Implant Placement When an Impacted Tooth and Supernumerary Teeth Are Present in the Maxilla

The presence of impacted and/or supernumerary teeth in the maxillary anterior region can cause complications when attempting to perform restorations with implants. Extracting these structures can lead to adverse issues related to the adjacent dentition and require osseous grafting to provide a base to house the planned implant, but such an approach increases treatment time and cost. In this case report, a patient presented with an impacted permanent canine oriented on the horizontal plane with several supernumerary teeth coronal to the impacted canine. CBCT analysis revealed a very thin buccal plate over the impacted supernumerary teeth. The proposed treatment followed the principles of partial extraction therapy (PET) whereby the impacted structures were treated like bone, and implants were placed in contact with them or through them to achieve the desired osseointegration and provide long-term survival of the restored implants.

Effect of maxillary anterior supernumerary tooth extraction on the underlying malocclusion

INTRODUCTION

Orthodontic discrepancies are a common finding in patients with supernumerary teeth (ST). The presence of a ST can cause a number of orthodontic discrepancies, including delayed eruption or retention of adjacent teeth, crowding, spacing, and abnormal root formation. The aim of the present study was to assess the effect of extraction of an anterior supernumerary tooth on the underlying orthodontic discrepancies without additional treatment for a 6-month period.

METHODS

This was a prospective, longitudinal, observational, study. It included 40 participants with orthodontic malocclusions due to maxillary anterior supernumeraries. We examined the changes in the crowding and excessive space in the anterior and posterior segments on cast models.

RESULTS

In the group that presented with crowding, a statistically significant decrease of 0.95 ± 0.17 mm (P < 0.001) was found between T0 and T1. Of the participants, three exhibited full self-correction. The excessive space at T0 (3.06 mm) decreased by 1.78 ± 0.19 mm to T1 (1.28 mm) in the anterior segment. Seven participants showed full self-correction of the diastemas after the 6-month observation period.

CONCLUSION

The results imply that orthodontic treatment can be postponed for at least 6 months after the extraction of the supernumerary tooth as potential self-correction can be expected. This natural alleviation of the malocclusions may make the orthodontic treatment simpler, shorten the treatment time and decrease overall appliance wear time.

Dentofacial manifestations of a Paediatric patient with Goltz-Gorlin Syndrome

Goltz-Gorlin syndrome is a rare X-linked inherited disorder associated with PORCN (porcupine homolog-Drosophila) gene mutation. It primarily affects the skin and its appendages. The characteristic cutaneous features include a blaschko-linear pattern, skin atrophy, pigmentary changes, and telangiectasia. The oral manifestations have been reported in more than half of the affected individuals. The most common oral findings include enamel hypoplasia, hypodontia, supernumerary teeth, microdontia, vertical grooving of the teeth, taurodontism, fusion, and abnormal root morphology reported in sporadic cases. The objective of this case report is to describe the dentofacial characteristics of a middle childhood aged girl with Goltz-Gorlin syndrome.

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Analysis of congenital deciduous teeth absence and its permanent teeth phenotype

OBJECTIVES

This study aimed to investigate the clinical characteristics of congenital deciduous teeth absence and its permanent teeth performance type by using panoramic radiographs.

METHODS

A total of 15 749 panora-mic radiographs of 3-6-year-old children with deciduous dentition were collected from January 2020 to December 2021. The incidence of congenital deciduous teeth absence was observed, and the abnormality of permanent teeth was recor-ded. SPSS 24.0 software was used for statistical analysis.

RESULTS

The incidence of congenital deciduous teeth absence was 2.54% (400/15 749), which was found in 217 girls and 183 boys, and the difference between the genders was statistically significant (P=0.003). The absence of one and two deciduous teeth accounted for 99.75% (399/400) of the subjects. In addition, 92.63% (490/529) of mandibular deciduous lateral incisor was congenitally absent, 44.80% (237/529) of deciduous teeth was absent in the left jaw, and less than 55.20% (292/529) was absent in the right; the difference between them was statistically significant (P=0.017). The absence of 96.41% (510/529) deciduous teeth in the mandibular was significantly more than that of 3.59% (19/529) in the maxillary, and the difference between was statistically significant (P=0.000). Furthermore, 68.00% (272/400) and 32.00% (128/400) of deciduous teeth were absent in unilateral and bilateral, respectively, and the difference was statistically significant (P=0.000). Four types of congenital deciduous teeth absence with permanent teeth were observed as follows: 1) 73.91% (391/529) of permanent teeth was absent; 2) 20.60% (109/529) of permanent teeth was not absent; 3) the number of fused permanent teeth accounted for 4.91% (26/529); 4) the number of supernumerary teeth was 0.57% (3/529).

CONCLUSIONS

Although the absence of congenital deciduous teeth is less common than that of permanent teeth, it affects deciduous and permanent teeth to some extent. Dentists should pay attention to trace and observe whether abnormalities are present in the permanent teeth and take timely measures to maintain children's oral health.

