Non-syndromic multiple supernumerary teeth transmitted as an autosomal dominant trait

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.

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.

Supernumerary maxillary fourth premolar teeth in five related Burmese cats

Case series summary

This article reports a case series of five Burmese cats with supernumerary teeth. All included cases displayed either unilateral or bilateral supernumerary maxillary fourth premolar teeth. Two cases also displayed supernumerary mandibular fourth premolar teeth, and in one case bilateral supernumerary maxillary third incisor teeth were found. Examination of the pedigrees of the affected cats revealed that all five cats were related with one common ancestor. All patients in this case series were successfully treated.

Relevance and novel information

Supernumerary maxillary fourth premolar teeth in cats have not been reported previously in the literature. As all five cats in this case series were shown to be related, supernumerary maxillary fourth premolar teeth may be yet another heritable health condition affecting the Burmese breed. Therefore, Burmese breeders should endeavour to reduce the incidence of supernumerary teeth within the breed by having animals examined by a veterinary dentist prior to breeding, and neutering affected, as well as related, individuals. Burmese cat owners must be made aware of the condition in order to institute early evaluation, diagnosis and treatment.

Non-syndromal multiple supernumerary and permanent impacted teeth in mother and her one child

Multiple permanent impacted supernumerary teeth are rare and are most of the times associated with syndromes. The prevalence for non-syndromic multiple supernumerary teeth is less than 1%. We herein presenting a case of non-syndromic multiple supernumerary impacted teeth in a female patient and her child. The patient has three children; out of them, two had normal dentition and the youngest child had 60 teeth (35 impacted supernumerary with 25 erupted teeth). The patient herself had a total of 54 teeth. Their medical history was not significant. The systemic investigations were not suggestive of any syndrome and disease. Very few cases reported more than 30 supernumerary and impacted teeth bilaterally in both the jaws. This case report becomes unique as both mother and her child presented with more than 30 supernumerary impacted teeth.

Two Rare Cases of Non-Syndromic Paramolars with Family Occurrence and a Review of Literature

Supernumerary teeth (or hyperdontia) are teeth that exceed the normal number of deciduous or permanent teeth in the oral cavity. The occurrence of supernumerary teeth without any associated syndrome has been frequently reported and many case reports have been published. This article reports two rare cases of familial occurrence of multiple paramolars without the presence of any other syndrome for two consecutive generations. Limited cases of bilateral maxillary or mandibular paramolars have been reported. In addition, prevalence, classification, etiology, complications, diagnosis and therapeutic strategies that may be adopted when supernumeraries occur are discussed. A review of similar cases published in the literature is included as well.

Fourth molar: A retrospective study and literature review of a rare clinical entity

Purpose

The prevalence of supernumerary teeth has been reported to be between 0.1% and 3.8%. The aim of this study was to determine the prevalence, clinical significance, and associated pathologies of fourth molars based on a retrospective study and a literature review.

Materials and Methods

A 5-year retrospective prevalence study was conducted at the Department of Oral Diagnosis and Dentomaxillofacial Radiology of Okayama University Hospital, Okayama, Japan. The study involved extracting data from the digital records of patients from January 1, 2013 through December 31, 2017. The sampling frame included all patients who had panoramic radiographs, cone-beam computed tomography (CT), and multislice CT images during the period under review.

Results

A total of 26,721 cases were reviewed and 87 fourth molars were identified. The prevalence of fourth molars in the 5-year study at Okayama was calculated as 0.32%. The mean age of patients with a fourth molar was 30.43 years, and the male-to-female ratio was 1:0.98. The vast majority of cases were in the maxilla (92%) and had normal shapes (89.7%); furthermore, 82.8% of cases were unerupted.

Conclusion

The prevalence of fourth molars in the study population was found to be 0.32%, and fourth molars occurred with approximately equal frequency in males and females. Fourth molars were more common in the maxilla and were predominantly unerupted and small.

Evaluation of Surgical Options for Supernumerary Teeth in the Anterior Maxilla

Aim

The purpose of this study was to evaluate the surgical options for supernumerary teeth (SNT) in the premaxillary region of children.

