Conservative orthodontic and multidisciplinary approaches for patients with cleidocranial dysplasia in late adolescence or young adulthood.

This case series describes conservative orthodontic and multidisciplinary approaches for treating two patients diagnosed with cleidocranial dysplasia in late adolescence and young adulthood. Most of the impacted permanent teeth erupted spontaneously within 3 to 4 years after surgical extraction of the deciduous and supernumerary teeth. The remaining unerupted permanent teeth were facilitated with traction or extracted followed by implantation or restoration. Repositioning of the maxilla and mandible via orthognathic surgery was also applied to correct skeletal and occlusal discrepancies and lead to satisfying results.

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.

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.

Microdont Developing Outside the Alveolar Process and Within Oral Diffuse and Plexiform Neurofibroma in Neurofibromatosis Type 1.

BACKGROUND/AIM: Numerical aberrations of permanent dentition and dystopic tooth eruption are part of the phenotype of the tumor predisposition syndrome neurofibromatosis type 1 (NF1). In these cases, surplus tooth germs usually develop in the alveolar processes of the jaw. This report attests to the dystopic development of a dysplastic supernumerary tooth in NF1 arising outside the jaw. CASE REPORT: The 8-year-old male patient developed a microdont outside the bone and above the occlusal plane of the retained maxillary right second molar. The supernumerary tooth was completely embedded in oral soft tissue. Hyperplastic oral soft tissue in the molar region and microdont were excised. Specimen of the mucosa surrounding the teeth was interspersed with diffuse and plexiform neurofibroma. The retained upper right first molar emerged spontaneously within a few months after surgery. The upper right second molar did not change position. CONCLUSION: Odontogenesis can take place within tumorous oral mucosa in NF1. Surgical removal of the tumorous mucous membrane facilitates tooth eruption in some cases.

A rare case of accessory maxilla: a case report and literature review of Tessier no. 7 clefts.

Bilateral Tessier no. 7 clefts are rarely reported in the literature. Here, we describe the presence of accessory maxilla with supernumerary teeth in a patient who exhibited bilateral Tessier no. 7 clefts; the diagnosis was established based on the patient's history, clinical presentation, and computed tomography images. A review of the available literature revealed 24 patients with Tessier no. 7 clefts from 2000 to 2020, including our patient. The most common clinical manifestation in patients with Tessier no. 7 clefts comprises bilateral facial clefts. Additionally, Tessier no. 7 clefts are more frequently found in boys or men, rather than in girls or women. The presence of an accessory maxilla with supernumerary teeth in a patient with bilateral Tessier no. 7 clefts is extremely rare. Early detection of craniofacial abnormalities is important, because it may influence patient prognosis and management.

Three-dimensional evaluation of morphology and position of impacted supernumerary teeth in cases of cleidocranial dysplasia.

Cleidocranial dysplasia (CCD) is a congenital anomaly characterized by the presence of impacted supernumerary teeth and delayed eruption of permanent teeth. However, there has been no detailed investigation on supernumerary teeth in patients with CCD using three-dimensional (3D) imaging techniques. The purpose of this study was to elucidate the morphology and position of supernumerary teeth using 3D images reconstructed from cone-beam computed tomography (CBCT) data in a group of five Japanese subjects (male, 3; female, 2; age, 15.0-25.4 years) with CCD. All five subjects exhibited supernumerary teeth (39 in total; average, 7.8; range, 1-15). All supernumerary teeth were impacted and existed as pairs with adjacent permanent teeth. Comparison of the size (the crown and dental-root lengths, the crown mesiodistal and buccolingual diameters), the number of cusps and dental roots, the position, and direction of supernumerary teeth in relation to the adjacent permanent teeth was analyzed. The results of relationship analyses revealed that, at sites other than the molar region, supernumerary teeth were positioned on the lingual and distal sides and supernumerary teeth resembled the morphology of their adjacent permanent teeth in terms of the number of cusps but were smaller than the adjacent permanent teeth. In the molar region, supernumerary teeth were microdontia, which were apparently small and obscure morphologically. In addition, while all adjacent permanent teeth exhibited normal direction, five supernumerary teeth exhibited inverse direction. The findings of this study will improve our understanding of the characteristics of CCD and provide important information for the pathophysiology and clinical treatment.

