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Journal of Indian Society of Pedodontics and Preventive Dentistry Official publication of Indian Society of Pedodontics and Preventive Dentistry
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ORIGINAL ARTICLE
Year : 2014  |  Volume : 32  |  Issue : 1  |  Page : 9-12
 

Prevalence and characteristics of supernumerary teeth in a non-syndromic South Indian pediatric population


1 Department of Pediatric Dentistry, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
2 Department of Conservative Dentistry, ACPM Dental College, Dhule, Maharashtra, India

Date of Web Publication15-Feb-2014

Correspondence Address:
Rajesh T Anegundi
Department of Pediatric Dentistry, SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-4388.127041

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   Abstract 

Background: Supernumerary teeth are one of the most widely reported and significant anomaly in patients affecting the primary and early mixed dentition. Aim: To describe the distribution and characteristics of the supernumerary teeth in South Indian population of paediatric patients. Design: In a 12 year retrospective study, a total of 63,569 patients up to the age of 14 years who visited our department between June 2003 and May 2013 were revised.790 cases of supernumerary teeth were found. Patients were evaluated for age, sex, site, status of dentition, number, position, orientation and type of supernumerary teeth. Statistical analysis was carried out using chi square test. Results: 790 subjects with supernumerary teeth (481 males and 309 females) were detected, revealing male-female ratio of 1.55:1.The most common supernumerary teeth were mesiodens (82.28%), the most common site was the anterior maxilla (92.53%)region. Majority of patients had a single erupted supernumerary oriented straight in the arch. Patients in mixed dentition stage reported with maximum number of supernumerary teeth. Conclusions: The prevalence of supernumerary teeth in non syndromicSouth Indian paediatric population is 1.24% with slight male predilection and conical mesiodens being the commonest.


Keywords: Hyperdontia, mesiodens, polydontison, supernumerary, supplemental teeth


How to cite this article:
Anegundi RT, Tegginmani VS, Battepati P, Tavargeri A, Patil S, Trasad V, Jain G. Prevalence and characteristics of supernumerary teeth in a non-syndromic South Indian pediatric population. J Indian Soc Pedod Prev Dent 2014;32:9-12

How to cite this URL:
Anegundi RT, Tegginmani VS, Battepati P, Tavargeri A, Patil S, Trasad V, Jain G. Prevalence and characteristics of supernumerary teeth in a non-syndromic South Indian pediatric population. J Indian Soc Pedod Prev Dent [serial online] 2014 [cited 2019 Nov 14];32:9-12. Available from: http://www.jisppd.com/text.asp?2014/32/1/9/127041



   Introduction Top


Dentists, in their routine practice are often confronted with developmental anomalies of teeth. The presence of supernumerary teeth is one of the most widely reported and significant anomaly in patients, affecting the primary and early mixed dentition. This may be visible in the oral cavity, or may be revealed as a chance finding on the radiograph or as a cause of an impacted permanent tooth.

Supernumerary teeth are teeth or tooth substance in excess of the usual configuration of twenty deciduous, or 32 permanent teeth. [1] These teeth were first described in 23 and 79 AD. [2]

Supernumerary teeth have been reported both in deciduous and permanent dentition with a male predilection. Supernumerary teeth may occur in any area of the dental arch, may be single or multiple, present unilaterally or bilaterally, malformed morphologically or normal in size and shape, straight or inverted in position and may be erupted or impacted. Cases involving one or two supernumerary teeth show a predilection for the anterior maxilla, followed by the mandibular premolar region. In other regions, differences have been reported in the relative frequency of these teeth. Cases involving multiple supernumeraries (more than five) tend to are most commonly seen the mandibular premolar region. [1]

Multiple supernumerary teeth are usually associated with conditions like cleidocranialdysostosis, Gardner's syndrome,  Ellis-van Creveld syndrome More Details and cleft lip and palate. [3] Supernumerary teeth, whether impacted or erupted may remain in position for years together, without causing any disturbances and clinical manifestations. However, in some cases, they may cause complications like impaction of permanent teeth, delayed or ectopic eruption of adjacent teeth, malocclusions like midline diastema or crowding and formation of cysts with bone destruction and root resorption of adjacent teeth. [4]

Classification



Various theories have been formulated to describe the etiology of supernumerary teeth, which include the atavism theory, dichotomy theory and dental lamina hyperactivity theory as well as genetic and environment factors. Most of the literature on supernumerary teeth supports the dental lamina hyperactivity theory. [2] Available literature from studies conducted in different parts of the world does present with impressive data. However there is no large scale study reported in South Indian pediatric population.

Therefore, the current study was aimed at studying and reporting the prevalence of supernumerary teeth in non-syndromic South Indian pediatric population.


