|Year : 2011 | Volume
| Issue : 4 | Page : 320-322
Differential expressions of bilaterally unerupted supernumerary teeth
S Masih, HS Sethi, N Singh, AM Thomas
Department of Pediatric and Preventive Dentistry, Christian Dental College, CMC, Ludhiana, Punjab, India
|Date of Web Publication||21-Oct-2011|
H S Sethi
Department of Pediatric and Preventive Dentistry, Christian Dental College, CMC, Ludhiana, Punjab
Source of Support: None, Conflict of Interest: None
| Abstract|| |
This article presents a case of bilateral unerupted supernumerary teeth in the mandibular premolar region. Surgical removal of the right-sided supernumerary tooth had to be carried out as it was impeding the eruption of the mandibular first premolar. However, its supernumerary antimere, lay dormant.
Keywords: Bilateral, premolars, supernumerary, unerupted
|How to cite this article:|
Masih S, Sethi H S, Singh N, Thomas A M. Differential expressions of bilaterally unerupted supernumerary teeth. J Indian Soc Pedod Prev Dent 2011;29:320-2
|How to cite this URL:|
Masih S, Sethi H S, Singh N, Thomas A M. Differential expressions of bilaterally unerupted supernumerary teeth. J Indian Soc Pedod Prev Dent [serial online] 2011 [cited 2020 Feb 28];29:320-2. Available from: http://www.jisppd.com/text.asp?2011/29/4/320/86379
| Introduction|| |
Supernumerary premolars represent between 8%  of all supernumerary teeth. They are more likely to develop in the mandible than in the maxilla and usually resemble the normal premolars in shape and size. Supernumerary premolars occur three times more in males than in females, indicating a sex-linked inheritance, with the highest frequency of occurrence in the mandibular premolar region (74%). They are also the most common supernumerary teeth in the mandibular arch (7%).  Supernumerary premolar locations are predominantly lingual. The buccally located ones are partially or completely erupted. The majority of the lingually located ones are in the alveolar bone. Seventy-five percent of these teeth are impacted, unerupted, and generally asymptomatic, and the majority are of a supplemental type. 
Bodin, Julin, and Thomsson  reported that only 2% of the supernumerary premolars exhibited any pathological changes and indicated that these teeth should be left untreated rather than risk surgical damage.
Removal of unerupted supernumeraries involves the risk of damage to the adjacent structures and a decision should be made whether to remove or monitor them. Early surgical intervention is recommended when the supernumerary is causing problems, such as, hindering the eruption or malposition of permanent teeth.
This article reports a case of bilaterally present supernumerary premolars where the surgical removal of the right-sided supernumerary had to be carried out as it was obstructing the eruption of the mandibular first premolar.
| Case Report|| |
A 13-year-old Indian male presented to the Department with a chief complaint of mild pain in the right side mandibular molar region since four days. On the same side, the first premolar was found to be missing [Figure 1]. There was no history of any tooth extraction in the past. A radiograph was taken to aid in the diagnosis. It revealed a shallow pocket, which was managed with local prophylaxis.
A radiographic examination revealed that a supplemental supernumerary tooth was obstructing the eruption of the mandibular first premolar. An orthopantamogram [Figure 2] was then taken, which revealed another supernumerary tooth present between the roots of the premolars on the contralateral side. The occlusal radiograph demonstrated the lingual position of the supernumerary tooth in relation to the permanent locked tooth. The patient's medical history was insignificant. Radiographic investigations of the parents and the sibling were undertaken to rule out the hereditary component.
It was decided to surgically remove the supernumerary tooth, to assist the eruption of the mandibular first premolar. The supernumerary tooth on the contralateral side lies dormant and is under observation. At the end of a regular eight-month follow-up period, the premolar was seen to erupt into the oral cavity [Figure 3], while the supernumerary tooth on the contralateral side was still at the same stage and no pathology could be detected. This one is still under follow-up.
|Figure 3: Postoperative view, after eight months, showing erupted premolar|
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| Discussion|| |
Cases of bilateral supplemental premolar teeth developing later than their counterparts have been reported in literature. Reports have demonstrated that supernumerary premolar teeth develop approximately seven to eleven years after normal development  and it appears that this case may be a similar example.
Supernumerary premolars are reported to have a wide range of expressions. A majority of these have been found to lie dormant between the roots of permanent premolars and molars as reported by Solares et al.  However, cases have been reported where these teeth have hindered the eruption of some permanent teeth. Scanlan and Hodges  reported a case in which supernumerary teeth had blocked the eruption of second permanent mandibular molars. Hyun et al. have also reported a case in which the supernumerary premolar had led to root resorption of an adjacent tooth.
In this case, the bilaterally impacted supernumerary premolars presented with an obstruction to the eruption of the first premolar on the right side, while on the contralateral side, it lay dormant between the roots of the premolars.
When supernumerary teeth are discovered, a decision needs to be made whether to remove or monitor them. Surgical removal of impacted teeth involves the risk of damage to the adjacent structure, and therefore, a decision needs to be made with regard to the surgical risks and the benefits of removal.
In this case, it was decided to remove the right side supernumerary tooth, as this had led to the obstruction of eruption of the first mandibular premolar. Eventually, this resulted in the eruption of the locked tooth. However, on the other side, the occlusion had developed normally. Therefore, a decision was made to leave the supernumerary tooth and continue to monitor the patient with a periodical radiographic examination.
| References|| |
|1.||Nazif MM, Ruffalo RC, Zullo T. Impacted supernumerary teeth: A survey of 50 cases. J Am Dent Assoc 1983;106:201-4. |
|2.||Solares R, Romero MI. Supernumerary premolars: A Literature Review. Pediatr Dent 2004;26:450-8. |
|3.||Bodin I, Julin P, Thomsson M. Hyperdontia I. Frequency and distribution of supernumerary teeth among 21,609 patients. Dentomaxillofac Radiol 1978;7:15-7. |
|4.||Bowden DE. Post-permanent dentition in the premolar region. Br Dent J 1971;131:113-6. |
|5.||Scanlan PJ, Hodges SJ. Supernumerary premolar teeth in siblings. Br J Orthod 1997;24:297-300. |
|6.||Hyun HK, Lee SJ, Ahn BD, Lee ZH, Heo MS, Seo BM, et al. Nonsyndromic multiple mandibular premolars. J Oral Maxillofac Surg 2008;66:1366-9. |
[Figure 1], [Figure 2], [Figure 3]
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|[Pubmed] | [DOI]|