Materials and methods

A total of 69 patients with 82 partially or completely formed SNT in the anterior maxillary region were identified over a 3-year period. All selected patients were assessed for the number, location, and family history of SNT, damage to adjacent roots, and associated symptoms. The surgical approaches used for removal were recorded. Postoperative clinical sequelae (loss of vitality, periodontal problems, pain, bleeding, and enanthema) were evaluated.

Results

A total of 43, 30, and 9 SNT were extracted with palatal, buccal, and bicortical approaches respectively. Peri-odontal and vitality assessments revealed no problems in adjacent teeth at 6 months after surgery. Postoperative pain was within acceptable levels in all patients and subsided within 3 to 7 days. Mild postoperative bleeding occurred in eight patients. Enanthema subsided within 10 days in all patients.

Conclusion

Our results suggest that early diagnosis and appropriate surgical treatment of SNT are important to decrease the risk of clinical complications.

How to cite this article: Maddalone M, Rota E, Amosso E, Porcaro G, Mirabelli L. Evaluation of Surgical Options for Supernumerary Teeth in the Anterior Maxilla. Int J Clin Pediatr Dent 2018;11(4):294-298.

Investigation of SOSTDC1 gene in non-syndromic patients with supernumerary teeth

Background

The etiology of supernumerary teeth is still unclear however heredity is believed to be a major factor and this idea was supported by several case reports. Recently, a relationship between supernumerary tooth formation and deficiency of Uterine Sensitization Associated Gene-1 (Usag-1), a rat gene that is expressed in sensitized endometrium, was reported in mice. The human homolog gene for Usag-1, Sclerostin Domain Containing 1 (SOSTDC1), shows 85% identity with mouse Usag-1. The present study aimed to investigate SOSTDC1 coding regions in non-syndromic patients with one or more supernumerary teeth.

Material and Methods

Twenty-five non-syndromic patients (21 male and 4 female) aged 5-15 years, with one or more supernumerary teeth were included in the study. Saliva samples were collected from patients and DNA samples were isolated and analyzed using PCR.

Results

Eight phenotypes of supernumerary tooth formation were observed in the study. From the DNA analysis, 2 novel and 3 previously identified sequence alterations were identified however, in investigating the Usag-1 homolog SOSTDC1 gene, the present study could not find any phenotype-genotype relationship.

Conclusions

There are many SOSTDC1 homolog genes in the human genome and future studies should investigate these candidate genes. Also studies in larger case groups including family members may reveal the hereditary pattern.

Key words:Genetics, Usag-1, mesiodens, DNA sequencing, pediatric dentistry, PCR.

Supernumerary Molars and Wisdom Tooth Shape Alterations in Patients with Neurofibromatosis Type 1

Objectives

The purpose of the present study was the systematic investigation of numerical and morphological aberrations of teeth in the wisdom teeth region in neurofibromatosis type 1 patients.

Material and Methods

The panoramic radiographs of 179 patients were analysed for supernumerary molars and dysplastic wisdom teeth with special reference to facial tumour type. The results were compared to radiographic findings obtained in panoramic radiographs of age- and sex-matched controls.

Results

The total number of dysplastic or supernumerary molars was 21 (17 individuals, 4.75%) and predominantly a finding of the maxilla (maxilla: 15, mandible: 1, maxilla and mandible: 1). Differences of dental findings between neurofibromatosis type 1 (NF1) patients (n = 15) and the control group (n = 2) were statistically significant (P < 0.01). All individuals with supernumerary molars were diagnosed as being affected with NF1. This difference achieved statistical significance when it was considered that the event may occur at least once per quadrant, and thus the individual potentially needs to be considered four times (P = 0.0038).

Conclusions

This investigation revealed that supernumerary molars and aberrations in wisdom tooth form are more common in patients than in age- and sex-matched controls. There is no association between these findings and a specific feature of the disease, id est facial manifestation of a trigeminal nerve sheath tumour (plexiform neurofibroma). The cause of this phenomenon is unknown. A review of these dental findings on other neurofibromatosis type 1 study groups should be attempted.

