Supernumerary and Supplementary Teeth in a Non-syndromic Patients.

BACKGROUND: Irregularities in the number of teeth can also occur in deciduous and in permanent dentition. OBJECTIVE: The aim of this article is to report the case of a seven years old child and a 27 years old male patient affected by a numeric dental anomaly. METHODS: This paper has shown the pathologic condition characterized by the presence of supernumerary tooth (mesiodens) and supernumerary canine as well as supplementary premolars in a non-syndromic patients. Clinical and instrumental examinations were made to perform a correct orthodontic examination and diagnosis. A young patient was affected by numeric dental anomaly in the upper jaw. An adult patient was affected by numeric anomaly in both jaws, supplementary premolars in lower jaw and a supernumerary canine in lower and upper jaw. DISCUSSION: The aim of surgical-orthodontic treatment was extraction of the erupted supernumerary teeth to obtain the physiologic eruption and placement of the permanent ones. CONCLUSION: Therapy of supernumerary/ supplementary teeth is the extraction. But also, an excess tooth in the dentition can be left as a replacement tooth, due to a previously lost permanent tooth from the dentition, if its biological value and potential is sufficient to complete the dentition both functionally and aesthetically.

Evaluation of dental age and associated developmental anomalies in subjects with impacted mandibular canines.

OBJECTIVES: To assess the null hypothesis that there is no difference in the rate of dental development and the occurrence of selected developmental anomalies related to shape, number, structure, and position of teeth between subjects with impacted mandibular canines and those with normally erupted canines. MATERIALS AND METHODS: Pretreatment records of 42 subjects diagnosed with mandibular canines impaction (impaction group: IG) were compared with those of 84 subjects serving as a control reference sample (control group: CG). Independent t-tests were used to compare mean dental ages between the groups. Intergroup differences in distribution of subjects based on the rate of dental development and occurrence of selected dental anomalies were assessed using χ(2) tests. Odds of late, normal, and early developers and various categories of developmental anomalies between the IG and the CG were evaluated in terms of odds ratios. RESULTS: Mean dental age for the IG was lower than that for the CG in general. Specifically, this was true for girls (P < .05). Differences in the distribution of the subjects based on the rate of dental development and occurrence of positional anomalies also reached statistical significance (P < .05). The IG showed a higher frequency of late developers and positional anomalies compared with controls (odds ratios 3.00 and 2.82, respectively; P < .05). CONCLUSIONS: The null hypothesis was rejected. We identified close association of female subjects in the IG with retarded dental development compared with the female orthodontic patients. Increased frequency of positional developmental anomalies was also remarkable in the IG.

A case-control study of dental development in Hypodontic and Hyperdontic children.

PURPOSE: The purpose of this study was to investigate the rate of dental development in children with nonsyndromic hypodontia and nonsyndromic hyperdontia compared to age- and gender-matched controls. METHODS: Dental age assessment was performed using orthopantomograms on 115 children (63 girls, 52 boys) with hypodontia and 61 children (22 girls, 39 boys) with hyperdontia and compared with 176 normal controls, case-matched for gender and age. RESULTS: Both girls and boys with hypodontia showed a significant delay in dental development compared to case controls. The mean differences between dental age and chronological age in hypodontia girls and boys were -0.1+/-1.5 years and -0.1+/-1.2 years, respectively, compared to 1.0+/-1.0 years and 0.8+/-0.8 years in the case controls, respectively (P<.001 for both boys and girls). The delay in dental development was accentuated during puberty. By contrast, no significant differences were observed between hyperdontic children and case controls. CONCLUSIONS: Nonsyndromic hypodontia children experience delayed dental development, whereas nonsyndromic hyperdontia children have similar rotes of dental development compared to normal children. These findings have implications for management of dental growth and development in children with agenesis of the teeth and supernumerary teeth.

Retrospective analysis of the factors influencing mesiodentes eruption.

