Abstract
Supernumerary teeth in the premolar region, unlike other supernumeraries, occur more often in the mandible where they are generally of the supplemental type. Occasionally, they are conical or smaller than normal, particularly in the upper premolar regions. They might occur singly or in multiples, be erupted or impacted, but the majority have been found to be unerupted and asymptomatic. The prevalence of supernumerary teeth in the premolar region has been demonstrated to be between 0.01 and 1 percent depending on the population studied. Interestingly, populations from the East or Africa are known to be the most affected. Various theories have been suggested to explain the etiology of supernumerary teeth in general including both genetic and environmental factors. Furthermore, it has been suggested that supernumerary premolar teeth belong to a third (postpermanent) series, developing from extensions of the dental lamina. Several consequences can result from the presence of supernumerary premolars, especially in the mandible, such as cyst formation, transposition, and other clinical scenarios.
Highlights
Introduction ere have been multiple review studies reporting on several aspects of supernumerary teeth [1,2,3,4] with the majority of these studies being case reports
General dental practitioners (GDP) and dental specialists faced with this not uncommon dental anomaly should have the appropriate knowledge and skills to be able to diagnose and manage patients with this condition safely and effectively. erefore, the purpose of this review is to provide the general dental practitioner with an update on all aspects of supernumerary teeth in the premolar region to raise their awareness of this dental anomaly so that the most appropriate approach in the diagnosis and management of patients with supernumerary premolars is followed
Seventy-five percent of supernumerary premolars were determined to be unerupted, and the majority of them appeared asymptomatic [16,17,18]. us, a follow-up radiograph is quite useful for orthodontic patients to detect any unerupted supernumerary premolars that might have an effect throughout the treatment. e mandibular premolar region was found to have the highest frequency of supernumerary teeth in the condition “nonsyndrome multiple supernumerary teeth” [19]
Summary
A literature search was undertaken with PubMed and Ovid Medline databases using the keywords premolar and supernumerary. About 8-9% of all supernumerary teeth occur in the premolar region [1, 4, 5]. Supernumerary teeth in the premolar region, unlike other supernumeraries, occur more frequently in the mandible [1, 2], where the supernumerary teeth are generally of the supplemental type (Figures 1–3) [1, 3, 4]. Supernumerary teeth in the premolar region might occur singly (Figures 1 and 5) or in multiples (Figures 2–4) [14, 15] and be erupted or impacted (Figure 5). It is evident that most of the supernumerary teeth reported in the premolar region have been found in patients from the East or from Africa. Seven supernumerary premolars were found in those six patients, five appeared on the left side, and six were impacted or erupted ectopically. e only other supernumerary teeth seen in this sample were two maxillary fourth molars and one mesiodens. e figures found in this study were not in agreement with what has been reported by many authors, neither in the frequency [1, 4, 21, 22] nor in the order of the affected teeth [1, 21, 23,24,25,26]. e small sample size in this study could possibly explain the difference found and emphasize the use of sufficient numbers to have comparative figures
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