Whole-exome sequencing analysis of supernumerary teeth occurrence in Japanese individuals

A common disorder of human dentition is the existence of supernumerary teeth. Impacted supernumerary teeth occur most frequently in the maxillary incisor area and are termed mesiodens. We conducted whole-exome sequencing of non-syndromic Japanese individuals possessing supernumerary teeth to identify genes and/or loci involved in the pathogenesis of the condition.

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

OBJECTIVE

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSIONS

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

Diagnosis and Surgical Management of Nonsyndromic Nine Supernumerary Teeth and Leong's Tubercle

Nonsyndromic multiple supernumerary teeth (ST) and Leong's tubercle are a condition with a very low prevalence and a multidisciplinary approach is required to restore function and aesthetics. So, this case report aimed at presenting a rare case of nonsyndromic nine supernumerary teeth and Leong's tubercle in a pediatric patient, without any evident familial history, showing its diagnosis and surgical management.

The frequency of non-syndromic distomolar teeth in a Greek population sample?

Background

To investigate the frequency of non-syndromic distomolars in a Greek population sample.

Material and Methods

The study population of this retrospective study consisted of 859 Orthopantomograms (OPGs) of 425 male and 434 female patients, attended the Department of Oral Diagnosis and Radiology, Dental School of Athens seeking for treatment. The OPGs were taken as a part of the patients treatment planning. Patients’ mean age was 33.57 years. Exclusion criteria from this study was cleft lip ± palate and diseases associated with systemic conditions and syndromes (such as cleidocranial dysplasia and Gardner syndrome). OPGs were only included in the study if at least one 3rd molar was present. The data collected were the number of 3rd molars, the number of distomolars, the age and the gender of each patient, information concerning previous extraction of 3rd molars. Statistical evaluation of the data included descriptive and bivariate analyses (Chi-square test and Spearman’s rho correlation coefficient). In an attempt to further estimate the correlation between the presence of upper and lower 3rd conditions we assumed that the absence of 3rd molars, the presence of 3rd molars, and the presence of distomolars was ordinal in nature and we calculated the Spearman Correlation Coefficient.

Results

The number of distomolars was greater in the maxilla than in the mandible. In the maxilla the distomolars were located almost equally in both left and right side. It was more possible lower left distomolars to be present in males than in females. Furthermore, males present higher prevalence of supernumerary teeth than females.

Conclusions

Early radiographic diagnosis of distomolars is fundamental so as to prevent complications such malocclusion, delayed eruption or displacement root or/ and resorption of adjacent teeth, pulp necrosis, follicular cyst, pain.

Key words:Non syndromic, distomolars, supernumerary molars, fourth molars.

Hyperactive Dental Lamina in a 24-Year-old Female - A Case Report and Review of Literature

An extra tooth to the normal formula of teeth sequence in any region of dental arch is regarded as Supernumerary teeth (ST). The reasons are still not clearly known, one of them being dichotomy of tooth bud, but the more accepted reason is the hyperactivity theory. Supernumerary teeth are present more in permanent dentition than in primary dentition and can present as a single entity or multiple, unilaterally or bilaterally, impacted or erupted, in either or both the dental arches. This article discusses the supernumerary teeth in detail with a case discussion of a non-syndromic 24-year-old girl, with six ST (bicuspids) present in all the four quadrants. In the mandible, ST's showed a classical clustered flower like presentation. The interesting feature in the presented case was the sequential orthopantomographs taken at various ages of the patient that showed continuous development of STs in all four quadrants, thus pointing to the theory of hyperactive dental lamina or atavism. An electronic search was conceded in PubMed, Cochrane Library and google scholar databases, and articles dated between December 1932 and December 2012 were selected to review the occurrence patterns of supernumerary teeth in non-syndromic cases.