Interceptação da impacção de um incisivo permanente superior / Interceptive approach of impacted maxillary permanent incisor

Um dente impactado é aquele que não conseguiu irromper na cavidade oral, geralmente devido a fatores genéticos ou obstáculos mecânicos. Acredita-se que a sua etiologia esteja mais ligada a fatores locais, sendo conhecidas as maiores incidências: terceiros molares inferiores, caninos superiores, terceiros molares superiores, segundos pré-molares inferiores e superiores e os incisivos centrais superiores, nesta ordem. A impacção de incisivos superiores é encontrada no cotidiano dos profissionais que tratam de pacientes jovens, tornando essenciais os embasamentos técnico e teórico-científico para condutas a serem tomadas durante a fase de dentadura mista para a obtenção de um sorriso harmônico e do restabelecimento psicossocial dos pacientes. A abordagem ortodôntica interceptora é indicada para minimizar os danos e reabilitar a estética do sorriso. Assim, o objetivo deste artigo é trazer uma revisão de literatura sobre a impacção dentária e relatar a fase interceptora ortodôntica de um paciente que apresentava um incisivo central superior permanente impactado (AU).

Impacted tooth is characterized by the failure of its eruption in the oral cavity due to genetic factors or mechanical obstacles. It is believed that its etiology is mainly associated to local factors, with the highest incidence of impaction found in lower third molars, upper canines, upper third molars, second lower and upper premolars, and upper central incisors, in this sequence. Impaction of permanent upper incisors tends to be found in the daily life of professionals who treat young patients, demanding previous technical and theoreticalscientific knowledge for conducts to be taken to obtain a harmonic smile and psychosocial balance. The orthodontic interceptive approach is indicated to minimize damage and rehabilitate the smile aesthetics. Thus the aim of this article is to perform a literature review on dental impaction and to report a clinical case of the interceptive phase of a patient with an impacted permanent upper central incisor (AU).

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.

Endoscopically Assisted Modified Caldwell-Luc Approach to Enucleation of Dentigerous Cyst With Ectopic Tooth From the Maxillary Sinus.

Dentigerous cysts in the craniomaxillofacial complex are a benign pathology commonly associated with ectopically placed teeth. Owing to slow and asymptomatic growth, they often attain considerable size before diagnosis that may compromise adjacent anatomical structures. Various techniques for removal of dentigerous cysts from the maxillary sinus have been described. This case report demonstrates a hybrid endoscopically assisted modification of the Caldwell-Luc approach to provide the technical advantages of both techniques.

Terapéutica quirúrgico-ortodóntica en adultos con dientes supernumerarios múltiples. Presentación de caso / Surgical-orthodontic therapy on adults with multiple supernumerary teeth

Se presentó a la consulta estomatológica, una paciente femenina de 39 años de edad, sin antecedentes médicos de interés, por presentar pérdida espontánea de un diente temporal. A través del examen físico intrabucal, se pudo corroborar la ausencia clínica del diente número 13, y en su lugar, la presencia de mucosa, que evidenciaba una exfoliación reciente de un diente, con notable disminución del espacio entre el incisivo lateral y la primera bicúspide superior izquierda. El examen radiográfico periapical mostró la presencia de una imagen radiopaca, ubicada entre el incisivo lateral y la primera bicúspide de la hemiarcada superior izquierda, la cual sugiere la presencia de múltiples órganos dentarios. Dada la afectación funcional, estética y psicológica de la paciente, y la existencia de discrepancia negativa moderada hueso-diente, se decidió realizar la exéresis quirúrgica de los dientes supernumerarios y en una segunda etapa, la corrección ortodóncica. El tratamiento quirúrgico se realizó sin complicaciones, pues la paciente mostró una evolución postquirúrgica positiva. Luego de la recuperación total del área intervenida, comenzaron los movimientos ortodóncicos, que finalmente permitieron obtener un resultado estético y funcional óptimo.(AU)

A 39 years old female patient, with no medical records, comes to dentistry consulting because of a temporal tooth loss. During the intraoral physical examination the absence of the 13 tooth was corroborated, and the recently exfoliation of a teeth with a considerable diminish of space between the left upper lateral incisor and the left first upper bicuspid were corroborated. The x-rays showed radiopacity, located between the lateral incisor and the first upper bicuspid of the left hemi-arcade, suggesting several dental organs. Due to functional, aesthetic and psychological influencies on the patient, and the presence of a moderated negative bone-teeth discrepancy, it was decided to practice surgical extraction of supernumerary teeth and the orthodontic correction. Surgical treatment was practiced without complications, and the patient showed a good postsurgical evolution. After a total recovery of the affected area, orthodontic movement began. It allowed an optimum aesthetic and functional outcome.(AU)

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.

Characteristics of Supernumerary Teeth in Nonsyndromic Population in an Urban Dental School Setting.