Rare Genetic Variants in Human APC Are Implicated in Mesiodens and Isolated Supernumerary Teeth

The activation of Wnt/β-catenin signalling is a prerequisite for odontogenesis. APC, a member of the AXIN-CK1-GSK3β-APC β-catenin destruction complex, functions to modulate Wnt/β-catenin signalling to establish regular teeth number and positions. APC loss-of-function mutations are associated with the over-activation of WNT/β-catenin signalling and subsequent familial adenomatous polyposis (FAP; MIM 175100) with or without multiple supernumerary teeth. The ablation of Apc function in mice also results in the constitutive activation of β-catenin in embryonic mouse epithelium and causes supernumerary tooth formation. The objective of this study was to investigate if genetic variants in the APC gene were associated with supernumerary tooth phenotypes. We clinically, radiographically, and molecularly investigated 120 Thai patients with mesiodentes or isolated supernumerary teeth. Whole exome and Sanger sequencing identified three extremely rare heterozygous variants (c.3374T>C, p.Val1125Ala; c.6127A>G, p.Ile2043Val; and c.8383G>A, p.Ala2795Thr) in APC in four patients with mesiodentes or a supernumerary premolar. An additional patient with mesiodens was compound as heterozygous for two APC variants (c.2740T>G, p.Cys914Gly, and c.5722A>T, p.Asn1908Tyr). Rare variants in APC in our patients are likely to contribute to isolated supernumerary dental phenotypes including isolated mesiodens and an isolated supernumerary tooth.

Retrospective study of concomitant hypodontia and hyperdontia in 145 subjects

OBJECTIVES

This study aims to investigate the incidence and clinical characteristics of concomitant hypodontia and hyperdontia (CHH) by performing panoramic radiographs.

METHODS

A total of 41 648 panoramic radiographs of pediatric patients who were admitted to the hospitals from January 2019 to May 2021 were reviewed, and 145 CHH patients were included in the study. The presence of CHH was recorded. SPSS 24.0 software was used for statistical analysis.

RESULTS

The prevalence of CHH was 0.35% (145/41 648). Males (102 cases) were obviously more than females (43 cases), and the difference between genders was statistically significant (P<0.001). The features of congenital permanent tooth loss in this group were predominantly 1 and 2 teeth missing and preferably mandibular lateral incisors and mandibular second premolars missing. The incidence of congenital permanent teeth loss was higher in the mandible than in the maxilla (P<0.001), but no difference was found in the distribution between left and right (P=0.84). The features of supernumerary teeth in this group were 1 and 2 teeth, mostly in the maxillary anterior area, mostly conical, mostly vertical inversion and orthotopic growth.

CONCLUSIONS

CHH is a rare mixed numeric dental anomaly characterized by congenital missing teeth and supernumerary teeth occurring in the same individual. CHH cases are higher in men than in women. The characteristics of their hypodontia and hyperdontia are similar to those of patients with congenital permanent tooth absence or supernumerary teeth. Early diagnosis of the condition and a multidisciplinary approach for management of such case is recommended.

RUNX2 Nonsense Mutation Associated with Cleidocranial Dysplasia with Unusual Dental Features

Purpose: The purpose of this case report is to describe a RUNX2 nonsense mutation associated with cleidocranial dysplasia (CCD) with unusual dental features. The patient was a 12-year-old Brazilian girl who sought dental care due to over-retention of primary teeth and absence of erupted permanent teeth. Clinical and radiographic examinations revealed multiple impacted permanent teeth, a prominent cingulum of the permanent impacted maxillary incisors and enamel defects (hypoplasia and hypomineralization) in addition to skeletal abnormalities. No supernumerary teeth were present. The diagnostic hypothesis of CCD was raised and the patient was refer- red to the genetic medical service, where the diagnosis was cofirmed. After RUNX2 genetic screening, including polymerase chain reaction and sequencing of both DNA strands, a heterozygous nonsense mutation was identified in exon 2 (c.193 C>T [Q65X]). This article reports unusual dental features in a patient with CCD.

Supernumerary tooth in nasopalatine canal: a rare cause of septal cartilage collapse

Mesiodens is the most common type of supernumerary tooth, located between the maxillary central incisors in close relation to the nasopalatine canal. A 20-year-old man presented with right-sided nasal blockage, nasal discharge and collapsed nose without history of trauma. Imaging revealed a calcified mass in the inferior meatus extending into dilated nasopalatine canal. Endoscopic removal of the mass revealed tuberculate appearance of an incompletely developed tooth, consistent with mesiodens. Based on the history of septal cartilage collapse with right-sided mucopurulent discharge, endoscopic findings of the right inferior turbinate being adherent to the septal cartilage and the underlying mesiodens, we believe that the patient developed a septal abscess secondary to infection in nasal mucosa surrounding the mesiodens causing collapse of septal cartilage. While a tooth or tooth-like mass causing nasal passage air-flow obstruction is uncommon, we believe that this is the first reported case of mesiodens presenting with septal cartilage collapse.

Delayed Eruption of Maxillary Central Incisors Associated with the Presence of Supernumerary Teeth: A Case Report with 18 Months Follow-up

AIM

The aim of this study is to discuss a case of an 11-year-old pediatric patient, who was diagnosed with delayed eruption of the permanent maxillary central incisors because of palatally impacted supernumerary teeth.

BACKGROUND

The delayed eruption of permanent teeth can be a result of blocking by supernumerary teeth and over-retained primary teeth. Early diagnosis can help in avoiding the complications. The management of such cases depends on the stage of teeth development, teeth position, and space availability. Treatment may combine both surgical and orthodontic interventions.

