Orthodontic treatment of fused and geminated central incisors: a case report

A 10-year old Egyptian male presented with a geminated upper right central incisor along with a fused and rotated upper left central incisor in cross bite. He also had severe crowding in the maxillary arch and a congenitally missing lower right first permanent premolar. Orthodontic treatment was carried out to align upper right and left central incisors, lateral incisors, and canines. Treatment options were discussed.

A premaxilla with a supernumerary tooth indicating a developmental region with a variety of dental abnormalities: a report of nine cases

The aim of this study was to elucidate whether a premaxilla with a supernumerary tooth has additional dental abnormalities. The study does not include premaxillas with a mesiodens, only premaxillas with parasagittally located supernumerary teeth. Radiographs from eight children, followed from 1 year and 5 months to 11 years and 5 months in the municipal dental health service in Denmark, were analyzed. One patient was seen only once. Dental abnormalities recorded included: invaginations on permanent incisors, resorption of roots of incisors, curved roots of incisors, delayed eruption, and delayed formation of roots. The study shows that there are dental abnormalities within the premaxillary region where the supernumerary tooth is located. This indicates that, apart from the supernumerary tooth, a more widespread deviation from normal conditions including tooth malformation, arrested eruption, and root resorption occur within the premaxillary region. The most important outcome of this study is that in the region with a supernumerary tooth the adjacent incisor shows delayed eruption after surgical removal of the supernumerary tooth. The deviations in root morphology, including root resorption, are not limited to patients who have had orthodontic treatment, but patients who did not receive orthodontic treatment also revealed deviations in root morphology. Therefore the treatment outcome can be different from the expected outcome.

Multidisciplinary treatment of "twinned" permanent teeth: two case reports

Twinned teeth usually appear in the anterior region of the dental arch. Besides orthodontic malocclusions, such as protrusion, crowding, or diastema, they also cause esthetic problems. Different treatment methods can be used according to the requirements of the situation. This article reports multidisciplinary treatment of 2 patients whose maxillary central teeth were twinned with supernumerary incisors. The twinned tooth was reshaped following endodontic treatment in 1 of the patients and orthodontic treatment was performed with edgewise mechanics. In the second case, however, it was determined that the twinned tooth had 2 separate roots. There was also another supernumerary lateral incisor in the dental arch that increased the severity of the crowding. The twinned tooth was hemisected and the other supernumerary tooth was extracted. The patient wore a removable appliance for initial tooth movements and treatment was finished with fixed appliances.

Clinical complications associated with supernumerary teeth: report of two cases

The presence of supernumerary teeth can interfere in normal occlusal development. The pediatric dentist should diagnose them as soon as possible, as most of the time they are asymptomatic. The objective of this paper is to show the presence of that dental anomaly in two pediatric patients, as well as the associated clinical complications with treatment.

Supernumerary fourth and fifth molars: a report of two cases

Panoramic radiographs of two female patients ages 22 and 21 revealed the presence of two impacted bilateral upper fourth molars and unilateral (right) upper fourth and fifth molars. All of the teeth were distomolars. The supernumerary teeth had normal tooth morphology with regard to their crowns and roots but were slightly smaller than the existing third molars. Their crowns were either two or three tuberculated and they all had single roots.

A case of Zimmermann-Laband syndrome with supernumerary teeth

BACKGROUND

Zimmermann-Laband syndrome is a rare autosomal dominant disorder that is characterized by gingival fibromatosis, ear, nose, bone, and nail defects, and hepatosplenomegaly.

METHODS

This case report describes the clinical presentation and periodontal findings in a 13-year-old female patient with previously undiagnosed Zimmermann-Laband syndrome.

