Prevalence and characteristics of supernumerary teeth: A survey on 7348 people

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.

Post-surgical complications of supernumerary teeth in the mandibular premolar area: A systematic review

In the mandibular premolar area, supernumerary teeth are a rare disorder that are rarely documented in the literature. The purpose of this study was to evaluate the post-surgical problems associated with the buccal and lingual techniques used to treat the extra teeth in this area. Using PubMed, PubMed Central, Science Direct, Cochrane, Wiley, and manual search, a thorough search was done to locate and identify cases and case series with extra teeth in the mandibular premolar region. For every study that was included, data on the surgical technique and postoperative problems were documented. Seven studies involving 90 patients were included. Supernumerary teeth in the mandibular premolar region were predominantly found in male patients (65.55 %), with most cases occurring in the right mandibular region (77.16 %). Postoperative complications after removing supernumerary teeth using buccal and lingual approaches were similar, with only one complication reported among the 90 cases reviewed. Although the findings suggest that surgical management of supernumerary teeth in the mandibular premolar region is relatively safe, caution is advised due to the limited sample size. Detailed pre-operative evaluation, a comprehensive treatment plan, and regular follow-up can minimize postoperative complications.

Risk prediction model of impacted supernumerary tooth-associated root resorption in children based on cone-beam computed tomography analysis: a case control study

BACKGROUND

External surface resorption is pressure-induced resorption and occurs on the external surface of the root, pressure exerted by impacted teeth, is common causes of external surface resorption. Predictive risk factors of impacted supernumerary tooth-associated root resorption (ISTARR) mentioned in this article include supernumerary teeth and patient factors. To investigate the risk factors of impacted supernumerary tooth-associated root resorption and predict the incidence of root resorption.

METHODS

This restrospective study enrolled 324 patients with impacted supernumerary tooth. All Cone-Beam Computed Tomography (CBCT) data and patient information were divided into two groups (without tooth root resorption and with root resorption). CBCT images and patient information (age and gender) of 133 patients had adjacent tooth root resorption and 191 did not. seven variables were analysed using binary logistic regression.

RESULTS

Individual analysis of potential risk factors showed that age, crown mesiodistal direction, root formation, and odontotheca of the impacted supernumerary tooth were associated significantly with ISTARR. Binary logistic regression showed that impacted supernumerary tooth with odontotheca (Odd Ratio = 2.926), the crown is in the middle (Odd Ratio = 1.446), located at the middle third of the adjacent tooth root (Odd Ratio = 1.614), complete root development (Odd Ratio = 1.334), and patient's age (Odd Ratio = 1.261) were significantly associated with ISTARR risk.

CONCLUSIONS

The risk factors of root resorption can be detected and predicted early according to the features of supernumerary tooth and patient's age. Still, more prospective studies with larger sample size are needed to validate the result.

Bilateral Supplemental Permanent Maxillary Lateral Incisor in a Non-syndromic Pediatric Patient: A Rare Case Report

In the present case report, a 13-year-old girl patient has bilateral supplementary maxillary lateral incisors, a rare type of supernumerary teeth. During a regular checkup, it was discovered that the patient had these additional teeth, although she had no notable medical or dental history. The patient had no symptoms, even though they may have led to occlusal problems. The tooth's morphology was identical to that of the nearby natural teeth, and radiographic imaging verified full root growth. The example illustrates the importance of early diagnosis and individualized treatment planning, taking into account the patient's decision to keep the extra teeth while attending to the main issue of widespread dental sensitivity. This study emphasizes the necessity for tailored patient treatment and the variations in the management of extra teeth.

Comparative proteomic analysis of dental pulp from supernumerary and normal permanent teeth

OBJECTIVES

To obtain and compare the protein profiles of supernumerary and normal permanent dental pulp tissues.

MATERIALS AND METHODS

Dental pulp tissues were obtained from supernumerary and normal permanent teeth. Proteins were extracted and analyzed by liquid chromatography-tandem mass spectrometry (LC/MS-MS). Protein identification and quantification from MS data was performed with MaxQuant. Statistical analysis was conducted using Metaboanalyst to identify differentially expressed proteins (DEPs) (P-value < 0.05, fold-change > 2). Gene Ontology enrichment analyses were performed with gProfiler.