CASE DESCRIPTION

The case was managed by surgically removing the primary retained teeth and supernumerary teeth in two visits then allowing the impacted permanent incisors to erupt without any intervention.

CONCLUSION

After 18 months follow-up, the two permanent incisors erupted spontaneously with no orthodontic intervention.

CLINICAL SIGNIFICANCE

dentists should be aware of the importance of early diagnosis of supernumerary teeth. The management of such cases should be designed by a multidisciplinary team decision.

Multidisciplinary management of an impacted maxillary central incisor associated with supernumerary teeth: a case report

Permanent maxillary central incisor impaction is a rare condition of multifactorial etiology that should be treated on diagnosis. This article describes multidisciplinary treatment of an 11-year-old patient presenting with a permanent maxillary right central incisor that was impacted due to the presence of 2 supernumerary teeth. The diagnosis was reached through clinical evaluation, radiography, and cone beam computed tomography. Treatment involved the surgical removal of the supernumerary teeth followed by traction of the impacted tooth through a combination of removable and fixed orthodontic appliances. Orthodontic treatment was completed after 18 months, resulting in adequate positioning of the right central incisor in the arch. Periodic follow-up visits were scheduled for prophylaxis and oral hygiene reinforcement. After 2 years, the teeth were adequately aligned, the gingiva was healthy, and the patient was esthetically satisfied. The multidisciplinary approach allowed functional and esthetic oral rehabilitation, thus helping the patient to avoid the psychological impact of a missing anterior tooth.

Genetic basis of dentigerous cysts associated with supernumerary teeth: A narrative review

In the present study, we sought to: (a) analyze the p53 gene status in dentigerous cysts (DC) associated with supernumerary teeth (ST) in a pair of siblings with ST, of whom one developed a DC; and (b) conduct a narrative review of the literature on ST associated with DC. Blood samples were obtained, and the isolated DNA was used to amplify exons 4-8 of the p53 gene using specific primers, and subsequently sequenced. No mutations were identified in the coding regions of the p53 gene. A review of the literature revealed a prevalence of DC associated with ST to be as high as 13.6%, and that 83% of the case reports performed enucleation of DC and removal of ST. Dentigerous cysts associated with ST in one sibling demonstrated that variations in phenotypes exist, and the absence of mutations cannot eliminate the potential influence of genetic risk factors.

Pre-maxillary hypohyperdontia: a report of two cases

BACKGROUND

Hypodontia and hyperdontia are considered to be at opposite ends of the dental development spectrum. Nevertheless, these anomalies may occur concomitantly (hypohyperdontia).

CASE REPORT

This clinical report describes two case of hypohyperdontia occurring exclusively in the premaxillary region, and the difficulties associated with its diagnosis and management. Following 24 months of follow-up examinations, Case 1 developed a sequential supernumerary tooth in the tooth 35 region.

CONCLUSION

Cases of hypohyperdontia can occur exclusively in the premaxillary region and may be difficult to diagnose. Multidisciplinary treatment planning is essential to facilitate appropriate management, and long-term follow-up is necessary as sequential supernumerary teeth may develop.

Early Assessment of Dental Arch Development in Repaired Unilateral Cleft Lip and Unilateral Cleft Lip and Palate versus Controls

Objective

To evaluate dental arch relationships and dimensions, relative to an age matched noncleft sample, in Caucasian 3-year-old children with repaired unilateral cleft lip (UCL) or unilateral cleft lip and palate (UCLP).

Design

Prospective, cross-sectional, case-control study performed in Scotland, U.K.

Participants

Eleven children with repaired unilateral cleft lip, 16 children with repaired unilateral cleft lip and palate, and 78 children as controls.

Main Outcome Measures

Dental arch relationships and linear arch dimensions.

Results

Prevalence of Class III incisor relationship was 31.3% in children with unilateral cleft lip and palate compared with 9.1% in children with unilateral cleft lip. A buccal crossbite was present in 36% of children with unilateral cleft lip, compared with 75.6% of children with unilateral cleft lip and palate. Mean linear maxillary arch dimensions did not differ significantly between children with unilateral cleft lip and the controls. Except for second intermolar width, statistically significant differences existed in mean linear maxillary arch dimensions between the unilateral cleft lip and the unilateral cleft lip and palate groups; the mean linear maxillary arch dimensions were significantly greater in the control group than in the unilateral cleft lip and palate group. The mean cleft-affected anterior quadrant length appeared to be the arch dimension with the greatest power of discrimination among the three groups. There were no significant differences in mean linear mandibular arch dimensions among the three groups.

Conclusions

Anterior crossbite was almost three times more common in the unilateral cleft lip and palate group than in the unilateral cleft lip group. Mean linear maxillary arch dimensions differed significantly between the unilateral cleft lip and palate group and the control group. There were no significant differences in mean linear maxillary arch dimensions between unilateral cleft lip and controls or between mean linear mandibular arch dimensions for unilateral cleft lip, unilateral cleft lip and palate, and controls.

Mesiodens: A Hospital Based Study

 Background: A mesiodens, is the most frequent supernumerary tooth present in the maxillary central incisor region. This study is conducted to know the radiographic characteristics and management of mesiodens in children visiting hospital.