RESULTS

Clinical and radiographic findings and genetic counseling confirmed the diagnosis of Zimmermann-Laband syndrome. The most striking oral findings were the presence of gingival enlargement involving both the maxillary and mandibular arches, anterior open bite, non-erupted teeth, and two supernumerary teeth. Periodontal treatment consisted of gingivectomy in four quadrants. Histopathologic evaluation of excised tissue supported the diagnosis of gingival fibromatosis. The patient was referred for appropriate orthodontic treatment and genetic counseling, and has been closely followed for the earliest signs of hepatosplenomegaly.

CONCLUSIONS

Dental practitioners should be alert for developmental abnormalities that may occur in patients with gingival fibromatosis as this may indicate the presence of a rare disorder like Zimmermann-Laband syndrome. A comprehensive medical history and physical systemic evaluation are essential for correct diagnosis and treatment of these cases.

Retarded eruption of maxillary second premolars associated with late development of the germs

This study focused on five unusual cases with anomalous eruptions of the maxillary second premolars that related to late development of the germs. In four cases, the affected premolars erupted between the ages of 12y3m and 14y6m. In one case, which was suspected to include bilateral anomalies, the eruption of the premolar was excessively late, continuing up to 17y8m old. It was surmised that the degree of tooth formation in the contralateral side might help to predict approximately at what age the late premolars will erupt.

Supernumerary teeth causing impaction of permanent maxillary incisors: consideration of treatment

The paper presents a discussion on etiology and treatment of maxillary central incisors impactions. Different treatment approaches which advocate teamwork approach, and importance of early diagnosis of such conditions is discussed.

The treatment of fusion and supernumerary maxillary central incisors: a case report

Changes in tooth form may result from heredity, disease, or trauma. Fusion is a union of one or more teeth during development. Gemination means that two separate morphological units are created by division of the tooth germ. Many studies have attempted to discuss the prevalence of double teeth (fusion and gemination) among the persons tested by examining gender, distribution (maxilla or mandible), and whether the anomaly occurred bilaterally or unilaterally. This article describes a case in which one individual was diagnosed with both a supernumerary maxillary central incisor and fusion of a maxillary central incisor.

Mesiodens--diagnosis and management of a common supernumerary tooth

Mesiodentes are the most common supernumerary teeth, occurring in 0.15% to 1.9% of the population. Given this high frequency, the general dentist should be knowledgeable about the signs and symptoms of mesiodentes and appropriate treatment. The cause of mesiodentes is not fully understood, although proliferation of the dental lamina and genetic factors have been implicated. Mesiodentes can cause delayed or ectopic eruption of the permanent incisors, which can further alter occlusion and appearance. It is therefore important for the clinician to diagnose a mesiodens early in development to allow for optimal yet minimal treatment. Treatment options may include surgical extraction of the mesiodens. If the permanent teeth do not erupt in a reasonable period after the extraction, surgical exposure and orthodontic treatment may be required to ensure eruption and proper alignment of the teeth. In some instances, fixed orthodontic therapy is also required to create sufficient arch space before eruption and alignment of the incisor(s). Early diagnosis allows the most appropriate treatment, often reducing the extent of surgery, orthodontic treatment and possible complications. This paper outlines the causes and modes of presentation of mesiodentes, and presents guidelines for diagnosis and management of nonsyndromic mesiodentes.

Three-dimensional evaluation of a rare case with multiple impacted teeth using CT

A 15-year-old patient is presented with 11 impacted teeth including 2 supernumerary teeth, who did not exhibit hereditary or clinical disease. The patient showed the extruded and lingually inclined lower incisors, the anteriorly inclined palatal plane, extremely large curve of Spee, and crowding in the bone. A detailed description of the positional relationship between each impacted tooth and the neighboring tooth was given using the 3D CT-image.

Compound odontoma associated with an unerupted and dilacerated maxillary primary central incisor in a young patient

The occurrence of odontoma in the primary dentition is uncommon. There are very few reports of non-eruption of a dilacerated primary tooth in the literature. A rare case of compound odontoma in association with an unerupted dilacerated maxillary primary incisor in a young patient is reported. There was also a developing supernumerary tooth in the vicinity of the odontoma. The clinical features and management of these conditions are discussed. The relevant literature is reviewed. A possible causal relationship between odontoma and dilaceration is highlighted.