PURPOSE: The purpose of this study was to analyze the clinical records of all patients evaluated for supernumerary teeth at the University of Illinois-Chicago Department of Oral and Maxillofacial Surgery postgraduate clinic from January 1, 2010 to October 31, 2015 to determine the demographics of impacted supernumerary teeth among different ethnicities in the city of Chicago. MATERIALS AND METHODS: A retrospective case series was completed on patients eligible for inclusion in the study who had a diagnosis of at least 1 full bony impacted supernumerary tooth (D7240). Other variables evaluated included date of surgical intervention, age at time of treatment, gender, ethnicity, location and number of supernumerary teeth present, and family history of supernumerary teeth. RESULTS: There were 459 male and 308 female patients (male-to-female ratio, 1.5:1). Patient ages ranged from 4 to 51 years (average, 13.1) at the time of surgery. Five hundred seventy-three patients (74.7%) were of Hispanic descent. Supernumerary teeth were found most frequently in the maxilla (69.9%), specifically in the central incisor region (526 teeth; 51.2%). Of the responding patient sample (258 patients), 53 patients (20.5%) reported a family history of supernumerary dentition. Of these 53 patients who reported a family history of supernumerary dentition, 37 (69.8%) were of Hispanic descent. Most of these Hispanic patients (83.8%) originated from Mexico. CONCLUSIONS: The incidence of supernumerary teeth is higher in male patients (male-to-female ratio, 1.5:1), and these teeth are most frequently found in the maxilla (69.9%), specifically the central incisor region (51.2%). A large percentage of patients (20.5%) also had first-degree relatives with a supernumerary dentition, and this fact might warrant further investigation into the possible genetics responsible for the formation of supernumerary teeth.

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.

A Case of Congenital Supernumerary Teeth in an Ovine Dental Pad.

A rare case of congenital supernumerary teeth, also known as hyperdontia, observed in a healthy 8-month-old female ewe is presented. The congenital defect consisted of the presence of 2 incisor teeth embedded in the lateral areas of the dental pad. The anomaly was found during a routine physical examination and no other congenital abnormalities were found in the patient. No prior congenital abnormalities had been seen in the herd and the study of possible associated teratogenic factors was inconclusive. To the authors' knowledge, this ovine odontogenic abnormality has not been described in the literature and appears to be an extraordinarily rare condition.

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.

Double mesiodens: a review and report of 2 cases.

Mesiodentes are the most frequently encountered supernumerary teeth. Recently, reports of double mesiodens have increased, which may be due to the availability of better diagnostic methods. This article discusses 2 cases of double mesiodens with varying clinical presentations. In addition, the literature related to the etiology, clinical presentation, diagnosis, and management of mesiodentes is reviewed.

Bimaxillary concomitant hypohyperdontia in a 10-year-old child.

Numerical anomalies, either addition or deletion, are quite a common findings in human dentition. However, it is extremely rare to find both hypodontia and hyperdontia simultaneously in the same individual. This condition is referred as concomitant hypohyperdontia (CHH). Aetiology of this condition is still obscure. The prevalence of CHH has been reported to be between 0.002% and 3.1%. This case report highlights a rare occurrence of bimaxillary CHH represented by the absence of both mandibular central incisors and presence of two supernumerary teeth in the maxillary anterior segment. The rarity of such condition of mixed hypodontia as well as hyperdontia in single human dentition prompted the author to report the case.

Bilateral Maxillary Paramolars in an Adolescent.

Paramolars are relatively uncommon supernumerary molars. Limited cases of bilateral maxillary or mandibular paramolars have been reported. This case report describes bilateral maxillary premolars and their management in a 15-year-old girl, whose chief complaint was food lodgment in these regions. After a diagnosis of bilateral maxillary premolars was made and confirmed by orthopantomogram, both of the paramolars were extracted.

The epidemiology of supernumerary teeth and the associated molecular mechanism.

Supernumerary teeth are common clinical dental anomalies. Although various studies have provided abundant information regarding genes and signaling pathways involved in tooth morphogenesis, which include Wnt, FGF, BMP, and Shh, the molecular mechanism of tooth formation, especially for supernumerary teeth, is still unclear. In the population, some cases of supernumerary teeth are sporadic, while others are syndrome-related with familial hereditary. The prompt and accurate diagnosis of syndrome related supernumerary teeth is quite important for some distinctive disorders. Mice are the most commonly used model system for investigating supernumerary teeth. The upregulation of Wnt and Shh signaling in the dental epithelium results in the formation of multiple supernumerary teeth in mice. Understanding the molecular mechanism of supernumerary teeth is also a component of understanding tooth formation in general and provides clinical guidance for early diagnosis and treatment in the future.