoolchildren in Kuwait was considered to be relatively high. Certain DA were associated with gender. The significant prevalence of DA highlights the need for early diagnosis using panoramic radiographs, particularly during the ages of 9 and 10, in order to ensure effective patient management.

Comprehensive Oral Diagnosis and Management for Women with Turner Syndrome

Turner Syndrome (TS) is a rare genetic disorder that affects females when one of the X chromosomes is partially or completely missing. Due to high genetic and phenotypic variability, TS diagnosis is challenging and is often delayed until adolescence, resulting in poor clinical management. Numerous oral, dental and craniofacial anomalies have been associated with TS, yet a comprehensive description is still lacking. This study addresses this gap through a detailed analysis of oral health and craniofacial characteristics in a cohort of 15 females with TS and their first-degree relatives. Subjects with TS ranged from 3 to 48 years old, none showed evidence of periodontal disease and only the youngest was in mixed dentition. Using the Multifunction System, we identified an aggregation of multiple signs and symptoms in each TS subject, including tooth anomalies (supernumerary molars, agenesis, microdontia, enamel defects, alterations in eruption patterns -advanced and delayed for chronological age-, crowding, rotations and transpositions), malocclusion (class II/1 and II/2) and Class II facial profile, while relatives exhibited fewer manifestations. The early detection of these signs and symptoms is crucial for appropriate referral and the optimal clinical management of TS, especially during the critical period of 9 to 10 years when congenital dental anomalies appear. The use of an established taxonomy to describe these phenotypic features is essential for early detection. Multidisciplinary teams are required to ensure holistic care management in rare diseases like TS.

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.

Is there an association between molar incisor hypomineralization and developmental dental anomalies? A case-control study

BACKGROUND

The aim of this study was to determine whether there is any association between molar incisor hypomineralization and developmental dental anomalies.

METHODS

Two pediatric dentists evaluated panoramic radiographs of 429 children aged 8-14 years with molar incisor hypomineralization (study group) and 437 children without molar incisor hypomineralization (control group) in terms of developmental dental anomalies. Twelve different developmental dental anomalies were categorized into four types: size (microdontia, macrodontia); position (ectopic eruption of maxillary permanent first molars, infraocclusion of primary molars); shape (fusion, gemination, dilaceration, taurodontism, peg-shaped maxillary lateral incisors); and number (hypodontia, oligodontia, hyperdontia) anomalies.

RESULTS

No significant difference was observed in the frequencies of developmental dental anomalies between the study and control groups in total, females, and males (p > 0.05). A statistically significant difference was found between the distribution of developmental size, position, shape, and number anomalies between the study and control groups (p = 0.024). The most common anomaly in both groups was hypodontia (6.3% and 5.9%, respectively). There was a significant difference between the study and control groups in terms of subtypes of shape anomaly in all children and females (p = 0.045 and p = 0.05, respectively).

CONCLUSIONS

While a significant difference was observed between the distributions of types of developmental dental anomalies between individuals with and without molar incisor hypomineralization, there was no difference in terms of the frequency of developmental dental anomalies.

Prevalence of Class I, II and III skeletal relationships and its association with dental anomalies in an ethnic Chinese orthodontic population

Objectives:

To investigate the prevalence of skeletal Classes I, II and III in a Chinese orthodontic population, and determine its association with the prevalence of dental anomalies.

Methods:

This retrospective cross-sectional study was conducted on 2508 ethnic Chinese orthodontic patients aged 14 to 25 years who attended the Department of Orthodontics at the National Dental Centre Singapore. Radiographs, photographs and clinical records of the study sample were examined for the prevalence of dental anomalies in the permanent dentition, excluding third molars. The anteroposterior skeletal relationship was determined based on the A point–Nasion–B point angle measured from the lateral cephalogram, whereby Class I: A point–Nasion–B point = 3.6° ± 2.5° (1 standard deviation) that is 1.1° to 6.1°; Class II: A point–Nasion–B point greater than 6.1°; Class III: A point–Nasion–B point less than 1.1°. Logistic regression was used to determine the association between the anteroposterior skeletal relationship and the occurrence of various dental anomalies.