RESULTS

A total of 3,534 proteins were found in normal dental pulp tissue and 1,093 in supernumerary dental pulp tissue, with 174 DEPs between the two groups. This analysis revealed similar functional characteristics in terms of cellular component organization, cell differentiation, developmental process, and response to stimulus, alongside exclusive functions unique to normal permanent dental pulp tissues such as healing, vascular development and cell death. Upon examination of DEPs, these proteins were associated with the processes of wound healing and apoptosis.

CONCLUSIONS

This study provides a comprehensive understanding of the protein profile of dental pulp tissue, including the first such profiling of supernumerary permanent dental pulp. There are functional differences between the proteomic profiles of supernumerary and normal permanent dental pulp tissue, despite certain biological similarities between the two groups. Differences in protein expression were identified, and the identified DEPs were linked to the healing and apoptosis processes.

CLINICAL RELEVANCE

This discovery enhances our knowledge of supernumerary and normal permanent pulp tissue, and serves as a valuable reference for future studies on supernumerary teeth.

Non-syndromic Bilateral Supernumerary Teeth in the Primary and Secondary Dentition: A Rare Case Report

Supernumerary teeth are presented in any region of the dental arches as additional teeth to the standard set of teeth and may present in either the primary or secondary dentition. They can be found as single or multiple teeth on one or both sides of the dental arches, with a preference for the premaxilla. The supernumerary teeth might cause aesthetic and/or functional problems, mainly if situated in the maxillary anterior region. Multiple supernumerary teeth are often related to specific conditions or in syndromic patients, i.e., cleft palate, cleft lip, cleidocranial dysplasia, and Gardner's syndrome. This report presents a case of an eight-year-old female patient with non-syndromic bilateral supernumerary teeth in the primary and secondary dentition. The patient is medically fit, and her family history was non-contributory.

The Role of an Endodontist in Victim Identification: A Narrative Review on Forensic Endodontics

This narrative review highlights the role of endodontists and the significance of various dental tools in forensic dentistry. An online search was conducted in peer-reviewed journals, including MEDLINE (Ovid), PubMed, Web of Science, Scopus, and Google Scholar databases, to retrieve studies regarding "the role of an endodontist in victim identification using different tools". The searches used controlled vocabulary and free-text terms. Articles written in English and published from 1923 to 2023 were selected. An essential stage in forensic dentistry is dental identification of the dead person and is regarded as an initial step for both judicial and humanitarian purposes if fingerprint records are missing or the remains have undergone significant changes. Endodontists should be aware of all available dental tools that aid in identification. The four fundamental tools for identification are dental radiographs, hard and soft dental structures, and dental materials. Dental radiographs provide a substantial nondestructive record for estimating age and sex. Moreover, maxillofacial hard and soft structures provide important tools for individual identification as they are considered the strongest structures in the human body and can withstand severe chemical and temperature changes. In addition, endodontic and restorative materials can be identified under different conditions and serve as excellent forensic identification measures.

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.

Bilateral Supernumerary Teeth Presenting as Nasal Masses and Recurrent Rhinitis: An Interesting Case Report

The presence of a tooth inside the nasal cavity is a rare clinical entity. The exact pathophysiology is not clear and most of the times, these patients present with non-specific symptoms. We encountered a 51-year-old male with symptoms of bilateral recurrent nasal obstruction and nasal discharge of 10 years' duration. Anterior rhinoscopy and diagnostic nasal endoscopy revealed a greyish white hard gritty mass covered with mucopurulent discharge in the floor of left nasal cavity and a mucosal covered bulge was noted in the floor of right nasal cavity. CT showed 2 hyperintense lesions in the maxilla reaching the floor of both nasal cavities. Diagnosis of supernumerary teeth was made and treated accordingly. Although the presence of tooth has been reported in ovaries, maxilla, maxillary sinus, mandibular condyle, mediastinum, this is the rare case reported with supernumerary teeth in both nasal cavities.