Multiple dental anomalies in the maxillary incisor region

A patient with multiple anomalies of the maxillary teeth, including shovel-shaped incisors, talon cusp, bilateral dens invaginatus and bilateral peg-shaped supernumerary incisors is reported. The patient also exhibited Carabelli's cusp on both maxillary first molars. No developmental syndrome was identified. This very unusual combination of anomalies has not been reported previously.

Endodontic and orthodontic treatment of a cross-bite fused maxillary lateral incisor

AIM

To describe combined endodontic and orthodontic treatment of a maxillary lateral incisor fused with a supernumerary.

SUMMARY

A rare case is presented in which combined endodontic and orthodontic treatment was performed on a cross-bite fused tooth. Clinical and radiographic examination showed the maxillary lateral incisor fused with a supernumerary and an impacted canine. The fused tooth required nonsurgical and surgical endodontic treatment for functional and aesthetic reasons. The root canals were dressed with calcium hydroxide for 2 months before they were obturated with thermoplasticized injectable gutta-percha. Then, the distal part of the fused tooth was removed and the mesial part of the tooth was replanted and fixed. Three months after the completion of orthodontic therapy, the impacted canine erupted between the remaining tooth and the first premolar. Recall examination, 3 years after completion of root canal treatment, showed clinical and radiographic evidence of healing.

KEY LEARNING POINTS

Fusion has been described as a development anomaly characterized by the union of two adjacent teeth. Proper combined endodontic and orthodontic treatment resulted in maintaining one tooth half and solving the aesthetic and functional problem of a fused tooth.

[Treatment of torsion abnormalities of central upper incisors caused by super-compact teeth]

A super-compact retained tooth is often responsible for rotation of a tooth round its axis; the retained tooth should be removed after preliminary x-ray examination of the site of abnormality. A great variety of etiopathological factors are responsible for the abnormality, and hence, the approaches to the choice of treatment are numerous. Rotation of teeth during orthodontic treatment involved stretching and strain of connective tissue fibers, which are not intended for rearrangement, and therefore the results are not stable. A long period of retention is needed for adaptation of tissues to a new position of the tooth.

Multidisciplinary evaluation and clinical management of mesiodens

Supernumerary teeth are a disorder of odontogenesis relatively common in the oral cavity and characterized by an excess number of teeth. The term mesiodens is used to refer to an unerupted supernumerary tooth in the central region of the premaxilla between the two central incisors. The complications associated with mesiodens include: lack of eruption of permanent teeth, the deviation of the eruption path, rotations, retention, root re-absorption and pulp necrosis with loss of vitality, and diastema. Early detection of mesiodens is most important if such complications are to be avoided. This report describes the treatment of a maxillary central incisor impacted by a mesiodens. The case initially required only surgical treatment, to remove the supernumerary tooth. Successively, orthodontic therapy was done to bring into position the left permanent central incisor, which erupted physiologically, but rotated 90 degrees around along its long axis.

Eruption disturbances of mandibular permanent incisors

In this study, we analyzed 7 eruption disturbance cases of mandibular permanent incisors (5 males and 2 females), aged 5y9m to 10y4m. The etiology was divided into 3 categories: traumatic injuries (3 cases), odontomas (2 cases), supernumerary teeth (2 cases). The procedures such as removal of cause (4 cases), surgical exposure (5 cases) and traction (1 case) were done.

Impacted supernumerary tooth developed under palatal polyp

We present a rare case of an infant's palatal polyp associated with an impacted supernumerary tooth. We have previously reported three cases of palatal polyps in infants [1]. In one case, after surgical removal of the palatal polyp at the age of 1 year and 8 months, the lesion subsequently began swelling. A periapical radiograph at the age of 2 years and 9 months revealed a small calcified mass in the maxillary left incisor region. The swelling was kept under observation, the calcified mass developed gradually and was removed surgically at the age of 5 years and 5 months. The removed calcified mass was clinically diagnosed as an impacted supernumerary tooth and this was confirmed histologically. Histological findings did not indicate any relationship between the palatal polyp and the impacted supernumerary tooth.