Anomalias dentárias de número em pacientes ortodônticos

ResumoIntroduçãoA prevalência e a distribuição das anomalias dentárias de número variam de acordo com a população estudada.ObjetivoDeterminar a prevalência de anomalias dentárias de número, verificando-se a frequência com relação a gênero, localização e dentes mais acometidos.MétodoForam avaliadas 1.054 radiografias panorâmicas de pacientes com idade entre 5 e 30 anos, realizadas no período de janeiro a março de 2010, em uma clínica particular de diagnóstico por imagem de Teresina-PI. Foram registrados dados relativos a gênero, idade, presença ou ausência de anomalia, dente acometido e localização. Foram realizados os testes estatísticos Qui-quadrado de Pearson e Teste Binominal, para duas proporções.ResultadoA hipodontia, com prevalência de 4,9%, foi encontrada com mais frequência na maxila, não apresentando diferença entre os lados e os gêneros. Os dentes mais ausentes foram: incisivos laterais superiores e segundo pré-molar inferior. Em relação à hiperdontia, com prevalência de 4,0%, não foram observadas diferenças entre gêneros, lados e maxilares. As regiões com maior presença de supranumerários foram: distal dos terceiros molares e entre pré-molares inferiores.ConclusãoFoi observada prevalência de hipodontia de 4,9%, sendo mais comum na maxila, e de hiperdontia de 4%, não apresentando diferença entre maxilares, lados e gêneros.

The doppelganger tooth: A diagnostic conundrum!

Abnormalities in tooth morphology and number are not uncommon. However, an exact clone of a normal tooth is a recondite clinical finding. Presence of supplementary teeth is mostly noticed in maxillary anterior, molar or premolar region, followed by mandibular premolar region in descending order of its site of occurrence. Supplemental tooth in mandibular anterior has a low prevalence of 0.01%. This paper reports one such rare case of nonsyndromic incisive jumeaux in mandibular anterior region during mixed dentition period.

Genetic background of supernumerary teeth

Supernumerary teeth (ST) are odontostomatologic anomaly characterized by as the existence excessive number of teeth in relation to the normal dental formula. This condition is commonly seen with several congenital genetic disorders such as Gardner's syndrome, cleidocranial dysostosis and cleft lip and palate. Less common syndromes that are associated with ST are; Fabry Disease, Ellis-van Creveld syndrome, Nance-Horan syndrome, Rubinstein-Taybi Syndrome and Trico–Rhino–Phalangeal syndrome. ST can be an important component of a distinctive disorder and an important clue for early diagnosis. Certainly early detecting the abnormalities gives us to make correct management of the patient and also it is important for making well-informed decisions about long-term medical care and treatment. In this review, the genetic syndromes that are related with ST were discussed.

Late developing supernumeraries in a case of nonsyndromic multiple supernumerary teeth

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

Prevalence and characteristics of non-syndromic distomolars: a retrospective study

AIM

Distomolars are defined as the supernumerary teeth that erupt distal to the third molar. The aim of the present study was to evaluate the prevalence of distomolars in permanent dentition in a non-syndromic Turkish subpopulation.

METHODS

A total of 10 111 panoramic radiographs of patients aged 18 years and over, who had no systemic diseases and syndromes, and who had not undergone any extractions in the third molar area, were examined to determine the presence, location, shape, and laterality of distomolars. The patients' age and sex were noted.

RESULTS

The results showed that distomolars were observed in 0.26% of the investigated population. Distomolars were seen in 0.29% of male patients and in 0.23% of female patients. In total, 30 distomolars were observed in 26 patients. Maxillary distomolars were more frequently encountered than mandibular teeth. Bilateral distomolars were found in three male patients. Of the 30 distomolars, 25 were impacted and five were erupted.

CONCLUSIONS

Although the frequency of distomolars is low, early diagnosis and treatment are important to minimize or prevent complications, such as delayed eruption, tooth displacement, crowding, root resorption of the adjacent tooth, and cystic formations.

