Multiple Supernumerary Teeth Research Articles

Metachronous supernumerary teeth in a non-syndromic patient

This paper presents a case of metachronous supernumerary teeth in the mandibular premolar region, following previous removal of a supernumerary tooth and orthodontic treatment, in an adolescent patient following an interval of eight years. Individual or multiple supernumerary teeth can develop anywhere in the jaws, although it is unusual for sequential supernumerary teeth to develop in late adolescence and after orthodontic treatment, particularly in non-syndromic patients. The management of asymptomatic supernumerary teeth should fully consider the risks and benefits of surgical removal. Clinicians should remain aware of the possibility of subsequent supernumerary removal, and the presented case emphasises the importance of radiographic monitoring if subsequent orthodontic treatment is being considered following previous identification of supernumerary teeth.

Custom‐made surgical guide with mucoperiosteal flap elevation function for the removal of multiple impacted supernumerary teeth: A case report

AbstractBackgroundSurgical guides manufactured with computer‐aided design/computer‐aided manufacturing (CAD/CAM) technology are effective tools for oral surgeries.Case presentationA new type of surgical guide with mucoperiosteal flap elevation function was custom designed, printed, and applied for the safe and accurate removal of six impacted supernumerary teeth in a 12‐year‐old male patient. The surgical guides were designed with access holes corresponding to the positions of the impacted teeth and the elevation structures of the mucoperiosteal flap.ConclusionThe novel custom‐made surgical guide system introduced in the present report was successfully utilized for minimally invasive teeth removal procedures.

Treatment and genetic analysis of multiple supernumerary and impacted teeth in an adolescent patient

BackgroundMultiple supernumerary teeth, combined with numerous impacted teeth, can lead to various malocclusions, posing significant treatment challenges. While certain genes associated with syndromic cases of multiple supernumerary and impacted teeth have been identified, the etiologies of non-syndromic cases still largely remain elusive.Case presentationHere, we report a treatment of a 12-year-old boy who presented with 10 supernumerary teeth and 6 impacted teeth, accompanied by a genetic analysis to explore the underlying etiology. During the treatment, fifteen teeth were extracted, and various skilled techniques, including the closed-eruption technique and the application of by-pass arches, were utilized. Post-treatment, traction was successful for all the impacted teeth, without any tooth mobility or reduction in gingival height. Space closure, well-aligned teeth, and excellent functional occlusion were achieved. Furthermore, comprehensive genetic analysis was conducted through whole-exome sequencing on the patient and his parents, which revealed a potential link between the patient’s numerous supernumerary teeth and abnormal mineralization. Notably, the p.Ser496Pro variant in the TCF7L2 gene was identified as a potential candidate variant in this patient.ConclusionsOverall, our findings not only report the treatment of a rare case involving multiple supernumerary and impacted teeth but also offer valuable insights into the molecular basis of supernumerary teeth.

Three-dimensional evaluation of dental characteristics in patients with Cleidocranial dysplasia

BackgroundCleidocranial dysplasia (CCD) is an autosomal dominant hereditary disorder. Besides skeletal abnormalities, CCD is often associated with dental complications, such as multiple supernumerary teeth and permanent teeth impaction or delayed eruption.MethodsSupernumerary teeth of axial, sagittal and coronal CBCT view was characterized in detail and 3D image reconstruction was performed. Number and location of teeth, morphology of supernumerary teeth, positional relationship between supernumerary and adjacent permanent teeth, direction of supernumerary teeth in CCD patients were analyzed.ResultsThe mean age of the 3 CCD patients in this study was 16.7 years. Among 36 supernumerary teeth, the majority of them were identified as apical side located and lingual side located. Normal orientation was the most common type in this study, followed by sagittal orientation, and horizontal orientation. Horizontal orientation teeth were all distributed in the mandible. Supernumerary teeth exhibited significantly shorter crown and dental-root lengths, as well as smaller crown mesiodistal and buccolingual diameters (P < 0.01). There was no difference in the number of supernumerary teeth between the maxilla and mandible, and the premolars region had the largest number of supernumerary teeth and the incisor region had the smallest number.ConclusionsThis study compares number and location of teeth, morphology of supernumerary teeth, positional relationship between supernumerary and adjacent permanent teeth and direction of supernumerary teeth, this study also provides a reference for the comprehensive evaluation of CCD patients before surgery.

Cleidocranial dysplasia associated with dentigerous cyst-review of literature and case report of two siblings.