Supernumerary teeth: review of the literature and a survey of 152 cases

INTRODUCTION

A review of the literature relating to supernumerary teeth is presented along with a survey of 152 cases.

METHODS

The study population consisted of 152 children who visited the department of Paediatric Dentistry at the Jordan University Hospital. Patients ranged in age from 5 to 15 years. Supernumeraries were detected by clinical examination and radiographs.

RESULTS

Males were affected more than females with a sex ratio of 2.2 : 1. Seventy-seven percent of the patients had one supernumerary tooth, 18.4% had double teeth, and 4.6% had three or more supernumeraries. Ninety percent of the supernumerary teeth occurred in the premaxilla, of which 92.8% were in the central incisor region and of these latter 25% were located in the midline. The other 10.4% of the supernumeraries were located in the premolar, canine, molar, and lower central incisor regions. Two cases were of non-syndrome supernumerary teeth. Seventy-five percent of the supernumeraries were conical, 83.1% were in the normal vertical position and 26.5% were erupted. Conical-shaped supernumerary teeth had a significantly higher rate of eruption compared to the tuberculate type.

Two uncommon uses of Bio-Oss for GTR and ridge augmentation following extractions: two case reports

Bio-Oss is natural bovine bone mineral, which has the property of bone conduction. It is recommended to be used in two- or three-walled bony defects with an ample supply of pleuripotential cells. Two cases are reported. The first was an intentional replantation, because of previous trauma, of a hopeless tooth affected with severe periodontitis. The tooth was replanted after complete elimination of granulation tissue. Bio-Oss, together with a guided tissue regeneration (GTR) membrane, was used to enhance periodontal regeneration. After 2 years of follow-up, the replanted tooth was quite stable. In the second case, Bio-Oss, together with bone taken from the retromolar area, was used in a sinus lift grafting procedure after the removal of two supernumerary teeth from the floor of the maxillary sinus. Four months after grafting, an orthodontic treatment was applied to move the two adjacent teeth through the grafted site and align them in the proper position. The clinical results of the two cases were satisfactory.

Bilateral maxillary fused primary incisors accompanied by succedaneous supernumerary teeth: report of a case

A rare case of fusion between maxillary primary central incisors and supplemental teeth occurring bilaterally, accompanied by succedaneous supernumerary teeth, is presented. The patient was an 8.5-year-old Japanese boy. Intraoral examination revealed fusion of left and right maxillary primary central incisors to supplemental teeth, which had labial and lingual grooves. The maxillary primary lateral incisors were present. Radiographs showed that the fused teeth had separate roots, pulp chambers and root canals. There were two impacted supernumerary teeth and eruption of the permanent maxillary central incisors was delayed. Treatment was performed and the fused primary teeth and the impacted supernumerary teeth were extracted. After 6 months observation, surgical exposure of the two crowns of the permanent maxillary central incisors was performed. The teeth began to erupt and have since been kept under observation.

Radiographic diagnosis of supernumerary teeth: report of six unusual cases

The purpose of this report was to describe the radiographic findings of 6 uncommon situations of supernumerary teeth in a Brazilian pediatric dentistry and orthodontic clinic. Six cases of supernumerary teeth were diagnosed in association with other dental anomalies such as number, position, and form. The supernumeraries were asymptomatic and were detected through routine radiographic examination. The importance of routine radiographic examination is emphasized for the correct diagnosis of supernumerary teeth, and avoidance of associated complications.