METHODS

A cross-sectional retrospective data collection was done from hospital dental records of children who visited the institution from December 2015-December 2016. Radiographic characteristic of mesiodens including the number, shape, position, direction of crown and complication caused by mesiodens were recorded. Data were analyzed using IBM SPSS v.20.0.

RESULTS

Out of 1871 dental records, it was found that 40 children had 53 mesiodens, with male female ratio of 3:1 and most of them were discovered at 8 years. Majority of mesiodens, 54.7% were erupted, conical, palatally placed with 77.3% vertically directed crown.Complications associated with it were crowding followed by diastema and delayed eruption. Among 40 children, one had three mesiodens, eleven had two mesiodens and rest had one each. Radiographically fully formed tooth was seen in 29 mesiodens. Immature apex was seen in 38 central incisors associated with mesiodens. Management undertaken was simple/surgical extraction and only few cases were kept for periodic observation.

CONCLUSIONS

Periodic radiographs act as an important tool for clinicians in detecting and managing mesiodens.

Management of Unusual Rotation of Maxillary Central Incisor with Impacted Mesiodens: Case Report

Supernumerary teeth are frequently found in the maxillary anterior region, largely in permanent dentition (rare in deciduous dentition). Shape of the supernumerary teeth may vary from conical, tueberculate, supplemental to odontome. Mesiodens is a conical type of supernumerary teeth located in the maxillary central incisor region and is generally unerupted. Presence of mesiodens may result in rotation, uneruption, or malalignment of adjacent maxillary incisors. In this article, we present a case report of unusual rotation of maxillary central incisor with impacted mesiodens.

Combined Surgical Removal of a Supernumerary Tooth and Orthodontic Traction of an Impacted Maxillary Central Incisor

Impaction of permanent maxillary central incisors is a rare condition that can affect esthetics and oral function. The etiology of impaction is multifactorial and may be related to embryologic reasons, hereditary factors, mechanical obstacles, and pathologic elements, such as the presence of supernumerary teeth. The purpose of this report is to discuss the case of a 10-year-old patient who presented an impacted permanent maxillary right central incisor due to a supernumerary tooth. Surgical removal of the supernumerary tooth and orthodontic traction of the impacted central incisor by the closed eruption technique were performed. After 12 months, the permanent maxillary right central incisor was adequately positioned in the arch. The multidisciplinary treatment allowed the functional and esthetic rehabilitation to happen in a short period of time, thus reducing the patient's psychological impact caused by the lack of an anterior tooth.

[Supernumerary teeth in the maxilla and mandible-an interdisciplinary challenge. Part 1: epidemiology, etiology, classification and associated complications]

Supernumerary teeth develop in addition to the normal dentition and are a therapeutic challenge for pedodontists, orthodontists and oral surgeons alike. Therefore, interdisciplinary treatment concepts are needed for the benefit of the patient. In the present, two-parted literature review on supernumerary teeth, current classification, associated complications, diagnostic steps and different therapeutic approches are presented and discussed. Supernumerary teeth are diagnosed in the primary and permanent dentition. Supernumerary incisors, canines, premolars, and molars, as well as distomolars and mesiodentes can be seen according to the location of the supernumerary teeth. Furthermore, based on the morphology of the supernumeraries four different types can be differentiated: conical, tuberculate, supplemental, and odontoma. Supernumerary teeth often remain asymptomatic, and are only diagnosed incidentally during a routine dental visit on radiographs (often intraoral). Nevertheless, various complications have been reported in the literature for supernumerary teeth such as disturbed eruption, malpositioning/rotation, root resorption of neighbouring teeth, and development of dentigerous cysts in impacted supernumeraries. Root resorption of neighbouring teeth can be radiographically diagnosed in up to 22.8% of the cases.

Multidisciplinary Treatment of Impacted Maxillary Central Incisors: Literature Review and Case Report

Tooth impaction is an eruption disorder frequently observed in orthodontic clinical practice. A 9-year-old female patient presented with impacted permanent maxillary central incisors and two supernumerary teeth in the region. The early diagnosis and multidisciplinary treatment approach adopted in our case allowed to successfully restore esthetic appearance and occlusion.

[Nasal cavity supernumerary tooth and maxillary sinusitis: one case reported]

Supernumerary tooth is a rare case. This report described a case of nasal cavity supernumerary tooth association with maxillary sinusitis. A 28-year-old male patient reported with the chief complaint of nasal obstruction, headache and purulent secretion for the past three months. Clinic examination and CT examination showed that there was a supernumerary tooth in the right nasal bottom, and maxillary sinus was infected in the same side. This patient was performed supernumerary tooth removing and given antibiotics for 3 days. Ten days after the operation, there was no clinical symptoms, and nasal bottom mucosa was normal. After 3 months of follow-up, reexamination of coronal CT scan appeared normal.

Closure of large midline diastema by a "HIV-Spring"

Midline diastema is a common orthodontic problem in mixed dentition caused by various factors like genetic, supernumery teeth, abnormal frenum attachment, habits and microdontia etc. Large diastemas need closure for the eruption of adjacent teeth. I present here a newly designed customized self active HIV-Spring (Hari Inverted 'V' Spring) for closing a large diastema with minimum orthodontic materials and less activation visits. The spring can be modfied for the three dimensional movement of central incisors.