Results:

The prevalence of the anteroposterior skeletal relationship was: 49.5% Class I; 23.1% Class II; and 27.4% Class III. Class III patients had significantly lower odds of impacted teeth compared to Class I patients (odds ratio 0.608, 95% confidence interval 0.463–0.798; P=0.00009). There was no significant difference in the occurrence of the anomalies among the various anteroposterior skeletal types.

Conclusions:

The occurrence of impacted teeth was lower in Class III than Class I, while no significant differences were noted for hyperdontia, hypodontia, peg-shaped upper lateral incisors, transposition and double teeth. The occurrence of all investigated dental anomalies had no significant difference between Class II and Class I.

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

Background

Supernumerary tooth is defined as any extra tooth or odontogenic structure that is formed on normal dentition. Supernumerary teeth cause such problems as deficiency in tooth growth, ectopic growth, displacement, crowding, diastema, odontogenic cyst formation, decay of the adjacent tooth, malocclusion, and esthetic problems. This study was conducted aiming at determining epidemiology of supernumerary teeth in Ardabil city in 2020. Materials & Methods. In this retrospective descriptive analytical study, 5000 panoramic radiographs of patients referring to Rad and Baser Oral and Maxillofacial Radiology Centers were selected through multistage sampling method during 2015-2020. The data were collected by checklist and analyzed with using SPSS-21 and chi-squared, Fisher, and one-way ANOVA tests with a significance level less than 5%.

Results

The prevalence of supernumerary teeth was estimated as 1.06% (n = 53), and no significant difference between the males and females was seen. Most supernumerary teeth were found in the distomolar (44.1%) and parapremolar (29.4%) locations. The majority of supernumerary teeth were present in the maxilla (73.5%) and were impacted (77.9%) and unilateral (71.7%). The number of supernumerary teeth was 68 cases and majority of patients (86.8%) had one supernumerary tooth.

Conclusion

Supernumerary tooth in this study had a high prevalence compared to similar studies, and unlike most previous studies, the most common type of supernumerary tooth was distomolar. Early diagnosis and proper medical planning are essential for managing supernumerary teeth.

Non-syndromic cleft lip with or without palate-susceptible SNPs is associated with hyperdontia

BACKGROUND

Non-syndromic supernumerary teeth (NSST) or hyperdontia may share common genetic determinants with non-syndromic cleft lip with or without palate (NSCL/P). The aim of this study was to test the associations between five genome-wide-associated NSCL/P-susceptible single nucleotide polymorphisms (SNPs) (rs2235371, rs7078160, rs8049367, rs4791774, and rs13041247) and the occurrence of NSST.

MATERIALS AND METHODS

A total of 163 cases and 326 controls were recruited and their genomic DNA was extracted from blood samples. Five NSCL/P-susceptible SNPs (rs2235371, rs7078160, rs8049367, rs4791774, and rs13041247) were genotyped by TaqMan method. Odds ratio (OR) and 95% confidence interval (CI) were used to estimate the associations between the SNPs and the risk of NSST by PLINK software.

RESULTS

Rs4791774 (A > G) and rs13041247 (T > C) were associated with risk of NSST (rs4791774: P_add  = 0.011, OR, 95% CI = 0.62, 0.43-0.90; rs13041247: P_homo  = 0.031, OR, 95% CI = 1.79, 1.05-3.05) and one supernumerary tooth (rs4791774: P_dom  = 0.009, OR, 95% CI = 0.56, 0.36-0.87; rs13041247: P_homo  = 0.034, OR, 95% CI = 1.82, 1.05-3.15). Rs4791774 (A > G) was also showed association with risk of upper arch supernumerary teeth only (P_add  = 0.010, OR, 95% CI = 0.60, 0.41-0.89).