Early diagnosis and treatment of supplemental mandibular tooth: report of a case

This report describes a rare case of a supplemental tooth with a morphology similar to a lateral incisor, found in the canine region of the mandible of a 6-year-old male. The purpose of this paper is to report the importance of early diagnosis and treatment during mixed dentition. The treatment was extraction of the primary mandibular left canine soon after the initial diagnosis of the condition to facilitate the spontaneous eruption of the supplemental tooth and his removal. Twenty-nine months after the removal of the supplemental tooth the mandibular left canine was fully erupted into normal position. No complication arose from the presence of this supernumerary and his early diagnosis has been very important for not disrupting the normal erupting or alignment of other teeth.

Dental morphologic characteristics of normal versus delayed developing dentitions with palatally displaced canines

An earlier study reported on the delayed dental age in about 50% of patients with palatally displaced canines (PDC), suggesting the possible existence of 2 different PDC phenotypes. The present study aimed to determine whether the PDC subgroup with late dental age displays different dental features from the PDC subgroup with normal dental age, supporting the above assumption. The 3 dental parameters examined were mesiodistal and buccolingual tooth sizes, the presence of anomalous maxillary lateral incisors, and other congenitally missing teeth. Fifty-eight subjects with PDC, 37 girls and 21 boys, were divided according to dental age and compared with age- and sex-matched controls. The results revealed marked sexual dimorphism. Delayed dental development was twice as prevalent among the PDC males. The existence of 2 distinct PDC subgroups was supported for males only. One subgroup was characterized by delayed dental development, smaller-than-average teeth, and a marked increase in the prevalence of anomalous lateral incisors. The second subgroup more closely resembled the controls, presenting a timely developed dentition, a moderate and nonsignificant increase of anomalous lateral incisors, and a reduction in the dimensions of only the central incisors and the first molars. In females, although the prevalence of anomalous lateral incisors was slightly increased in the late dental age subgroup, tooth sizes were remarkably similar, negating the existence of 2 distinct subpopulations. Studying the overall PDC group as a single entity produced confusing results because important differences were obscured when the 2 sexes and the 2 dental age subgroups (in males) were combined.

Multiple supernumerary teeth in association with malocclusion: report of two cases

Although multiple supernumerary teeth without any associated syndromes are rare, their occurrence can create a variety of clinical problems such as derangement of the occlusion, prevention of eruption of permanent teeth, damage to adjacent teeth, cystic degeneration and root resorption. Hence, clinical and radiographic evaluation of patients should always be thorough in order to detect their presence. Furthermore, because the clinical management of multiple supernumerary teeth poses a great challenge to clinicians, timely, appropriate consultation and interdisciplinary approach to treatment is extremely important. We report two cases, a 14 year-old boy with eight and a 13-year-old girl with seven supernumerary teeth not associated with syndromes. In the boy, the teeth were bilaterally distributed in all quadrants in the premolar regions, and in the girl they were distributed bilaterally in the premolar regions in the mandible and bilaterally distal to the upper third molars. The clinical implications and management are discussed.

A case of complex odontoma associated with an impacted lower deciduous second molar and analysis of the 107 odontomas

OBJECTIVE

Odontoma is a comparatively common odontogenic tumor, and it may lead to interference with the eruption of its associated tooth. Odontomas are mostly associated with permanent teeth, and they are rarely associated with deciduous teeth. The purpose of this report is to analyze 107 odontomas and to present a case of complex odontoma associated with a lower deciduous second molar.

SUBJECT AND METHODS

The 106 cases were analyzed with regard to the following parameters: age, gender, location, erupted teeth, congenital missing teeth, radiological features, histopathological features and prognosis.

RESULTS

Of the 106 cases, 41 were complex odontoma, 62 were compound odontoma, and three were immature odontoma. Compound odontoma had a predilection for the anterior. Complex odontoma occurred more often at the mandible.

CONCLUSION

Odontoma located above the tooth crown of lower deciduous molar did not behave clinically different from that associated with permanent tooth. An odontoma could be related with a supernumerary tooth or a missing tooth. If odontomas, which interfered with tooth eruption, were extirpated early, the impacted teeth would probably erupt normally and be normal in shape.