Midline diastema and its aetiology--a review

Maxillary midline diastema is a common aesthetic complaint of patients. Treating the midline diastema is a matter of concern for practitioners, as many different aetiologies are reported to be associated with it. The appearance of midline diastema as part of the normal dental development makes it difficult for practitioners to decide whether to intervene or not at an early stage. The aim of this article is to review the possible aetiology and management options which will help the clinician to diagnose, intercept and to take effective action to correct the midline diastema. The available data shows that an early intervention is desirable in cases with large diastemas. Treatment modality, timing and retention protocol depends on the aetiology of the diastema. Therefore, priority needs to be given to diagnosing the aetiology before making any treatment decisions. Clinical Relevance: This article aims to determine and evaluate the aetiology and possible treatment options of midline diastema.

Is there a relationship between increased tooth number and increased tooth size? A case report

A unifying theory has been proposed that links anomalies of tooth size and number. Application of this theory suggests that anomalies of tooth size and number may share a common aetiology but could also be predicted. This article highlights an association between macrodontia and hyperdontia as demonstrated by two clinical cases. These cases demonstrate a localized association and effect on the dentition and highlight the possible predictive application of this theory.

CLINICAL RELEVANCE

Clinicians should be made aware of the possibility of supernumeraries associated with macrodont teeth.

An impacted central incisor due to supernumerary teeth: a multidisciplinary approach

BACKGROUND

Hyperdontia is a disorder of odontogenesis characterised by excess teeth. Many complications can be associated with supernumerary teeth, such as crowding, tooth displacement, diastema, deep caries, retention or impaction, delayed eruption or ectopic eruption of adjacent teeth, aesthetic problems, neuralgic manifestations, root resorption of adjacent teeth, and dentigerous cyst formation with significant bone destruction. Treatment of hyperdontia depends on the area and number of supernumerary teeth, and also on the presence of pathologic processes that can affect them and/or the teeth of the normal series that could be erupted, retained or impacted.

CASE REPORT

The present case report describes the clinical management of two impacted supernumerary teeth, which impeded the eruption of the maxillary right central incisor in a paediatric patient. A multidisciplinary treatment approach was planned, including the surgical removal of the supernumerary teeth and the orthodontic correction of the unerupted permanent maxillary right central incisor. Combined surgical and orthodontic treatment resulted in an aesthetically pleasant and balanced occlusion. Thus, early multidisciplinary treatment is required for greater hard and soft tissue preservation.

Investigation of prevalence and characteristics of mesiodens in a non-syndromic 11256 dental outpatients

AIM

To investigate the prevalence of mesiodens in a sample of Turkish dental patients and their distribution among genders.

PATIENTS AND METHODS

A retrospective study was performed using panoramic radiography of 11256 patients, who ranged in age from 15 to 55 years old. All data (age, sex and or syndrome) were obtained from the patient files and analyzed for mesiodens. Statistical evaluation of the presence of mesiodens related to gender was performed by the Pearson chi-squared test.

RESULTS

Mesiodens was detected in 15 subjects (0.13%). The prevalence of mesiodens for females and males was 0.20% and 0.057%, respectively (p = 0.037). The most commonly observed mesiodens was maxillary canine-like type (60%). Most of the mesiodens (67%) were found in the vertical position, followed by horizontal position (33%). The age and sex distribution, number of mesiodens per patient, shape, direction, size, and effect on permanent maxillary incisors are also presented in this study. The most common complication caused by mesiodens was midline of the permanent incisors.

CONCLUSIONS

Mesiodens is an uncommon developmental anomaly in Turkish dental patients. Early diagnosis allows the most appropriate treatment, often reducing the extent of surgery, orthodontic treatment and possible complications.

Bilateral impacted inverted mesiodens associated with dentigerous cyst

Mesiodens, the most common type of supernumerary tooth, usually results in malocclusion, poor esthetics and cyst formation. The occurrence of a dentigerous cyst around the crown of an unerupted supernumerary tooth is infrequent. We present a case of a dentigerous cyst associated with a nonsyndromic bilateral impacted inverted supernumerary tooth in a 13-year-old boy. A thorough clinical workup, including 3-D reconstruction image and histological examination confirming the features of a dentigerous cyst is presented in this report.

[Diagnosis and treatment of supernumerary teeth in the premaxillary region: a literature review]

Supernumerary teeth are more frequently located in the premaxillary region. Mesiodentes are the most common supernumerary teeth, occurring in 0.15% to 1.9% of the population. Supernumerary teeth are frequently diagnosed in a random radiograph, or after clinical symptoms appear. The majority of the complications consist of delayed or ectopic eruption of the permanent incisors. It is important for the clinician to be aware of the phenomenon and its implications, in order to diagnose it as early as possible. Extraction of the supernumerary teeth in the late mixed dentition, will minimize the chances of damaging the adjacent permanent teeth, but will reduce the possibility of spontaneous eruption of an impacted permanent incisor. Extraction in the early mixed dentition can expedite the eruption of the permanent incisor, although it may involve sedation or general anesthesia, due to lack of cooperation in the young patient. Because to the risk of uneruption of the permanent impacted incisor, exposure of the teeth and bonding a ligature or bracket at the same procedure, and providing a possibility for the dentist to make the incisor erupt after the first operation, should the incisor not erupt spontaneously. Treating these cases require the cooperation of pediatric dentist, orthodontic and dental surgeon, and sometimes the involvement of an anesthesiologist.