Cleidocranial dysplasia (CCD) is a developmental anomaly of the skeleton and teeth which may be inherited, be transmitted as dominant characteristics in either male or female or even appear spontaneously. A case was reported in the department of oral medicine and radiology of two sisters age 17 and 19 years old with a chief complaint of milk teeth not falling since childhood. They presented specific physical and oral findings in common which suggested the idea of an undiagnosed syndrome. The sisters showed CCD characteristics including short stature (4 feet) and frontal bone resorption indicating delayed closure of fontanels. The stature is moderately shortened with the neck appearing long and narrow and the shoulders markedly dropped. Dental abnormalities such as retention of primary dentition, multiple supernumerary teeth, and delayed eruption of permanent dentition. OPG showed the presence of multiple impacted permanent and supernumerary teeth with radiolucency involving the crowns of impacted teeth revealing a cystic lesion. Lateral cephalogram also revealed the presence of multiple impacted teeth. The provisional diagnosis of CCD with dentigerous cyst was given. The enucleation of cyst was done and submitted for histopathological examination. Histopathologically, the soft tissue section suggested the features of dentigerous cyst. The final diagnosis of CCD associated with dentigerous cyst was confirmed.

Multiple supernumerary teeth causing permanent tooth impaction: A case report

Multiple supernumerary teeth causing permanent tooth impaction: A case report

Surgical and Orthodontic Management of Multiple Supernumerary Teeth Associated with Impacted Permanent Teeth: A Case Report

Background: Clinical problems are frequently detected when there are various irregularities in the number, structure, quantity, size, and eruption of the teeth. Supernumerary teeth can be found in almost any part of the dental arch, and because they are typically asymptomatic, they are frequently found by radiographic screening. Case report: The existence of the supernumerary teeth is the most frequent reason for impacted permanent teeth. This article describes the surgical and orthodontic treatment of a 20-year-old female with many supernumerary teeth and an impacted permanent tooth. All supernumerary teeth in the maxillary arch were extracted as part of the patient's treatment, and then the maxillary teeth were aligned using fixed appliances. The mandibular arch is left untreated, as the surgical removal of mandibular supernumerary teeth could damage the inferior alveolar nerve and result in numbness in the lower lip. Conclusion: In this case, we removed the extra teeth and used orthodontic traction to bring the remaining teeth into the proper position. After the procedure, the cosmetic outcome was greatly improved, and the patient's confidence increased.

Continuous supernumerary teeth development in cleidocranial dysplasia post-surgical extraction – A novel case report

The diagnosis of Cleidocranial dysplasia is approached via clinical features, genetic testing, and imaging. CCD includes delayed or non-closure of cranial sutures the presence of bulging anterior fontanelle and multiple supernumerary teeth. We report two twin sisters presenting all CCD characteristics but surprisingly post-extraction of supernumerary teeth they both developed newly formed dental buds.

Multiple supernumerary teeth: a sign of an underlying syndrome?

Supernumerary teeth can be an important sign for early diagnosis of an underlying syndrome, and in some circumstances, may be one of the only presenting features. Dentists are best placed to detect supernumerary teeth and therefore, it is important to understand the syndromes associated with them to aid early diagnosis of any associated syndromes. Craniofacial, ophthalmological and gastro-intestinal findings are just a few of the characteristics that may cause a dentist to suspect an underlying genetic disorder. Although it is not within the scope for dentists to diagnose these rare associated syndromes, early referral to the general medical practitioner may in turn help patients access the interdisciplinary management they may need. CPD/Clinical Relevance: An awareness of the signs and symptoms of syndromes associated with supernumerary teeth can aid early diagnosis.

Incidental finding of impacted supernumerary teeth in cone-beam computed tomography 3D

Objectives: To evaluate the value of cone-beam CT (CBCT) in the diagnosis and orientation of impacted supernumerary teeth in the dental arches.&#x0D; Case Report: A 50 year old man came to the Udayana University Hospital with the chief complaint of missing bilateral posterior teeth of the mandible and wanted to make denture. Before the treatment begin, a panoramic radiographic examination was performed. The panoramic image shows an impacted supernumerary teeth on the inferior from lower right premolar. Due to the inability to determine the precise position of those teeth within the mandible and the possible vital structures surrounding, a CBCT imaging was taken. Examination of the images from the CBCT shows an impacted supernumerary teeth in the area of teeth 44 and 46.&#x0D; Conclusion: The position of the supernumerary teeth is varied in the mandible, and often causes permanent dentition complications. In this case CBCT imaging two supernumerary teeth were found in the tooth area 44-45 and 45-46. apical of the two germ teeth appear to be fully formed. Supernumerary crowns between teeth 44-45 inclined buccally &amp; between teeth 45-46 lingually. CBCT is crucial for exact localization, for treatment planning, and for the surgical approach in cases of multiple supernumerary teeth.