Primary incisor triplication defect

Conjoining abnormalities occur in less than 1 percent of the population. Triplication of primary teeth is even a rarer phenomenon with a prevalence of 0.02 percent. This study describes the clinical features and the light microscopic appearance of a case of triplicated primary teeth. The teeth with the conjoined defect were examined by light microscopy to evaluate the exact level and appearance of the fusion area. The light microscopic examination revealed grooves and cracks consisting of enamel and dentine in the fusion area, fusion was irregular and both dentin and cementum were confluent. It is concluded that the clinician should identify children were conjoined anomalies and should be aware of the oncoming problems.

Fusion of the permanent maxillary right incisor to a supernumerary tooth in association with a gemination of permanent maxillary left central incisor: a dental, genetic and dermatoglyphic study

The relationship between fusion of the permanent maxillary right central incisor to a supernumerary tooth in association with gemination of permanent maxillary left central incisor and dermatoglyphics were investigated.

A rare non-syndrome case of concomitant multiple supernumerary teeth and partial anodontia

Concomitant hypo-hyperdontia is an uncommon condition of coexistence of partial anodontia and supernumerary teeth. Its etiology is still unknown. Very few cases have been reported in the literature of this condition. Presented here is a rare and first such case of simultaneous presence of multiple supernumerary teeth and a missing tooth (canine) without any associated systemic conditions or syndromes involving both jaws.

Midline space closure in the mixed dentition: a case report

Supernumerary teeth which occur both in the primary and the permanent dentition are seen more frequently in the permanent dentition causing a variety of pathological disturbances. Presented herewith is a case report of a patient with a mesiodens which had caused flaring of the maxillary central incisors and impeded normal eruption of the maxillary lateral incisors. Extraction of the mesiodens was carried out; subsequently followed by the space closure utilizing simple fixed orthodontic therapy.

Histological and analytical studies of a tooth in a patient with cleidocranial dysostosis

A histopathological and analytical study of a permanent tooth from a patient with cleidocranial dysostosis (CCD) was performed. The patient was a 47-year-old woman, who had 10 erupted permanent teeth and 2 partially erupted and 19 completely impacted teeth, including supernumerary teeth. The erupted right upper premolar was extracted and observed using a light microscope and an electron probe X-ray microanalyzer (EPMA). Findings showed enamel hypoplasia, predominantly irregular globular dentin and Tomes' granular layer, and a complete lack of cellular cementum in the ground section. The incremental von Ebner and counter Owen lines were obscure. Comparative quantitative analysis using the EPMA showed that the quantities of calcium and phosphate were lower in the enamel and dentin than those of the control sample.

Management of a Class II deep bite malocclusion with combined straightwire appliance and bioprogressive therapy

Development of straightwire appliances and improvement in archwire technology have simplified fixed appliance therapy in orthodontics. Although straightwire appliances are routinely used to treat most malocclusions, there are inherent limitations and it is necessary to look at the needs of each individual case rather than to simply proceed through a "cookbook" series of archwires to achieve a desired result. The Bioprogressive Therapy, although biomechanically complex, offers several advantages that can be integrated with the straightwire appliances to overcome the latter's shortcomings. This article illustrates the use of simplified Bioprogressive mechanics by means of utility arch in the treatment of a Class II deep bite malocclusion with high anchorage requirement.

Management of median diastema

In mixed and early permanent dentitions, median diastema can be a major esthetic concern for patients and/or their parents. The space can be transient or created by developmental, pathological, or iatrogenic factors. Different treatment techniques have been proposed to manage the situation. This paper reviews the common causes of median diastema and presents four cases to illustrate a range of restorative and orthodontic options.

Congenital tooth anomalies and malocclusions: a genetic link?