Association of agenesis of mandibular lateral incisors with other dental anomalies in a Japanese population

PURPOSE

The purpose of this study was to explore the association of mandibular incisor agenesis with other dental anomalies in Japanese orthodontic patients.

METHODS

A total of 52 subjects with 1 or 2 congenitally missing permanent mandibular lateral incisors (group A) were selected and divided into group 1a (26 subjects with 1 lateral incisor missing) and group 2a (26 subjects with 2 lateral incisors missing). Fifty two sex-matched subjects without agenesis of the mandibular lateral incisor served as controls (group C). Radiographs, study models, and medical and dental records were used to identify anomalies of teeth.

RESULTS

The prevalence rate of agenesis of teeth other than the mandibular lateral incisors and third molars was significantly increased in group A. Agenesis of the maxillary second premolars was significantly increased in groups 2a and A. Significantly increased prevalence rates of symmetrical tooth agenesis, with third molars excluded, and third molar agenesis were observed in group 1a and A.

CONCLUSIONS

Japanese subjects with agenesis of 1 or 2 permanent mandibular lateral incisors have significantly increased prevalence rates of other permanent tooth agenesis and symmetrical tooth agenesis.

Prevalence of teeth number anomalies in orthodontic patients

OBJECTIVES

The purpose of this study was to determine if the prevalence of teeth number anomalies (TNA) is more frequent in orthodontic patients than in common population and what is TNA clinical manifestation.

MATERIAL AND METHODS

The records of 824 orthodontic patients (average age 15.22 years) from Orthodontic Clinic of Lithuanian University of Health Sciences were analyzed. The radiographs were analyzed by trained observer who followed a pre-established protocol: general observation of the teeth including third molar, followed by a systematic analysis of the erupted and unerupted teeth number in each quadrant. Descriptive statistics were performed for the study variables. A chi-square test was used to determine the difference in the prevalence of hypodontia between the genders. A value of P<0.05 was considered significant.

RESULTS

The prevalence of hypodontia was 17.11 percent with no statistically significant difference between the genders (P>0.05). More frequently teeth were missing in the lower jaw: in the upper jaw - 10.3%, in the lower - 12.5% without statisticaly significant diference. Unilateral occurrence of dental agenesis was 1.5 times more common than bilateral occurrence. If more than one tooth was missing, usually other missing tooth was in the same group and in the same jaw. The upper and lower third molars were the most frequently missing teeth, followed by the mandibular second premolar. The prevalence of hyperdontia was 0.85 percent. Mesiodens was the most frequently found supernumerary tooth.

CONCLUSIONS

It was found, that 17.96% of orthodontic patients had teeth number anomalies. The upper and lower third molars were the most frequently missing teeth, followed by the mandibular second premolar. Hypodontia occurred more frequently than hyperdontia. Mesiodens was the most frequently found supernumerary tooth. The results confirm that TNA are more often found in orthodontic patients and these patients should be treated with multidisciplinary approach.

Treatment of an impacted supernumerary tooth using limited fixed orthodontic appliances

A 42-year and 9-month-old female with an impacted supernumerary tooth was treated with limited fixed orthodontic appliances. As seen in this case, it is possible to successfully treat impacted teeth in adults even though the most common time to treat impactions is during adolescence.

Pre-maxillary hypo-hyperdontia: report of a rare case

Agenesis of bilateral maxillary canines is very rare and mesiodens is a commonly occurring supernumerary tooth type. Concomitant occurrence of both hypodontia and hyperdontia is extremely rare and it is a condition of mixed numeric variation in the same individual. The reported prevalence of this condition ranges between 0.002% and 3.1%. The purpose of this case report is to describe a rare occurrence of hypo-hyperdontia involving agenesis of both maxillary canines, mesiodens and associated with taurodontism.

Impacted incisors associated with supernumerary teeth treated with a modified Haas appliance

Tooth impaction involves factors such as lack of space in the alveolar process, trauma, ankylosis, and mechanical barriers such as abnormal frenum, supernumerary teeth, tumors, and local cysts. When impaction occurs in the anterior region, esthetics are compromised. This report describes the successful approach to treatment for a young boy who had 2 supernumerary teeth associated with impaction of the left central and lateral permanent incisors. Treatment consisted of extracting the supernumerary teeth and performing maxillary expansion with a modified Haas appliance to guide the left central incisor into its appropriate position. The teeth erupted spontaneously after maxillary expansion and an increase in space. A fixed edgewise appliance was placed incrementally to correct the maxillary anterior tooth positions and finish the treatment. Adequate esthetics and function were achieved.

Concomitant hypodontia and hyperodontia: an analysis of nine patients

INTRODUCTION

Congenital absence of tooth germs and presence of supernumerary teeth (CHH) are anomalies which are classified as embryologically determined disorders. Both disorders can occur together (CHH), but relatively rarely.

