|Year : 2012 | Volume
| Issue : 2 | Page : 113-115
Supernumerary teeth: Review of case series
Vijaykumar G Biradar1, Surekha M Angadi2
1 Department of Oral and Maxillofacial Pathology, MIDSR Dental College & Hospital, Latur, Maharastra, India
2 Department of Oral Medicine and Radiology, MIDSR Dental College & Hospital, Latur, Maharastra, India
|Date of Web Publication||4-Sep-2012|
Vijaykumar G Biradar
Department of Oral and Maxillofacial Pathology, MIDSR Dental College & Hospital, Latur, Maharastra
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Supernumerary teeth are the teeth present in addition to the normal set of teeth. They may be single, multiple, unilateral or bilateral, erupted, or unerupted and in one or both jaws and may or may not be associated with other disease or syndrome. This article reviews case series of supernumerary teeth with no associated disease or syndromes.
Clinical Relevance to Interdisciplinary Dentistry
- Multidisciplinary approach is necessary to meet the treatment challenges of supernumerary teeth.
- Supernumerary teeth can be managed either by removal/ endodontic/ orthodontic therapy or by maintaining them in the arch and frequent observation.
- Removal of supernumerary teeth is recommended where there is compromised esthetic and functional status.
Keywords: Etiology, management, nonsyndromic, supernumerary teeth
|How to cite this article:|
Biradar VG, Angadi SM. Supernumerary teeth: Review of case series. J Interdiscip Dentistry 2012;2:113-5
| Introduction|| |
A supernumerary tooth is an additional entity to the normal series and is seen in all the quadrants of the jaw.  The presence of supernumerary teeth is a dental anomaly of patterning and morphogenesis. Patterning alterations in human dentition often occur and are characterized by alterations in the number, size, and shape of the teeth. Supernumerary teeth are developmental alterations of number and morphology that result in the formation of teeth in excess of the usual number.  Supernumerary teeth may occur as single (76-86%) double (12-73%) or multiple (<1%), unilaterally or bilaterally, and in one or both jaws.  The prevalence of supernumerary teeth in permanent teething oscillates from 0.5-3.8%, in comparison with 0.3-0.6% in primary teething. Supernumerary teeth appear with a higher frequency in males than in females, with a 2:1 ratio. Supernumerary teeth, also called hyperdontia, occur in both dentitions, unilaterally or bilaterally, and in one or both jaws. Multiple supernumerary teeth are in individuals with no other associated diseases or syndromes.  Supernumerary teeth are most frequently located in the maxillary incisor region (64.3%) with mesiodens accounting for 32.4% of such presentation.  A mesiodens is the most frequent type of supernumerary tooth. The frequency and prevalence of supernumerary teeth according to dental group is given in [Table 1]. 
|Table 1: Frequency and prevalence of the supernumerary teeth according to dental group|
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0The development of supernumerary teeth is not clear. It may be due to dichotomy of tooth bud or due to hyperactivity theory, suggesting that they are formed as a result of local independent, conditional hyperactivity of dental lamina. 
Classification of supernumerary teeth may be on the basis of position and morphology. Positional variations include: 
Mesiodens: Present in the incisor region
- Paramolar: Present beside a molar
- Distomolar: Present distal to the last molar
- Parapremolar: Present beside a premolar
Based on the morphology they can be of four types : ,
- Conical: Peg shaped teeth
- Tuberculate: Made of more than one cusp or tubercle. They are barrel shaped, usually invaginated
- Supplemental: Resemble normal teeth may incisor, premolar or molar
- Odontome: Does not resemble any teeth but is only a mass of dental tissue.
Supernumerary teeth may lead to delayed or noneruption, displacement of permanent teeth, resorption, or malformation of adjacent roots, and cystic formation (rarely). 