The aim of the present study was to investigate putative relationships between different malocclusions such as Class III and Class II division 1, and congenital tooth anomalies. Two-hundred Class III and 215 Class II division 1 patients were examined for the presence of any of the following congenital tooth anomalies: maxillary incisor hypodontia, maxillary canine impaction, transpositions, supernumerary teeth, and tooth agenesis. Their occurrence rates were then calculated as a percentage of the total sample and were compared for statistical differences. The results revealed no statistical difference (P > 0.05) in the occurrence rates of upper lateral incisor agenesis, peg-shaped laterals, impacted canines, or supernumerary teeth between the Class III and the Class II division 1 malocclusions. When the occurrence rate of all congenital tooth anomalies was compared between the two malocclusions, Class III subjects showed significantly higher rates (P < 0.05). Comparison with published surveys on general populations showed similar occurrence rates. It can be concluded that subjects with Class III and Class II division 1 malocclusions show patterns of congenital tooth anomalies similar to those observed in the general population. Congenital tooth anomalies may represent another criterion for the study of malocclusion, with respect to their origin and development.

Description of a clinical technique for tooth extraction in the cleft lip and palate area

Cleft lip and palate are relatively common congenital malformations, which may require specialist paedodontic treatment. In this article, the case of a 9-year-old boy with bilateral complete cleft lip and palate is presented. He attended the Hospital for Rehabilitation of Craniofacial Anomalies (HRAC) for routine examination, during which the presence of pre-canine supernumeraries bilaterally in the cleft area was seen. The extraction of these dental elements was justified by extensive carious lesions and because they represented a potential problem during secondary palatoplasty. The precautions needed in tooth extraction in patients with cleft lip and palate are described, together with illustrations of the clinical procedure.

Prevalence of numeric anomalies in the permanent dentition of patients with Down syndrome

The purpose of this study was to evaluate the prevalence of numeric anomalies in the permanent dentition of patients with Down syndrome by means of panoramic radiographs. The sample consisted of panoramic radiographs from 70 subjects. We examined the radiographs to detect hypodontia as well as supernumerary teeth. Our results confirm the high prevalence of hypodontia among patients with Down syndrome (60%), mostly with mild expression. The teeth most often missing were the upper lateral incisors, usually bilaterally, followed by the lower second premolars and upper second premolars. Supernumerary teeth were seen in 6% of the subjects, and the concomitant occurrence of hypodontia and supernumerary teeth occurred in one patient.

Supernumerary teeth: literature review

A review of the literature on supernumerary teeth in general and supernumerary molars in particular was carried out on prevalence, aetiology, complications and the treatment of supernumerary teeth. Additional teeth are relatively common and are usually of simple conical shape (supernumerary teeth) but may resemble teeth of the normal size and shape. The aim of this review is to provide reference material for dental practitioners in Zimbabwe.

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.

A multidisciplinary approach to the treatment of an intruded maxillary permanent incisor complicated by the presence of two mesiodentes

Treatment of a traumatically intruded maxillary incisor with an immature apex remains controversial. Treatment options include observation, surgical repositioning, or orthodontic forced eruption. Likewise, the ideal timing of surgical removal of a mesiodens is highly controversial: immediate versus delayed intervention. The complications associated with untreated supernumerary teeth include: overretention of primary teeth, delayed eruption of permanent incisors, rotations, impaction, diastema, pulp necrosis and root resorption. Less common sequelae include enlarged follicular sacs, cystic degeneration and nasal eruption. This paper describes another risk factor associated with delayed removal of a mesiodens previously not mentioned in the dental literature, namely potential complications arising from a traumatic injury, in particular intrusion, of the maxillary permanent incisors.

Orthodontic treatment of a patient with multiple supernumerary teeth and mental retardation

Supernumerary teeth may lead to impaction or ectopic eruption of maxillary incisors, crowding, oronasal fistula, follicular cyst, migration of adjacent teeth and root resorption. In this presentation, an 11-year-old male patient with 4 supernumerary teeth in the maxillary anterior region and a slight mental retardation problem will be presented. After extraction of the supernumerary teeth, the large space created by distal migration of central incisors was closed by orthodontic treatment. Although initial patient compliance was weak and caused difficulties in the course of treatment, orthodontic treatment was completed successfully.