Further evidence for phenotypic signatures of hybridization in descendant baboon populations

Hybridization may have played a substantial role in shaping the diversity of our evolving lineage. Although recent genomic evidence has shown that hybridization occurred between anatomically modern humans (AMHS) and Neanderthals, it remains difficult to pin down precisely where and when this gene flow took place. Investigations of the hybrid phenotype in primates and other mammals are providing models for identifying signatures of hybridization in the fossil record. However, our understanding of intra- and inter-taxon variation in hybrids is still limited. Moreover, there is little evidence from these studies that is pertinent to the question of how long hybrid skeletal traits persist in descendants, and therefore it is not clear whether observed hybrid phenotypes are evidence of recent (e.g., F1) or much earlier hybridization events. Here, we present an analysis updating a previous study of cranial variation in pedigreed olive and yellow baboons and their hybrids. Results suggest that traits previously associated with hybrids in baboons and other mammalian species are also present in this expanded data set; many of these traits are highly heritable, confirming a genetic basis for their variation in this mixed population. While F1 animals - and especially F1 males - still have the highest number of dental anomalies, these and other atypical traits persist into later hybrid generations (such as F2 and B1). Moreover, non-F1 recombinants also show extremely rare trait variations, including reduced canines and rotated teeth. However, these results must be considered in light of the possibility that some founding individuals may have themselves been unrecognized hybrids. Despite this, the data are compelling, and indicate once again that further controlled research remains to be done on primates and other mammals in order to better understand variation in the hybrid phenotype.

Multiple supernumerary teeth in a nonsyndromic 12-year-old female patient - a case report

Supernumerary teeth (ST) are uncommon alterations of development that may appear in either of the dental arches and that are frequently associated with syndromes such as cleidocranial dysplasia and Gardner syndrome. Multiple ST in individuals with no other disease or syndrome are very rare. In view of this situation, correct diagnosis, treatment and evaluation of ST with the use of appropriate imaging techniques are highly important. This case report presents radiographic images of a nonsyndromic 12-year-old female patient who presented with 14 supernumerary teeth and was treated under general anesthesia, with the extraction of all ST in a single surgical intervention. During the postoperative period, the patient did not complain of pain nor did she present any signs or symptoms of infection. During late follow-up period, due to difficulty in traction of the maxillary right canine and mandibular left first premolar towards the dental arch, it was necessary to extract these teeth under local anesthesia. Radiographic examination 3 years after surgery revealed the absence of ST and of diseases related to the existence of these teeth.

Aetiology of supernumerary teeth: a literature review

BACKGROUND

Supernumerary teeth are teeth, or tooth-like structures that have either erupted or remain unerupted in addition to the 20 primary and 32 permanent teeth.

AIMS

This paper attempts to (a) provide an overview of the proposed hypotheses and the current understanding of the aetiology of supernumerary teeth, and (b) review the published cases of supernumerary teeth occurring in families.

REVIEW

No studies have been able to distinguish between different aetiologies for the different locations of supernumerary teeth, while, from a developmental or molecular perspective, the proposed hypotheses may be plausible and explains the origin of different types of supernumerary teeth.

CONCLUSION

The only clearly evident feature, based on the existing published reports, is that it is logical to state that supernumerary teeth have a genetic component in their aetiology.

An epidemiological study on supernumerary teeth: a survey on 5,000 people

BACKGROUND

The formation of dental tissues is a highly delicate and complex phenomenon. Any alteration in this process leads to various dental anomalies which affect the tooth number, size, shape and structure. Supernumerary teeth are one such anomaly which affects the tooth number. Supernumerary teeth can give rise to various complications and pathologies or they may have a familial / syndromic association. They may occur along with other dental anomalies. Thus, such teeth have a definite clinical significance.

AIMS AND OBJECTIVES

The aim of the following study was to know the prevalence of the supernumerary teeth and the distribution of the cases according to the age, sex, jaw, region, eruption status, and the position.

MATERIALS AND METHODS

A total of 5000 patients were examined for a period of 1 year's duration and they were divided into different groups. Group I consisted of individuals who were aged between 5-20 years, Group II consisted of individuals who were aged between 21-40 years, and Group III consisted of individuals who were aged 41 years and above. The dental examination was conducted by using a mouth mirror and a probe, to determine the presence of supernumerary teeth. All the cases with supernumerary teeth were further observed and the details were recorded in a prepared porforma. These cases were also subjected to general physical examinations (to rule out any syndromes) and radiographic examinations. Photographs were also made.

CONCLUSION

Although supernumerary teeth is an unusual anomaly, it is not as rare as was previously reported. The identification of this anomaly could provide a hint towards the possibility of complications, pathologies, other dental anomalies, syndromes and a familial association.