Clinical and radiographic identification of all the teeth is very important for a good treatment planning. It may be difficult to formulate an ideal treatment with supernumerary teeth, but an effort can definitely be made. Treatment may vary from just extraction of supernumerary teeth or extraction followed by orthodontic correction to establish a good occlusion. In particular, there are two approaches for the extraction of mesiodens. Early extraction (before the radicular formation of permanent incisors) and late extraction (when permanent incisors have completed their formation). Early extraction favors the eruption of permanent incisors, prevents the loss anterior space in the dental arch, and averts further complications of cystic (follicular cyst) or pulpal (rhizolysis of permanent incisor) nature. However, in cases where the supernumerary tooth does not cause any symptoms or when there is an elevated size of damaging the development of permanent tooth it is advisable to avoid the therapeutic approach and instead adhere to periodic clinical and radiologic examination. 
| Case Series|| |
The data collected on the basis of age at diagnosis, sex, location, and type of tooth associated, unilateral/bilateral occurrence, who presented to the outpatient Department of Dental college and Hospital, between March 2011 and December 2011. Clinical diagnoses are tabulated in [Table 2].
| Discussion|| |
The 10 patients with diagnosed cases of supernumerary teeth were evaluated statistically on the above-mentioned criteria [Table 2]. Of the total 10 patients, 80% were male and 20% were female, 70% were in maxilla and 30% were in mandible and 40% were mesiodens [Figure 1]a-d, 30% para-premolar [Figure 2]a-c (among them 10% were unilateral para-premolar, 20% bilateral para-premolar), and 30% para-molar [Figure 3]a-c (of which 20% were unilateral para-molar and 10% bilateral para-molar).
In our case series, the proportion of supernumerary teeth in relation to sex was more prevalent in men, maxillary jaw was more involved than mandible, mesiodens were the most frequent group of supernumerary teeth followed by para-premolar and para-molar with similar results reported by other authors. ,,,
In our case series, most of the patients complained of food lodgment, trauma to the soft tissues, displacement, esthetic problem, and malocclusion. So, extraction was advised as a treatment plan followed by further necessary correction to avoid complications.
| Conclusion|| |
Supernumerary teeth can present in any region of the oral cavity. These may erupt or remain impacted and may lead to various complications. Though the occurrence of para-molars is rare, clinicians should be aware of their presence and associated problems in order to formulate a sound treatment plan after through clinical and radiographic investigations, to meet the challenges.
| References|| |
|1.||Rajendran R. Developmental disturbances of oral and paraoral structures. In: Rajendran R, Shivapathsundaram S, (editors). Shafer's Text book of Oral Pathology, 5 th ed. New Delhi: Elsevier; 2006. p. 64-5. |
|2.||Küchler EC, Costa AG, Costa Mde C, Vieira AR, Granjeiro JM. Supernumerary teeth vary depending on gender. Braz Oral Res 2011;25:76-9. |
|3.||So LL. Unusual supernumerary teeth. Angle Orthod 1990;60:289-92. |
|4.||Varela M, Arrieta P, Ventureira C. Non-syndromic concomitant hypodontia and supernumerary teeth in an orthodontic population. Eur J Orthod 2009;31:632-7. |
|5.||Scheiner MA, Wayne J. Sampson. Supernumerary teeth: A review of the literature and four case reports. Aust Dent J 1997;42:3. |
|6.||Fernández Montenegro P, ValmasedaCastellón E, BeriniAytés L, Gay Escoda C. Retrospective study of 145 supernumerary teeth. Med Oral Patol Oral Cir Bucal 2006;11:E339-44. |
|7.||Shah A, Gill DS, Tredwin C, Naini FB. Diagnosis and management of supernumerary teeth. Dent Update 2008;35:510-20. |
|8.||Parolia A, Kundabala M, Dahal M, Mohan M, Thomas MS. Management of supernumerary teeth. J Conserv Dent 2011;14:221-4. |
|9.||Sood PB, Patil B, Godhi S, Shetty DC. Multiple supernumerary teeth and odontoma in the maxilla: A case report. Contemp Clin Dent 2010;1:45-6. |
[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2]