Early intervention to remove mesiodens and avoid orthodontic therapy

Recognition of dental anomalies is essential in determining appropriate treatment for each patient. Diagnosis and assessment of mesiodens are critical in avoiding complications such as blocking the eruption of the maxillary central incisors, cyst formation, and dilaceration of the permanent incisors. Collecting data for diagnostic criteria, utilizing diagnostic radiographs, and determining when to refer to a specialist are important steps in the treatment of mesiodens. Early diagnosis and timely intervention could reduce or eliminate the need for orthodontic treatment and prevent serious complications.

A retrospective study of unerupted maxillary incisors associated with supernumerary teeth

We retrospectively reviewed the clinical records and radiographs of 100 patients who had had supernumerary teeth removed. Their mean (SD) age was 9 years 3 months (2). The 100 patients had a total of 127 unerupted maxillary incisors associated with supernumerary teeth. The supernumerary tooth was removed without exposure of the permanent tooth more often among the 79 younger children (aged 10 years or less) (SND=3.52, P<0.01), and when the incisors were less mature (Cvek classification 1, 2, and 3) (SND=5.27, P<0.01). Of these incisors with immature roots that were treated conservatively, 60 (72%) erupted and 24 (28%) required further operation. Of the mature incisors treated conservatively, 10 (63%) required further operation. In this study, almost three-quarters of immature incisors erupted spontaneously after removal of the associated supernumerary teeth. Over half of the mature teeth required further operation. Mature teeth should be exposed with or without bonding at the time of removal of the supernumerary teeth.

Retention of permanent incisors by mesiodens: a family affair

The term mesiodens refers to a supernumerary tooth that is present in the midline of the maxilla between the two central incisors. One or two mesiodentes may be present. We present a rare case of two sisters, in both of whom a pair of mesiodentes caused the retention of permanent incisors. They were referred to our hospital with asymptomatic delayed eruption of upper incisors. This article is written to point out genetic factors as the possible origin of supernumerary teeth.

A supernumerary tooth fused to the facial surface of a maxillary permanent central incisor: case report

A case of a supernumerary tooth fused to the facial surface of a maxillary permanent central incisor is reported. Root canal therapy on the maxillary central incisor was performed due to pulpal communication between the supernumerary tooth and the maxillary central incisor after removing the supernumerary tooth structure. The communication was sealed with mineral trioxide aggregate. The difference between fusion and gemination is discussed.

A case of supernumerary teeth in the premaxilla, maxillary cuspid, and mandibular premolar regions

A case of several developing supernumerary teeth is reported. A seven-year-old African-American boy presented with retained primary maxillary central incisors, two impacted mesiodens, and unerupted permanent maxillary central incisors. A dentigerous cyst was removed at the time of surgical removal of the mesiodens. Approximately fourteen months post-extraction, a new panoramic radiograph showed the presence of six previously unidentified developing and unerupted supernumerary teeth, one on each of the maxillary cuspid areas and two on the mandibular premolar regions bilaterally. Practitioners should be aware that supernumerary teeth may develop late. Thus, periodic reevaluation with appropriate radiographs is indicated, especially in patients who have presented with supernumerary teeth.

Cleidocranial dysplasia: modern concepts of treatment and a report of an orthodontic resistant case requiring a restorative solution

A case is presented of a young boy with cleidocranial dysplasia, whose multiple supernumerary teeth prevented the eruption of most of his permanent teeth. His maxillary incisor teeth failed to erupt following removal of anterior supernumerary elements and orthodontic traction. Lack of abutment teeth and a difficult maxillary base made prosthetic treatment almost impossible. A horseshoe acrylic denture retained by milled crowns bonded to the deciduous canines and a maxillary first molar proved a very successful restoration. The problems of treating this group of patients are discussed.