The Effects of Exercise Training on Plasma Volume Variations: A Systematic Review

The aim of this systematic review was to summarize the evidence on the acute and long-term effects of exercise training on PV, in both trained and untrained individuals and to examine associations between changes in %PVV and change in physical/physiological performance. Despite the status of participants and the exercise duration or intensity, all the acute studies reported a significant decrease of PV (effect size: 0.85<d<3.45, very large), and ranged between 7 and 19.9%. In untrained individuals, most of studies reported a significant increase of PV in response to different kind of training including endurance training and high intensity interval training (effect size: 0.19<d<3.52, small to very large), and ranged from 6.6 to 16%. However, in trained individuals the results are equivocal. We showed that acute exercise appears to induce a significant decrease of PV in both healthy untrained and trained individuals in response to several exercise modalities. Moreover, there is evidence that long-term exercise training induced a significant increase of PV in healthy untrained individuals. However, it seems that there is no consensus concerning the effect of long-term exercise training on PV in trained individuals.

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.

Prevalence of Supernumerary Teeth and Its Associated Complications among School-going Children between the Ages of 6 and 15 Years of Jamshedpur, Jharkhand, India

Background

Supernumerary teeth (ST) are those that exceed the normal dental formula. This phenomenon is also known as hyperdontia, and can occur in solitary or multiple forms, might be unilateral or bilateral, and affect one or both jaws.

Aim

To study the prevalence, gender variations in terms of frequency, characteristic, distribution, and associated complications with the presence of ST in 3,000 school-going children of age 6-15 years in Jamshedpur, Jharkhand, India.

Materials and methods

The study consisted of an examination of randomly selected 3,000 children, female (group I) and male (group II), between the age-group of 6 and 15 years, from both private and government-aided schools. Clinical examinations were carried out by a single investigator under natural daylight in a systematic manner using a mouth mirror and straight probe only. The demographic profiles and number of teeth, including the presence of any ST (site, region, eruption status, morphology, and whether it was present unilaterally or bilaterally), were ascertained. Malocclusion or any complications associated with ST were also noted.

Results

ST prevalence was found to be 1.87%, with male to female ratio of 2.29:1. Out of 56 children with ST, eight children had double ST while 48 had single, 53 ST were present in maxilla, and only three in mandible. Based on the region, 51 ST were present in the midline, four in the central incisor region, and one in the molar region. According to morphology, 38 ST were conical, 11 ST were tuberculate, and seven ST were supplementary. Twenty-two ST had associated complications, while 34 ST were asymptomatic.

Conclusion

ST prevalence is relatively less, but if left neglected, it can pose serious associated dental problems in the child.

How to cite this article

Singh AK, Soni S, Jaiswal D, et al. Prevalence of Supernumerary Teeth and Its Associated Complications among School-going Children between the Ages of 6 and 15 Years of Jamshedpur, Jharkhand, India. Int J Clin Pediatr Dent 2022;15(5):504-508.

Vertical direction impaction of kissing molars: A case report

BACKGROUND

Kissing molars (KMs) are a scarcely reported form of molar impaction in which the occlusal surfaces contact each other within a single dental follicle and the roots point in opposite directions. The direction of KMs impaction is generally tilted. KMs with vertical direction impaction have not been reported in the literature.

CASE SUMMARY

A 25-year-old female visited a dentist for right maxillary wisdom teeth extraction and was diagnosed with two vertically impacted KMs in the left mandible on panoramic radiography. After cone-beam computed tomography examination confirmed no secondary complication, the patient chose to undergo observation and regular follow-up. A literature review of KMs revealed that vertical impacted KMs are rare; high-quality evidence regarding their prevalence is still lacking. At present, the causality of KMs is controversial. In this study, we have tried to provide a detailed definition of KMs to allow an accurate evaluation of their prevalence and classification based on their impaction direction which may be related to their pathogenesis. The treatment plan of KMs depends on the condition and location of the affected teeth and associated complications; they may be either directly extracted or treated using a multidisciplinary approach including maxillofacial surgeons and orthodontists.