   Materials and Methods Top


The population for the study comprised of patients who visited the Department of Pedodontics and Preventive Dentistry, between June of 2003 and May of 2013. Of the 63,569 patients who visited, 790 consist of 481 boys and 309 girls patients aged between 3 and 14 years and diagnosed as having supernumerary teeth were included for the study. The patients were non-syndromic and free from any disease. The inclusion data gathered was age, sex, gender, number of supernumerary teeth, type and morphology of supernumerary teeth, localization and whether it is erupted or impacted and whether it is straight or inverted.


   Results Top


Of these 790 patients, 481 (60.89%) were males and 309 (39.11%) were females [Graph 1]. The male to female ratio was 1.55:1. Out of 790 patients, 481 patients (60.89%) with supernumerary teeth were in mixed dentition stage, 225 (28.48%) patients in the permanent dentition stage and 84 in the primary dentition stage, which accounts to 10.63%, a significant finding [Graph 2]. A total of 650 (82.28%) patients reported with mesiodens, 66 (8.35%) patients had supplemental type, 15 (1.9%) patients had molariform, 4 (0.51%) patients had tuberculate and 4 (0.51%) patients had odontome type of supernumerary teeth. 51 (6.46%) patients showed combination of various types of supernumerary teeth [Graph 3]. 31 (92.53%) patients had supernumerary teeth in the anterior maxilla, 24 (3.04%) patients had in posterior maxilla and mandible and 11 (1.39%) patients reported with supernumerary teeth in the anterior mandible [Graph 4]. Majority of patients (88.61%) presented with one supernumerary tooth,11.14% patients reported with two supernumerary teeth and only 0.25% patients reported with three supernumerary teeth [Table 1]. 651 patients had erupted supernumerary teeth, 75 patients had impacted supernumerary and remaining patients had both erupted and impacted [Graph 5]. A total of 751 patients had supernumerary teeth, which were oriented straight and the remaining (39) were inverted [Graph 6].
Table1: Distribution of supernumerary by number

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   Discussion Top


Supernumerary teeth are relatively common developmental anomalies encountered in pediatric patients.

The present study included 790 children between 3 and 14 years with primary, mixed and permanent dentitions. Supernumerary teeth have been reported in both males and females. Various studies have described the prevalence and gender predilection of these teeth in different populations. Ersin et al. [5] described the prevalence with a frequency of about 0.10% to 6% in permanent dentition and 0.02-1.9% in the primary dentition. Shah et al. [6] reported that prevalence ranges between 0.3% and 0.8% in the primary dentition and 0.1-3.8% in the permanent dentition and that males are affected approximately twice as often as females.

The study showed a relative male predominance (1.5:1) which is in close agreement with studies conducted by Gábris et al. [7] - (1.4:1); Brook [8] - (1.4:1) and Fernández Montenegro et al. [9] - (1.4:1). However Giancotti A et al and Berrocal et al., found no difference between the sexes. [10],[11]

In this study, supernumerary teeth showed 92.53%, predilection for the premaxilla, which is also seen in many published studies. [12],[13] The lower incisor region showed a prevalence of about 1.39% in our study, in contrast to 2.7% in Yassin and Hamori. [2] The prevalence of supernumerary teeth in posterior segment of maxilla and mandible was 3.04%.

The most common morphology of supernumerary teeth was conical type (82.28%), which is in agreement with various studies. [2],[13],[14],[15],[16] This was followed by supplemental type (8.35%), tuberculate form of supernumerary was reported in about only 0.51% of the studies, which is different from other studies. Interestingly, patients with more than one supernumerary tooth showed different combinations of supernumerary teeth. The odontome type of supernumerary teeth was reported in only about 0.51% of the cases, which is low when compared to study carried out by Rajab and Hamdan, [13] who reported a prevalence of odontome as 6.4%.

The study also interestingly showed 1.9% of molariform type of supernumerary teeth, as compared to other studies where relatively it is a rare finding. [1],[3 ],[4],[ 7]

Supernumerary may occur as a single tooth, or may be more than one in number. In the present study, 88.61% had a single supernumerary tooth, 11.14% had two supernumerary teeth and only 0.25% had more than two supernumerary teeth. These observations are in support with reported studies. [2],[13],[17],[18]

Supernumerary teeth may erupt in the oral cavity, or remain impacted. Supernumerary teeth, impacted or erupted may remain in position for years together, without causing any disturbances and clinical manifestations. However, in some cases, they may cause complications like impaction of permanent teeth, delayed or ectopic eruption of adjacent teeth, malocclusions like midline diastema or crowding and formation of cysts with bone destruction and root resorption of adjacent teeth. [20] These can cause potential harm to the developing occlusion in a child patient, which can be difficult to intervene or may require aggressive treatment at a later stage.

If more than one supernumerary tooth is present, then one of them may be erupted, while the other impacted. In the current study, 82.41% were erupted, 9.49% were impacted and 8.10% were both impacted and erupted.

