Bilateral supplemental maxillary incisors with both dens invaginatus and dens evaginatus in a non syndromic patient: a rare case report.

Abstract

A 13-year-old boy was reported with complaint of unaesthetic look due to crowding of teeth. Family and medical history was non contributory. Intra oral examination revealed presence of multiple supernumerary anterior teeth resulting into crowding [Table/Fig-1,Table/Fig-2]. Clinical and radiographic (occlusal and orthopentamograph) [Table/Fig-3,Table/Fig-4] examination confirmed the presence of erupted bilateral three supernumerary (supplemental) teeth resembling one central and two lateral incisors teeth in maxilla in non syndromic patient. Radiographically left central incisor presented with both dens invaginatus and dens evaginatus which is uncommon anomaly [Table/Fig-5]. Clinically all supplemental and permanent incisors were visible in the oral cavity. Two supplemental lateral incisors were palatally placed and supplemental central incisor was rotated. Treatment was planned to extract all supplemental teeth followed by orthodontic correction of spacing and diastema. Upon surgical extraction of supplemental teeth, supplemental lateral incisor showed enamel projection at cemento-enamel junction (CEJ) on proximal side for about 2.5 mm, which is uncommon [Table/Fig-6]. The patient didn’t turned up on follow up for the management of chief complaint