CONCLUSION

KMs are a rare clinical condition of impacted teeth with unclear pathogenesis. Vertically impacted KMs were seldom reported. Reasonable definition and classification of KMs can help in the understanding of their causes and prevalence.

Prevalence of Dental Number Anomalies Among A Group of Turkish Children

Background/Aim: The study aimed to evaluate the prevalence and distribution of congenital dental number anomalies in the permanent dentition among a group of Turkish children in the Inner Aegean Region of Turkey.

Material and Methods: A total of 5377 patients aged 7–9 who visited our clinic for the first time between September 2018 and September 2019 were investigated. The children were examined for tooth agenesis and supernumerary teeth using panoramic radiographs taken for various reasons and clinical records reviewed. Dental number anomalies were evaluated according to gender and localization. Descriptive and comparative statistical analyses were performed using the SPSS package software program Version 23.

Results: For the study, the data of 1987 patients (947 female, 1040 male) were examined. The tooth agenesis was found in 109 patients (5.5%), the supernumerary teeth were found in 24 patients (1.2%). The prevalence of tooth agenesis was 5% in males, 6% in females. There was no statistical difference between genders (p>0.05). The distribution of tooth agenesis according to jaws and sides by gender was not statistically different (p>0.05). The most commonly missing teeth were mandibular left second premolar (37.6% of patients) and mandibular right second premolar (33% of patients). According to types of teeth and gender, molar tooth agenesis was seen more common in females than males (p<0.05), there was no significant difference in other types of teeth by gender. The prevalence of supernumerary teeth were 1.9% in males, 0.4% in females and the difference between genders was found to be statistically significant (p<0.05). All the supernumerary teeth were located in the anterior maxilla, and half of them were mesiodens.

Conclusions: Early diagnosis and appropriate treatment choice are very important managing complications associated with congenital dental number anomalies and for differential diagnosis of characteristic syndromes.

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.

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.

Chronic odontogenic nasal discharge: report of two cases

Supernumerary teeth are those that form in excess to the normal dental formula and while there is no clear pathogenesis for their formation, they are known to vary in size, morphology, location and presentation. We present two cases of otherwise healthy patients who presented with pain, discomfort and discharge from the nasal passages. CT imaging identified a tooth-like density present in the bone of the nasal floor in both patients. In both cases, the tooth was extracted surgically under anaesthetic. A symptomatic supernumerary in the nasal floor might cause a plethora of symptoms and complications, decreasing the overall quality of life for a patient. Patients who present with a supernumerary tooth in the nasal floor should be further investigated with a simple nasal speculum examination and a CT scan. Their surgical management is simple and brings near immediate relief of symptoms.

Conservative surgical management of a supernumerary tooth in the nasal cavity

A 9-year-old girl presented with a foreign body obstruction inside her nose. The condition led to pain and nasal congestion. CT showed the presence of a radiopaque mass similar to a tooth in the right nasal cavity. Diagnosis of a supernumerary intranasal tooth was made and extraction was performed under general anaesthesia. An ectopic tooth in the nasal cavity is rare and surgical removal is recommended to eliminate the symptoms.

Surgical Management of Unerupted Permanent Maxillary Central Incisors Due to Presence of Two Supernumerary Teeth

Aim and objective

The present report aims to present a case of delayed eruption of permanent maxillary central incisors in an 11-year-old male child due to the presence of two supernumerary teeth in anterior maxilla.

Case description

In this case, clinical and radiographic assessment revealed the presence of two supernumerary teeth palatal to unerupted maxillary permanent central incisors. These teeth were removed surgically under local anesthesia and were diagnosed as supplemental incisor, and the other appeared like tuberculate with dens invaginatus.

Conclusion

The permanent incisors erupted spontaneously within 6 months follow-up after extraction of the two supernumerary teeth without any orthodontic interception.

How to cite this article

Alsweed AA, Al-sughier Z. Surgical Management of Unerupted Permanent Maxillary Central Incisors Due to Presence of Two Supernumerary Teeth. Int J Clin Pediatr Dent 2020;13(4):421–424.