Non-syndromic multiple supernumerary teeth in permanent dentition: a rare phenomenon

Hyperdontia or supernumerary teeth in the absence of associated systemic condition or syndrome is an uncommon phenomenon. Non-syndromic supernumerary teeth need to have periodical radiographic observation. In the case of asymptomatic condition, as they impacted in the jaw, a careful examination is necessary because they may develop into pathological status such as dentigerous cysts. Surgical removal of such teeth is indicated if evidence of any pathologies, such as cystic lesion, resorption, delayed eruption, altered eruption and displacement of adjacent teeth, is evident or have occurred.

Genetics and presence of non-syndromic supernumerary teeth: A mystery case report and review of literature

Presence of supernumerary teeth is well-recognized clinical phenomenon. However, it is uncommon to find multiple supernumeraries in individuals with no other associated disease or syndrome. Presence of multiple supernumerary teeth is thought to have genetic component. We report a rare case where multiple supernumerary teeth were seen without presence of any other syndrome in 3 generations; father, son, and two grandsons. We also present a review of similar cases published in literature till date. The role of genetics in development of supernumerary teeth is highlighted.

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.

Non-syndromic multiple supernumerary teeth: a rare entity

Hyperdontia or supernumerary teeth without associated syndromes is a rare phenomenon, as supernumerary teeth are usually associated with cleft lip and palate or other syndromes such as Gardeners syndrome, cleidocranial dysplasia, trichorhinophalangic syndrome, etc. A 15-year-old girl reported for orthodontic treatment with a chief complaint of irregular teeth and unaesthetic smile. On examination class I malocclusion with severe crowding of upper anteriors, anterior open bite of 5 mm, cross bite with upper right posteriors, upper midline shift to right by 5 mm and two supernumerary teeth placed buccally in between 16 & 17 and 26 & 27, respectively, were found. On routine radiographical examination, two additional impacted supernumerary teeth were noticed distal to 18 and in mandibular arch in between roots of 35 and 36. A general physician was consulted who confirmed that there was no associated syndrome. Family history did not reveal any positive findings.

Nonsyndromic multiple hyperdontia in a series of 13 patients: epidemiologic and clinical considerations

BACKGROUND

The authors conducted a retrospective-casuistic study to determine the prevalence of nonsyndromic multiple hyperdontia in a sample of the population of Madrid, as well as possible complications associated with the presence of such supernumerary teeth.

METHODS

The study included a data assessment of all patients seeking dental care at a hospital's department of oral surgery across four years. The authors studied data from patients who had nonsyndromic multiple hyperdontia. We used univariate and bivariate analysis to make comparisions between variables.

RESULTS

The authors identified nonsyndromic multiple hyperdontia in the records of 13 patients (0.1 percent) of the total population studied. These patients had 55 supernumerary teeth. Premolars were the most frequently seen type of supernumerary tooth and constituted 45.5 percent of the sample.

CONCLUSIONS

Nonsyndromic multiple hyperdontia usually is diagnosed as a coincidental radiographic finding in the course of routine examination rather than as the result of an associated disease. However, the authors found a higher percentage of comorbidity than they initially expected; mechanical or obstructive pathology was associated with 20.0 percent of the supernumerary teeth and enlargement of the follicular sac of more than 3 millimeters was present in 23.6 percent of the sample.

CLINICAL IMPLICATIONS

The early diagnosis and follow-up of patients with multiple supernumerary teeth should help clinicians prevent the diseases associated with this kind of hyperodontia.

Supernumerary teeth in non-syndromic patients

Hyperdontia or supernumerary teeth without associated syndrome is a rare phenomenon, as supernumerary teeth are usually associated with cleft lip and palate or other syndromes such as Gardner's syndrome, cleidocranial dysplasia, and so on. Five patients with supernumerary teeth visited our department. They had no familial history or other pathology, certain treatment protocols was modified due to the presence of supernumerary teeth. Non-syndromic supernumerary teeth, if asymptomatic, need to have periodical radiographic observation. If they showed no variation as they impacted in the jaw, careful examination is necessary because they may develop into pathological status such as dentigerous cysts. The importance of a precise clinical history and radiographic examination for patients with multiple supernumerary teeth should be emphasized.