OBJECTIVE

The aim of the present study was to present and analyze nine cases collected during the past 24 years, where congenitally missing teeth occurred with supernumerary teeth in the same patient.

MATERIALS AND METHODS

Dental records, radiographs and casts of nine patients, six boys and three girls (aged 9-29 years, mean age: 19 years) were examined. All the family members of the patients were also investigated regarding the presence of tooth disorders.

RESULTS

The boys showed hypo-hyperodontia twice as often as the girls (6:3). Congenital absence of tooth germs was more common than the presence of supernumerary teeth (25:11). CAP were not present in the other family members.

CONCLUSIONS

The full diagnosis of hypo-hyperodontia is only possible on the basis of radiographic examination, because some teeth may remain unerupted or missing. The results of this study showed that concomitant hypo-hyperodontia is rare and sex-related, with predominance of hypodontia. The genetic influence seems unclear.

Mandibular midline supernumerary tooth associated with agenesis of permanent central incisors: a diagnostic conundrum

Concomitant hypo-hyperdontia is a rare mixed numeric anomalous condition. The presence of this condition in the same area of dental arch and specifically in the mandibular anterior region is reported very infrequently. This case report presents a case of 20 years old male with congenitally missing permanent mandibular central incisors in conjunction with a mandibular midline supernumerary tooth. Only 3 cases have been documented in English literature till date. The article focuses on the review of mandibular mesiodens and the clarity regarding the usage of the terminology "mesiodens".

Impacted mandibular permanent incisors related to supernumerary teeth: a rare condition

Supernumerary permanent teeth in the mandibular incisor area are rare, and there are very few reported cases of the supernumerary teeth in the mandibular incisor area leading to impaction of incisors. A south Indian boy aged 14 presented with 3 supernumerary teeth in the mandibular right permanent incisor area resulting in impacted permanent central and lateral incisors.

Treatment of supernumerary teeth

AIM

The finding of supernumerary teeth in the oral cavity is a common occurrence, and they are interesting because of their potential to lead to aesthetic and functional alterations. When they are present in the anterior area of the maxilla, they may cause complications, such as late tooth eruption or impaction of the central incisors. They affect from 0.5 to 3.8% of the population, with men being more affected.

CASE REPORTS

This article describes two cases of impaction of the permanent maxillary left central incisor, due to the presence of a supernumerary tooth in the parasagittal area of the pre-maxilla, as well as the surgical and orthodontic procedures adopted.

Interdisciplinary management of dental anomalies: fusion and supernumerary teeth

A 16-year-old boy presented with a fused permanent maxillary left central incisor with a supplemental tooth and an additional supplemental tooth lingual to the permanent maxillary right central incisor. Following leveling, alignment, and endodontic therapy, the maxillary fused left central incisor was sectioned and the mesial portion extracted as planned. Fixed orthodontic treatment commenced after 10 days to align the maxillary anterior segment. After completion, the midline diastema was closed with veneers. This case highlights the treatment options of a fused tooth and the need for multidisciplinary planning and treatment.

[A man with pain in his upper jaw]

A 66-year-old man came to the hospital with pain in the frontal left side of his upper jaw. Pressure along the left nostril could evoke a sharp pain, which radiated upwards. The patient had already consulted several specialists. After extended clinical and radiological investigation a mesiodens was found that gave pressure on the nasopalatine nerve.

Survey of mesiodens and its characteristics in 2500 children of Davangere city, India

AIM

The aim of the present study is to report the prevalence of mesiodens and its characteristics and also to present 25 cases with 27 mesiodentes in 2500 children in Davangere city, India.

MATERIALS AND METHODS

A survey of 2500 children examined in the Department of Paediatric Dentistry was conducted. Their ages ranged from 3 to 12 years. A total of 27 mesiodentes were diagnosed in 25 patients (1%). The patients' records and radiographs were evaluated and the following variables were studied: age and sex distribution, number, shape, position, eruption status, associated dentition and arch, associated complications and anomalies.

RESULTS

In this study were enrolled 16 males and 9 females: 96.2% of the mesiodentes were seen in the maxillary arch while only one in the mandibular arch; 92.5% were observed in the permanent dentition. Most mesiodentes (92.5%) were conical in shape, and about 96.2% were placed vertical in position with only one mesiodens impacted and inverted. Of the 27 mesiodentes, 23 were u%% caused a midline diastema, 14.8% occlusal interference, 7.4% root resorption, and 3.7% had caused delayed eruption of permanent incisors. Rare anomalies like facial talon cusp were found in two mesiodentes (7.4%), and only one (3.7%) had a root anomaly.

CONCLUSION

Mesiodens may occur as an isolated finding or can be associated with other odontogenic anomalies.

An unusual triplication of primary teeth-a rare case report

Odontogenic anomalies can occur as a result of conjoining or twinning defects. This article reports the case of fusion in a 10-year-old boy in relation to the primary maxillary right incisors. Clinicoradiographic examination revealed the presence of triple teeth, ie, fusion between the maxillary right incisors along with a supernumerary tooth on the labial surface. The offending triple tooth was extracted under local anesthesia. The extracted tooth was sectioned using a hard tissue microtome at three levels-the coronal, middle root, and apical levels, respectively-and these sections were visualized under a stereomicroscope. Based on the histologic findings, a final diagnosis of fusion was confirmed. A brief review of the literature on triple teeth is also presented.