CONCLUSION

Non-syndromic cleft lip with or without palate-susceptible loci rs4791774 (A > G) and rs13041247 (T > C) were associated with the risk of supernumerary teeth.

Secondary dentition characteristics in an ethnic Chinese orthodontic population: A retrospective cross-sectional study

AIM

To determine the prevalence of dental anomalies and its association with gender.

METHODS

This retrospective cross-sectional study was conducted using radiographs, photographs and clinical records of patients who attended the Department of Orthodontics at the National Dental Centre Singapore. Records of 2508 ethnic Chinese orthodontic patients aged 14-25 years were examined for the prevalence of dental anomalies in the permanent dentition, excluding third molars. Statistical analyses were performed using SAS version 9.4 (SAS Institute Inc.). Logistic regression was used to determine the association between gender and the occurrence of various dental anomalies. Kappa coefficients were calculated to test for intra-examiner reproducibility. Statistical significance was set at P < 0.05.

RESULTS

Prevalence of dental anomalies was 5.7% hyperdontia, 11.1% hypodontia, 5.5% peg-shaped upper lateral incisors, 21.9% impacted teeth, 1.3% transposition and 0.4% double teeth. There was no significant gender difference in the occurrence of the anomalies except hyperdontia, with males having significantly higher odds of hyperdontia compared with females (odds ratio, 1.488; 95% confidence interval, 1.062-2.085; P = 0.021).

CONCLUSION

Occurrence of hyperdontia is greater in males than females, while no significant gender differences were noted for hypodontia, peg-shaped upper lateral incisors, impacted teeth, transposition and double teeth.

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.

A novel mutation of adenomatous polyposis coli (APC) gene results in the formation of supernumerary teeth

Supernumerary teeth are teeth that are present in addition to normal teeth. Although several hypotheses and some molecular signalling pathways explain the formation of supernumerary teeth, but their exact disease pathogenesis is unknown. To study the molecular mechanisms of supernumerary tooth‐related syndrome (Gardner syndrome), a deeper understanding of the aetiology of supernumerary teeth and the associated syndrome is needed, with the goal of inhibiting disease inheritance via prenatal diagnosis. We recruited a Chinese family with Gardner syndrome. Haematoxylin and eosin staining of supernumerary teeth and colonic polyp lesion biopsies revealed that these patients exhibited significant pathological characteristics. APC gene mutations were detected by PCR and direct sequencing. We revealed the pathological pathway involved in human supernumerary tooth development and the mouse tooth germ development expression profile by RNA sequencing (RNA‐seq). Sequencing analysis revealed that an APC gene mutation in exon 15, namely 4292‐4293‐Del GA, caused Gardner syndrome in this family. This mutation not only initiated the various manifestations typical of Gardner syndrome but also resulted in odontoma and supernumerary teeth in this case. Furthermore, RNA‐seq analysis of human supernumerary teeth suggests that the APC gene is the key gene involved in the development of supernumerary teeth in humans. The mouse tooth germ development expression profile shows that the APC gene plays an important role in tooth germ development. We identified a new mutation in the APC gene that results in supernumerary teeth in association with Gardner syndrome. This information may shed light on the molecular pathogenesis of supernumerary teeth. Gene‐based diagnosis and gene therapy for supernumerary teeth may become available in the future, and our study provides a high‐resolution reference for treating other syndromes associated with supernumerary teeth.

Dental anomalies: prevalence and associations between them in a large sample of non-orthodontic subjects, a cross-sectional study

Background

To analyze the prevalence and associations between dental anomalies detectable on panoramic radiographs in a sample of non-orthodontic growing subjects.