Genetic basis of non-syndromic anomalies of human tooth number

Teeth organogenesis develops through a well-ordered series of inductive events involving genes and BMP, FGF, SHH and WNT represent the main signalling pathways that regulate epithelial-mesenchymal interactions. Moreover, progress in genetics and molecular biology indicates that more than 300 genes are involved in different phases of teeth development. Mutations in genes involved in odontogenesis are responsible for many dental anomalies, including a number of dental anomalies that can be associated with other systemic skeletal or organic manifestations (syndromic dental anomalies) or not (non-syndromic dental anomalies). The knowledge of the genetic development mechanisms of the latter is of major interest. Understanding the mechanisms of pathogenesis of non-syndromic teeth anomalies would also clarify the role of teeth in craniofacial development, and this would represent an important contribution to the diagnosis, treatment and prognosis of congenital malformations, and the eventual association to other severe diseases. Future research in this area is likely to lead to the development of tests for doctors to formulate an early diagnosis of these anomalies.

Non-syndromic multiple supernumerary teeth: meta-analysis

BACKGROUND

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSION

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

Continuous dental replacement in a hyper-chisel tooth digging rodent

Contrary to their reptilian ancestors, which had numerous dental generations, mammals are known to usually develop only two generations of teeth. However, a few mammal species have acquired the ability to continuously replace their dentition by the constant addition of supernumerary teeth moving secondarily toward the front of the jaw. The resulting treadmill-like replacement is thus horizontal, and differs completely from the vertical dental succession of other mammals and their extinct relatives. Despite the developmental implications and prospects regarding the origin of supernumerary teeth, this striking innovation remains poorly documented. Here we report another case of continuous dental replacement in an African rodent, Heliophobius argenteocinereus, which combines this dental system with the progressive eruption of high-crowned teeth. The escalator-like mechanism of Heliophobius constitutes an original adaptation to hyper-chisel tooth digging involving high dental wear. Comparisons between Heliophobius and the few mammals that convergently acquired continuous dental replacement reveal that shared inherited traits, including dental mesial drift, delayed eruption, and supernumerary molars, comprise essential prerequisites to setting up this dental mechanism. Interestingly, these dental traits are present to a lesser extent in humans but are absent in mouse, the usual biological model. Consequently, Heliophobius represents a suitable model to investigate the molecular processes leading to the development of supernumerary teeth in mammals, and the accurate description of these processes could be a significant advance for further applications in humans, such as the regeneration of dental tissues.

Nonsyndromic double mesiodentes--hidden lambs among normal flock!

Mesiodens, a common supernumerary tooth, is found in the midline in anterior maxilla between the incisors. Its occurrence as multiples is termed as 'mesiodentes'. Double mesiodentes, a rare phenomenon, is seldom reported in literature and show a plethora of manifestations as described in the case report. They may not be apparent clinically, necessitating the use of imaging modalities and require careful evaluation to prevent complications. This paper presents a report of six double mesiodentes cases with negative family history for supernumerary teeth and absence of any syndromes. This is an effort to educate dentists about signs, symptoms, complications and management of mesiodentes.

Molecular genetics of supernumerary tooth formation

Despite advances in the knowledge of tooth morphogenesis and differentiation, relatively little is known about the aetiology and molecular mechanisms underlying supernumerary tooth formation. A small number of supernumerary teeth may be a common developmental dental anomaly, while multiple supernumerary teeth usually have a genetic component and they are sometimes thought to represent a partial third dentition in humans. Mice, which are commonly used for studying tooth development, only exhibit one dentition, with very few mouse models exhibiting supernumerary teeth similar to those in humans. Inactivation of Apc or forced activation of Wnt/β(catenin signalling results in multiple supernumerary tooth formation in both humans and in mice, but the key genes in these pathways are not very clear. Analysis of other model systems with continuous tooth replacement or secondary tooth formation, such as fish, snake, lizard, and ferret, is providing insights into the molecular and cellular mechanisms underlying succesional tooth development, and will assist in the studies on supernumerary tooth formation in humans. This information, together with the advances in stem cell biology and tissue engineering, will pave ways for the tooth regeneration and tooth bioengineering.