Management of Multiple Supernumerary Teeth Followed by Fixed Appliance Therapy: A Case Report

Management of Multiple Supernumerary Teeth Followed by Fixed Appliance Therapy: A Case Report

Heterozygous Variants in FREM2 Are Associated with Mesiodens, Supernumerary Teeth, Oral Exostoses, and Odontomas

Supernumerary teeth refer to extra teeth that exceed the usual number of dentitions. A mesiodens is a particular form of supernumerary tooth, which is located in the premaxilla region. The objective of the study was to investigate the genetic etiology of extra tooth phenotypes, including mesiodens and isolated supernumerary teeth. Oral and radiographic examinations and whole-exome sequencing were performed on every patient in our cohort of 122 patients, including 27 patients with isolated supernumerary teeth and 94 patients with mesiodens. A patient who had multiple supernumerary teeth also had odontomas. We identified a novel (c.8498A>G; p.Asn2833Ser) and six recurrent (c.1603C>T; p.Arg535Cys, c.5852G>A; p.Arg1951His, c.6949A>T; p.Thr2317Ser; c.1549G>A; p.Val517Met, c.1921A>G; p.Thr641Ala, and c.850G>C; p.Val284Leu) heterozygous missense variants in FREM2 in eight patients with extra tooth phenotypes. Biallelic variants in FREM2 are implicated in autosomal recessive Fraser syndrome with or without dental anomalies. Here, we report for the first time that heterozygous carriers of FREM2 variants have phenotypes including oral exostoses, mesiodens, and isolated supernumerary teeth.

Rare Genetic Variants in Human APC Are Implicated in Mesiodens and Isolated Supernumerary Teeth

The activation of Wnt/β-catenin signalling is a prerequisite for odontogenesis. APC, a member of the AXIN-CK1-GSK3β-APC β-catenin destruction complex, functions to modulate Wnt/β-catenin signalling to establish regular teeth number and positions. APC loss-of-function mutations are associated with the over-activation of WNT/β-catenin signalling and subsequent familial adenomatous polyposis (FAP; MIM 175100) with or without multiple supernumerary teeth. The ablation of Apc function in mice also results in the constitutive activation of β-catenin in embryonic mouse epithelium and causes supernumerary tooth formation. The objective of this study was to investigate if genetic variants in the APC gene were associated with supernumerary tooth phenotypes. We clinically, radiographically, and molecularly investigated 120 Thai patients with mesiodentes or isolated supernumerary teeth. Whole exome and Sanger sequencing identified three extremely rare heterozygous variants (c.3374T>C, p.Val1125Ala; c.6127A>G, p.Ile2043Val; and c.8383G>A, p.Ala2795Thr) in APC in four patients with mesiodentes or a supernumerary premolar. An additional patient with mesiodens was compound as heterozygous for two APC variants (c.2740T>G, p.Cys914Gly, and c.5722A>T, p.Asn1908Tyr). Rare variants in APC in our patients are likely to contribute to isolated supernumerary dental phenotypes including isolated mesiodens and an isolated supernumerary tooth.

SURGICAL EXPOSURE OF TEETH IN CLEIDOCRANICAL DYSPLASIA UNDER PROCEDURAL SEDATION:- CASE REPORT

Cleidocranial Dysplasia (CCD) is a rare autosomal dominant condition which is mainly characterised by skeletal abnormalties like hypoplastic or aplastic clavicles, increase in transverse diameter of the cranium, delayed closure of fontanelles with presence of open sutures and skeletal changes in maxilla and mandible. 2,4 These patients usually presents with delayed exfoliation of deciduous teeth, delayed or failed eruption of the permanent dentition with multiple supernumerary teeth, protruding mandible and mid- face retrusion.2 We present a case report of a 16 year old girl undergoing multiple surgical exposure of impacted permanent teeth under conscious sedation so as to move them in normal occlusion with orthodontic traction

Suspected Endodontic Failure in a Patient with Cleidocranial Dysplasia: A Case Report