Identical unerupted maxillary incisors in monozygotic twins

Mesiodens is the most common type of supernumerary tooth found in the premaxilla. It might be discovered by the orthodontist by chance on a radiograph or as the cause of an unerupted maxillary central incisor. The genetic transmission of supernumerary and impacted teeth is poorly understood. The occurrence of identical unerupted maxillary central incisors and mesiodentes in monozygotic twins suggests that genetic factors might influence the etiology of this problem. In this case report, we discuss the treatment of unerupted maxillary permanent incisors caused by mesiodentes in monozygotic twins.

Delayed eruption of maxillary permanent central incisors due to bilateral tuberculate supernumerary teeth: case report

The purpose of this case report is to discuss the delayed eruption of permanent maxillary central incisors in a 10-year-old boy with retained primary maxillary central incisors. Radiological investigations revealed the presence of impacted bilateral supernumerary teeth and impacted permanent incisors. These supernumerary teeth were surgically removed and were diagnosed as tuberculate type. The patient is on clinical and radiological follow up for spontaneous eruption of the permanent teeth.

Multidisciplinary management of multiple maxillary anterior supernumerary teeth: a case report

Supernumerary teeth are a relatively frequent disorder of odontogenesis. They may occur alone or in multiple; be unilateral or bilateral; and appear in the maxilla, mandible, or both. Mesiodens is a supernumerary tooth in the anterior maxilla between the two central incisors. This case report describes the treatment of maxillary central incisors displaced and impacted because of the presence of four mesiodens in a 12-year-old boy. After clinical and radiographic examination, surgical removal of the mesiodens and exposure of the maxillary right central incisor was performed. This resulted in a 14-mm space between the displaced central incisors. Successively, fixed orthodontic treatment was planned with cephalometric analysis. The central incisors were brought to the occlusal plane and aligned, and the space between the incisors was redistributed. Remaining minor spaces between the incisors were closed with composite resin buildup.

Taurodontism in children with hypodontia and supernumerary teeth: a case control study

PURPOSE

The aim of the present investigation was to compare the prevalence of taurodontism in the permanent mandibular first molars of nonsyndromic children with hypodontia and supernumerary teeth with age- and gender-matched controls.

METHODS

The crown-body root ratios of the permanent first molars were determined from orthopantomograms of 83 children with hypodontia (> or =1 missing teeth) and 37 children with supernumerary teeth (> or =1 extra teeth) compared with normal case controls.

RESULTS

In children with hypodontia, only girls showed a significantly higher tendency for taurodontism compared to case controls (P=.003), while boys with hypodontia showed a similar prevalence of taurodontism as controls (P=.83). Children with multiple missing teeth were significantly more susceptible to taurodontism than children with a single missing tooth (P=.004). By contrast, the prevalence of taurodontism in children with supernumerary teeth was not significantly different from that of controls.

CONCLUSIONS

Compared to normal case controls, children with nonsyndromic hypodontia are more likely to show taurodontism of the permanent first molar teeth whereas children with nonsyndromic supernumerary teeth are not.

Determination of the optimum time for surgical removal of unerupted anterior supernumerary teeth

PURPOSE

The purpose of this study was to determine the optimum time for surgical removal of unerupted maxillary anterior supernumerary teeth.

METHODS

The study population consisted of 126 children. Stages C to H of the Demirjian classification were used to classify the dental development of the adjacent incisors. Associations were sought between the complications and the developmental stage of the adjacent maxillary incisors at the time of surgical removal. Tests of association were carried out using Fisher's exact test with a probability level of P=.05 for statistical significance.

RESULTS

Significant differences were evident: for mature maxillary central incisors (N=170); between all the proportions for root resorption, with the greatest difference being between stages E and H (P<.001); for arrested root development between stages D and E (P=.013), and D and H (P=.02); and for persistent malocclusion between stages E and G (P=.004), E and H (P=.02), F and G (P=.005), and F and H (P=.01).

CONCLUSION

Early removal of unerupted maxillary supernumerary teeth seems to be advantageous with a cutoff point of approximately 6 to 7 years old, after which more complications are expected.

[Correlations between the presence of a mesiodens and position abnormalities, diastemas, and eruption disturbances of maxillary frontal teeth]

A mesiodens is often diagnosed coincidentally during a radiological examination. However, a mesiodens may also be diagnosed in relation to a clinically identified central diastema and an eruption disturbance, or a rotation of a central incisor. In this study of a group of 162 children and adolescents varying in age from 4 to 18 years, with a mesiodens, the frequency of position abnormalities, diastemas, and eruption disturbances of the maxillary frontal teeth was registered retrospectively. One or more of these complications was diagnosed in 72% of the patients. Usually, removal of the mesiodens in children and adolescents results in spontaneous recovery of the complications. Early diagnosis and early treatment are therefore important.

Endoscopic removal of a supernumerary tooth from the nasal cavity in an adult

Eruption of a tooth into the nasal cavity is a rare event. However it is important to identify such a condition as it has the potential to cause significant morbidity. We report a unique case of intranasal supernumerary tooth erupted into nasal causing significant nasal symptoms in an otherwise healthy patient which was removed endoscopically.