A clinical epidemiologic analysis of a sample of 73 supernumerary premolars

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

CLINICAL IMPLICATIONS

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

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

OBJECTIVE

To investigate the prevalence, characteristics (malocclusion, location, type) and gender distribution of supernumerary teeth (ST) in an Iranian orthodontic population.

MATERIAL AND METHODS

A retrospective study was carried out using radiographs (periapicals, panoramic) and study models of 1751 subjects (870 girls, 881 boys; age range 9-27 years). The Pearson chi-square test was used to determine differences in the distribution of ST when stratified by gender and malocclusion type.

RESULTS

Fourteen ST were found in 13 patients (six males, seven females), giving a prevalence rate of 0.74%. The prevalence rate of ST was higher in Class III malocclusions (5.2%) and was a rare finding among Class II malocclusions (0.1%). The occurrence rate of ST was higher in maxilla (78.5%) than in mandible (21.5%). The most common type of ST was the conical form (43%). We did not observe any late-developing paramolar or distomolar ST.

CONCLUSION

The prevalence rate of ST in our study was 0.74% and ST were more common among Class III malocclusions.

Non-syndromic multiple supernumerary teeth in a family unit with a normal karyotype: case report

Introduction. Hyperdontia is an odontostomatologic anomaly characterized by an excess in tooth number. It seems to occur more often in patients with hereditary factors concerning this anomaly: this case represents a rare form of hyperdontia, with bilateral multiple supernumerary teeth, with evident penetrance of the phenotype in the family unit engaged in the present study. The karyotype determination excludes a pathogenesis on chromosomal basis.Case report. A 30 years old patient came to our observation with five impacted teeth (1.8, 2.8, 3.8, 4.7 and 4.8), as well as with the presence of an impacted supernumerary tooth (distomolar 4.9). The patient was suggested to allow us to perform a radiologic screening to his two sisters aged 17 and 13 years.The X-ray photography showed that the elder sister had nine impacted teeth; these were 1.8 - 1.9 - 2.8 - 2.9 - 2.10 - 3.8 - 3.9 - 4.8 - 4.9; while the youngest sister had four impacted teeth, that is 1.8 - 1.9 - 2.8 - 2.9.Conclusions. The value of the present case report can be used as a paradigm for the assessment of the hereditary factors predisposing the onset of hyperdontia, and for the consequent management by oral surgeon of family units in which the odontostomatologic anomaly was detected without any syndromic forms.

Multiple supernumerary premolars in two siblings: a case report

The presence of three or more supernumerary teeth in one patient is uncommon. Genetic as well as environmental causes have been suggested as possible aetiological factors in the pathogenesis of supernumerary teeth. This report describes the dental findings and management of multiple supernumerary premolars in two siblings. The number and locations of the supernumeraries in both cases were almost identical. The findings from these cases give further support to the important role of genetic factors in the aetiology of supernumerary teeth. Primary care dentists who treat children should be aware of the possibility of familial occurrence of supernumerary teeth.

Characteristics of 283 supernumerary teeth in southern Chinese children

OBJECTIVES

This was a retrospective study to determine the characteristics and distribution of supernumerary teeth in southern Chinese children.

METHODS

The study population consisted of 208 children aged from 2 to 16 years.

RESULTS

Males were more frequently affected than females in the ratio 3.1:1. Of the 283 supernumerary teeth, 95.0% were located in the premaxilla, 71.5% were conical, 70.7% were unilateral, 29.3% were bilateral, 47.7% were inverted, and 16.9% were erupted. The mean age at the time of diagnosis and removal of the supernumerary teeth was 7.3 +/- 2.7 years (the minimum age was 2.1 years) and 8.1+/- 2.7 years (the minimum age was 4.1 years), respectively. Seventy percent of the children were in the mixed dentition and 81.3% of the supernumeraries were removed under general anesthesia.

CONCLUSION

In accordance with previous studies, the majority of the supernumerary teeth were located in the premaxillary region, were conical shaped, and remained unerupted.