Majority of the supernumerary teeth are oriented straight in the arch (crown toward the oral cavity) and erupted in the oral cavity. The inverted (root toward the oral cavity) supernumerary teeth are generally impacted. The study also showed the same. 95.06% were oriented straight and 4.94% were inverted. This is in agreement with Liu, Yassin and Hamori and Rajab and Hamdan study. [2],[13],[19] Knowledge about the supernumerary teeth can enable pediatric dentist in early diagnosis, intervention and prevent many possible complications associated with supernumerary teeth.

 
   References Top

1.Scheiner MA, Sampson WJ. Supernumerary teeth: A review of the literature and four case reports. Aust Dent J 1997;42:160-5.  Back to cited text no. 1
    
2.Yassin OM, Hamori E. Characteristics, clinical features and treatment of supernumerary teeth. J Clin Pediatr Dent 2009;33:247-50.  Back to cited text no. 2
    
3.Garvey MT, Barry HJ, Blake M. Supernumerary teeth - An overview of classification, diagnosis and management. J Can Dent Assoc 1999;65:612-6.  Back to cited text no. 3
    
4.Hattab FN, Yassin OM, Rawashdeh MA. Supernumerary teeth: Report of three cases and review of the literature. ASDC J Dent Child 1994;61:382-93.  Back to cited text no. 4
    
5.Ersin NK, Candan U, Alpoz AR, Akay C. Mesiodens in primary, mixed and permanent dentitions: A clinical and radiographic study. J Clin Pediatr Dent 2004;28:295-8.  Back to cited text no. 5
    
6.Shah A, Gill DS, Tredwin C, Naini FB. Diagnosis and management of supernumerary teeth. Dent Update 2008;35:510-2, 514.  Back to cited text no. 6
    
7.Gábris K, Fábián G, Kaán M, Rózsa N, Tarján I. Prevalence of hypodontia and hyperdontia in paedodontic and orthodontic patients in Budapest. Community Dent Health 2006;23:80-2.  Back to cited text no. 7
    
8.Brook AH. Dental anomalies of number, form and size: Their prevalence in British schoolchildren. J Int Assoc Dent Child 1974;5:37-53.  Back to cited text no. 8
    
9.Fernández Montenegro P, Valmaseda Castellón E, Berini Aytés L, Gay Escoda C. Retrospective study of 145 supernumerary teeth. Med Oral Patol Oral Cir Bucal 2006;11:E339-44.  Back to cited text no. 9
    
10.Giancotti A, Grazzini F, De Dominicis F, Romanini G, Arcuri C. Multidisciplinary evaluation and clinical management of mesiodens. J Clin Pediatr Dent 2002;26:233-7.  Back to cited text no. 10
    
11.Leco Berrocal MI, Martín Morales JF, Martínez González JM. An observational study of the frequency of supernumerary teeth in a population of 2000 patients. Med Oral Patol Oral Cir Bucal 2007;12:E134-8.  Back to cited text no. 11
    
12.Bergström K. An orthopantomographic study of hypodontia, supernumeraries and other anomalies in school children between the ages of 8-9 years. An epidemiological study. Swed Dent J 1977;1:145-57.  Back to cited text no. 12
    
13.Rajab LD, Hamdan MA. Supernumerary teeth: Review of the literature and a survey of 152 cases. Int J Paediatr Dent 2002;12:244-54.  Back to cited text no. 13
    
14.Koch H, Schwartz O, Klausen B. Indications for surgical removal of supernumerary teeth in the premaxilla. Int J Oral Maxillofac Surg 1986;15:273-81.  Back to cited text no. 14
    
15.Khandelwal V, Nayak AU, Naveen RB, Ninawe N, Nayak PA, Sai Prasad SV. Prevalence of mesiodens among six- to seventeen-year-old school going children of Indore. J Indian Soc Pedod Prev Dent 2011;29:288-93.  Back to cited text no. 15
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16.Mukhopadhyay S. Mesiodens: A clinical and radiographic study in children. J Indian Soc Pedod Prev Dent 2011;29:34-8.  Back to cited text no. 16
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17.Asaumi JI, Shibata Y, Yanagi Y, Hisatomi M, Matsuzaki H, Konouchi H, et al. Radiographic examination of mesiodens and their associated complications. Dentomaxillofac Radiol 2004;33:125-7.  Back to cited text no. 17
    
18.von Arx T. Anterior maxillary supernumerary teeth: A clinical and radiographic study. Aust Dent J 1992;37:189-95.  Back to cited text no. 18
    
19.Liu JF. Characteristics of premaxillary supernumerary teeth: A survey of 112 cases. ASDC J Dent Child 1995;62:262-5.  Back to cited text no. 19
    
20.Hattab FN, Yassin OM, Rawashdeh MA. Supernumerary teeth: Report of three cases and review of the literature. ASDC J Dent Child 1994;61:382-93.  Back to cited text no. 20
    



 
 
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