AIM: This study aimed to evaluate the factors that predict the spontaneous eruption of mesiodens. DESIGN: From the records of 431 patients (346 boys and 85 girls, average age 8.8 years) who visited Samsung Medical Center from January 2002 to December 2006, 471 mesiodentes were reviewed. The eruption rate was investigated according to the width/length ratio, angulation, location, and shape determined from periapical or panoramic radiographs. RESULTS: The regression model showed that the width/length ratio and angulation were important determinants influencing the eruption of mesiodentes (P < 0.001, Pearson's r = 0.619). The location of the mesiodentes also affected their eruption (P < 0.01). However, no significant relationship was detected between the shape and eruption rate of mesiodentes (P > 0.05). CONCLUSIONS: A lower probability of spontaneous eruption existed when the tooth had a greater angulation, shorter length, and wider width. Spontaneous eruption occurs more often when the mesiodens is located between the permanent incisors.

A late-forming mandibular supernumerary: a complication of space closure.

This case report describes a situation in which a mandibular supernumerary developed during orthodontic treatment and prevented space closure.

Multiple supernumerary teeth in non-syndromic patients: report of 5 clinical cases

A supernumerary tooth is one that is additional to the normal series and can be found in almost any region of the dental arch. They have been described in both primary and permanent dentition. Multiple supernumerary teeth are rare in non-syndromic patients. The purpose of this study was to evaluate non-syndromic patients with five or more supernumerary teeth, by general and local clinical examinations, periapical, occlusal and panoramic radiographs. The patientsÆ data were collected regarding to the number of supernumerary teeth, location, shape, position and association to pathological lesion. Thirty-five supernumerary teeth were found, 17 in the mandible and 18 in the maxilla. In the lower arch, 16 supernumerary teeth were localized in the premolar region and 1 in a disto molar region. However, in the upper arch, there were 7 in the premaxilla, 6 in the premolar and 5 in the disto molar region. From the total, 28 were supplemental and 7were found in a rudimentary shape. Completing the observations, 29included teeth were detected and one showed a radiolucent area that suggested a dentigerous cyst. Six other teeth showed a widened follicular space. One of the upper molar from the normal series was related to an odontoma. We could conclude that mandible and maxilla were equally affected and most of the teeth morphology was similar in size and shape to normal tooth (supplemental). Twenty-nine teeth were impacted; however few have caused pathologies.

Multiple and relapsing supernumerary teeth associated to dens invaginatus. Review of the literature and case report.

The aim of this paper is to show problems related to supernumerary teeth therapy according to their formation and mineralization. The clinical case of an 11-year old boy suffering from alteration of the eruptive sequence of the upper incisor teeth caused by 2 supernumerary teeth in the premaxilla, is reported. What is interesting about this case is that after the surgical removal of the supernumerary teeth, with a radiographic examination taken 6 months later, 2 other supernumerary teeth were observed. The authors point out that while the clinical approach can be the same for different situations it is not possible to have the same approach for the surgical therapy which may be different from case to case.

Bilateral maxillary fourth molars and a supernumerary tooth in maxillary canine region--a case report.

The occurrence of supernumerary teeth is a relatively uncommon dental anomaly. The aetiology is not clear. Supernumerary teeth have frequently been observed as solitary teeth and impacted in the maxillary arch. This case report describes the rare presence of bilateral maxillary fourth molars and a supernumerary tooth in the maxillary canine region. On the left side, the third molar was extracted first, allowing the fourth molar to move into a more favourable position for later extraction. Two-year postoperative radiography confirmed that the supernumerary tooth had migrated occlusally and mesially permitting a safer extraction procedure.

Early intervention to remove mesiodens and avoid orthodontic therapy.

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

Delayed dental maturation in cleidocranial dysplasia.