Methods

For this cross-sectional study, digital panoramic radiographs of 5005 subjects were initially screened from a single radiographic center in Rome. Inclusion criteria were: subjects who were aged 8–12 years, Caucasian, and had good diagnostic quality radiographs. Syndromic subjects, those with craniofacial malformation, or orthodontic patients were excluded and this led to a sample of 4706 subjects [mean (SD) age = 9.6 (1.2) years, 2366 males and 2340 females]. Sample was subsequently divided into four subgroups (8, 9, 10, and 11–12 year-old groups). Two operators examined panoramic radiographs to observe the presence of common dental anomalies. The prevalence and associations between dental anomalies were also investigated.

Results

The overall prevalence of dental anomalies was 20.9%. Approximately, 17.9% showed only one anomaly, 2.7% two anomalies, while only 0.3% had more than two anomalies. The most frequent anomalies were the displacement of maxillary canine (7.5%), hypodontia (7.1%), impacted teeth (3.9%), tooth ankylosis (2.8%), and tooth transposition (1.4%). The lower right second premolar was the most frequent missing teeth; 3.7% had only one tooth agenesis, and 0.08% had six or more missing tooth (Oligodontia). Mesiodens was the most common type of supernumerary tooth (0.66%). Two subjects had taurodontic tooth (0.04%). Tooth transpositions and displacement of maxillary canine were seen in 1.4 and 7.5%, retrospectively (approximately 69 and 58% were in the 8 and 9 year-old groups, retrospectively). Significant associations were detected between the different dental anomalies (P < .05).

Conclusions

The results of our study revealed significant associations among different dental anomalies and provide further evidences to support common etiological factors.

Electronic supplementary material

The online version of this article (doi:10.1186/s12903-017-0352-y) contains supplementary material, which is available to authorized users.

Radiographic Follow-Up during Orthodontic Treatment for Early Diagnosis of Sequential Supernumerary Teeth

Most supernumerary teeth are impacted and asymptomatic. Objective. The aim of this paper is to describe two cases of sequential development of supernumerary teeth in the mandibular premolar region, identified during orthodontic treatment. Reports. The first case describes the radiographic follow-up of a female patient that presented a supernumerary tooth at the age of 9 years and 10 months in the right mandibular premolar region, followed by a further supernumerary tooth in the left mandibular premolar region identified at the age of 11 years and 3 months. In the second case, the radiographic follow-up of a male patient demonstrated 3 supernumerary teeth in the premolar region at the age of 16 years. During orthognathic surgery planning at the age of 20 years and 5 months, a supplemental supernumerary tooth was found in the left mandibular region. Conclusion. Considering the late developing of supernumerary premolars, appropriate follow-up with panoramic radiographs of patients with previous experience of supernumerary teeth is essential for early diagnosis of supplemental premolars to prevent possible complications.

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.

Odontomas and supernumerary teeth: is there a common origin?

The aim of the present work is to analyze all scientific evidence to verify whether similarities supporting a unified explanation for odontomas and supernumerary teeth exist. A literature search was first conducted for epidemiologic studies indexed by PubMed, to verify their worldwide incidence. The analysis of the literature data shows some interesting similarities between odontomas and supernumerary teeth concerning their topographic distribution and pathologic manifestations. There is also some indication of common genetic and immuno-histochemical factors. Although from a nosological point of view, odontomas and supernumeraries are classified as distinct entities, they seem to be the expression of the same pathologic process, either malformative or hamartomatous.

An Unusual Accessory Mandible and a Submucosal Cleft Palate—A Case Report and Review of the Literature

An accessory mandible is a rare congenital anomaly that requires multidisciplinary management. This case report describes a female patient with an unusual accessory mandible, a dysplastic overgrowth of bone, containing teeth that extended from the midsymphyseal region. A submucosal cleft palate and cleft of the lower lip were also present. Her treatment plan took a staged approach with initial surgical resection of the accessory bone and teeth. The second stage, still in the planning phase, will correct the secondary deformity of an anterior open bite and will restore the missing lower anterior teeth. The original deformity and subsequent growth are discussed with the relevant literature.