A patient’s medical history and related dental manifestations can significantly contribute to confounding signs and symptoms leading to a diagnostic challenge. An 18-year-old female patient presented with persistent radiographic radiolucency associated with the apex of a previously treated tooth (tooth 9); asymptomatic apical periodontitis and endodontic failure were suspected. This report presents how a patient’s condition of cleidocranial dysplasia had a profound effect on her dental history, which included the presence of multiple supernumerary teeth. Extensive surgical intervention during the patient’s childhood was required to remove the supernumerary teeth, which resulted in an endodontic misdiagnosis in her adult life. After clinical and radiographic examination, the patient was diagnosed with a periapical scar. Periapical fibrous scars have a prevalence of between 2.5% and 12% and are a rare healing process with fibrous tissue after surgical and nonsurgical interventions. This report describes the diagnosis and pathophysiology of fibrous scars, including their risk factors and long-term monitoring approaches.

Orthodontic management of multiple supernumerary teeth in a non-syndromic patient: A case report

Orthodontic management of multiple supernumerary teeth in a non-syndromic patient: A case report

A case report of multiple supernumerary teeth: Post-permanant dentiton or hyperactivity of dental lamina

Supplementary teeth in simple terms could be be defined as those supernumerary teeth which are well aligned in the arch resembling the normal anatomical structures of teeth. There has been evidences of supplementary premolars and molars since from beginning of the civilization. According to Darwin’s theory of evolution which stated that during the course of humans evolution the organs which do not have greater use in regular became vestigial which included the appendix, tail bone, fourth molar. Supernumerary teeth often remain asymptomatic, and only get diagnosed incidentally during a routine dental visit on radiographs. Nevertheless, various complications have been reported in literature related to supernumerary teeth such as disturbed eruption, malpositioning or rotation, root resorption of neighbouring teeth, and development of dentigerous cysts in impacted supernumeraries. Root resorption of neighbouring teeth can be radiographically diagnosed in up to 22.8% of the cases. Here we report an unusual case of multiple supernumerary teeth in a non-syndromic patient of African native.

Identification of a novel missense mutation in non-syndromic familial multiple supernumerary teeth

ObjectiveThis study intended to evaluate the involvement of genetic factors in the etiology of non-syndromic multiple supernumerary teeth. DesignWe filtered the single nucleotide polymorphisms (SNPs) of the proband and his mother with similar phenotypes through whole-genome sequencing (WGS). By integrating multiple databases related to human genome mutations and disease information for mutation annotation, we excluded the SNPs of people without supernumerary teeth. Subsequently, the bioinformatics analysis tools (Sorting Intolerant From Tolerant (SIFT) < 0.05, Polymorphism Phenotyping (PolyPhen) > 0.90) were used to screen out the most correlated SNPs of the disease, besides, Gene Ontology (GO) analysis (P<0.05, FDR<0.05) and Sanger sequencing was applied to further verify the candidate pathogenic mutation point. ResultsA novel heterozygous variant in fer-1 like family member 6 (FER1L6) gene likely denoted pathogenicity in non-syndromic familial multiple supernumerary teeth. We identified a cohort of 3499 non-synonymous SNPs (nsSNPs), and only 142 nsSNPs with the score of SIFT < 0.05 and PolyPhen > 0.90 were retained. Then we got 54 nsSNPs from 31 candidate genes through GO analysis. Sanger sequencing revealed a missense variant in exon 31 of the FER1L6 gene, causing a transition from guanine to adenine in position 1447 of protein kinase C conserved region 2. ConclusionsWe identified a novel heterozygous chromosome 8q24.13 mutation of FER1L6, which was a new mutation site identified in non-syndromic familial multiple supernumerary teeth through genetic analysis of a Chinese family.

Mesiodens- A Report of Two Cases

Teeth more than normal in number are termed as supernumerary. The presence of multiple supernumerary teeth is termed ‘mesiodentes’. Supernumerary tooth usually results in oral problems such as malocclusion, food impaction, poor aesthetics, and cyst formation. This paper presents a case report on the successful management of mesiodens and mesiodentes.

Retention of Central Incisors Caused by Four Supernumerary, Molariform Teeth in A Non-Syndromic Patient

The presence of supernumerary teeth is one of the most common factors that can alter the normal eruption pattern. We present here a rare phenomenon of four, molariform mesiodentes in a systemically healthy, non-syndromic patient, with non-contributory family history, causing delayed eruption of permanent, upper, central incisors. Multiple supernumerary teeth can be an important component of distinctive disorders and a valuable clue for their early diagnosis. However, this case highlights the importance of non-hereditary factors in the pathogenesis of multiple supernumerary teeth in a non-syndromic patient.