Cleidocranial dysplasia (CCD), a rare, inherited, generalized, skeletal and dental dysplasia, exhibiting an autosomal dominant mode of transmission, may be associated with delays during tooth maturation. To test whether permanent tooth formation is delayed in patients with CCD and if the presence of supernumerary teeth adversely influences maturation of the dentition, a group of CCD patients (eight females, three males) was compared to an equal number of control subjects matched for age and gender. Dental maturity was assessed using panoramic radiographs and the Dental Maturity Ratio, (DMR = mean dental age divided by the chronological age) was calculated. The mean DMR in CCD patients (0.87 +/- 0.14) was lower than in the control group (1.06 +/- 0.14), p < 0.01. Among patients with CCD, patients with supernumerary teeth, had a lower DMR (0.82 +/- 0.13 vs. 0.91 +/- 0.16), but the difference did not reach statistical significance. After adjusting for the presence of supernumerary teeth the diagnosis of CCD was still found to be associated with lower DMR than controls, p = 0.0569. We conclude that CCD patients have delayed tooth development of approximately 2.1 years and that among these patients, those with supernumerary teeth were further delayed by 1.5 years.

Characteristics of jaw growth in cleidocranial dysplasia.

OBJECTIVE: The purpose of this pilot study was to assess craniofacial morphology in young and adult individuals with cleidocranial dysplasia (CCD). DESIGN: Craniofacial morphology in young individuals (primary dentition) and in young adults was compared with control data using ratios and angles obtained from lateral head films. SETTING: The CCD individuals were referred to the Center for Craniofacial Anomalies for diagnostic workup and treatment recommendations. SUBJECTS: The sample consisted of 14 Caucasians. The inclusion criterion for the young, prepubertal group (A) was complete primary dentition, and for the adult, postpubertal group (B), the eruption of all four first molars was required. INTERVENTIONS: No treatment other than extraction or surgical removal of selected primary or supernumerary teeth was performed. RESULTS: Both groups showed significantly smaller anterior upper face height compared with controls. Group B subjects demonstrated significantly smaller face height values than the controls in the A point-nasion-B point (ANB) angle, facial axis, mandibular plane angle, palatal plane/mandibular plane angle, and gonial angle. No significant differences were found between group A individuals and the controls for these measurements. The older group had shorter anterior lower face height compared with both anterior upper face height and posterior lower face height. CONCLUSIONS: Whereas young CCD subjects showed relatively normal jaw proportions and morphology of the mandible, older CCD individuals tended to have short lower face height, acute gonial angle, anterior inclination of the mandible, and mandibular prognathism. These differences can be attributed to pronounced horizontal mandibular growth resulting from lack of vertical maxillary growth and impaired eruption of permanent teeth.

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

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

Root development in relation to impacted mesiodens.

Presented here is a case of 7 years 6 month old child with an apically impacted mesiodens in relation to the developing root of right upper central incisor. The removal of mesiodens was deferred in order to avoid disturbance in the natural development of the upper central incisor. Serial X-rays are presented and case is discussed.

[Syndromes. 1. Cleidocranial dysplasia]. / Syndromen. 1. Dysostosis cleidocranialis.

Dysostosis cleido-cranialis is mainly characterized by a pathognomonic deformity of the skull, a hypoplastic midface, lack of eruption of permanent teeth, supernumerary teeth, defects in the clavicles, short stature and multiple other skeletal deformities. The inheritance is autosomal dominant, but there is a considerable number of new mutations.

Desarrollo tardío de dientes supernumerarios en la región de premolares: reporte de un caso / Late development of supernumerary teeth in the premolar region: report of a case

Este reporte describe el desarrollo tardío de premolares suplementales supernumerarios en tres cuadrantes de la región premolar. El descubrimiento de estas piezas fue por medio de radiografías de aleta de mordida y posterior confirmación con radiografías periapicales

Late development of maxillary supernumerary tooth: a case report.

A case is presented of a late developing maxillary supernumerary tooth in the permanent dentition. The patient had a supernumerary tooth fused to a central incisor in the primary dentition. This case emphasizes the importance of careful follow-up of patients with a history of supernumerary teeth and, where clinically indicated, of further radiographic examination.

Late development of supernumerary teeth in the premolar region: a case report.

Supernumerary teeth are considered to be among the most significant dental anomalies affecting the primary and the early mixed dentitions. Early removal of such teeth is recommended if they impede the eruption of adjacent permanent teeth, appear inverted or rudimentary, or are associated with certain pathologic conditions. This report describes the appearance of late-developing supernumerary teeth in the premolar region in three quadrants.