Journal of Indian Society of Pedodontics and Preventive Dentistry
Journal of Indian Society of Pedodontics and Preventive Dentistry
                                                   Official journal of the Indian Society of Pedodontics and Preventive Dentistry                           
Year : 2006  |  Volume : 24  |  Issue : 5  |  Page : 33--34

Coexistent partial anodontia and supernumerary tooth in the mandibular arch: A rare case


G Das, Subir Sarkar, B Bhattacharya, N Saha 
 Department of Pedodontics and Preventive Dentistry, Dr. R. Ahmed Dental College & Hospital, Kolkata, West Bengal, India

Correspondence Address:
Subir Sarkar
46/2, B T. Road, Deep Mahal, Kolkata - 700 002
India

Abstract

Coexistent partial anodontia and supernumerary tooth in the lower jaw is a very uncommon condition. Very few cases have been reported in the literature of this condition, etiology of which is still obscure. Presented here is a rare case of simultaneous presence of single supernumerary tooth together with missing permanent central incisor teeth in the lower jaw without any associated systemic condition or syndrome.



How to cite this article:
Das G, Sarkar S, Bhattacharya B, Saha N. Coexistent partial anodontia and supernumerary tooth in the mandibular arch: A rare case.J Indian Soc Pedod Prev Dent 2006;24:33-34


How to cite this URL:
Das G, Sarkar S, Bhattacharya B, Saha N. Coexistent partial anodontia and supernumerary tooth in the mandibular arch: A rare case. J Indian Soc Pedod Prev Dent [serial online] 2006 [cited 2020 Feb 21 ];24:33-34
Available from: http://www.jisppd.com/text.asp?2006/24/5/33/26036


Full Text

 Introduction



Coexistent partial anodontia or, oligodontia or, hypodontia and supernumerary teeth or, hyperdontia is a rare mixed numeric anomalous condition of human dentition. Still rarer is presence of this condition in the same area of dental arches. Very rare is presence of this condition in the mandibular anterior region. The etiopathogenesis of this simultaneous hyper- hypodontia is obscure.[1] Disturbance in migration, proliferation and differentiation of the neural crest cells and interaction between the epithelial and mesenchymal cells during initiation stage of tooth development has been suspected as possible cause.[2] Very few cases have been reported of this condition in the literature. Again most of the reported cases were in the maxillary arches. Brooke and Winter and Camilled each reported a case of missing upper lateral incisor and presence of a midline supernumerary tooth, while Munns Nathanail and Mercer each reported a case of missing upper lateral incisors associated with supernumerary premolars.[3] Amita Sharma reported a non syndrome case of concomitant multiple supernumerary teeth in both maxillary and mandibular arches and missing maxillary permanent left canine in a 12 year old girl.[2] A combination of partial anodontia and supernumerary tooth in the mandibular anterior region has not been found in the available literature except one reported by T. Low in 1977.[3] The rarity of this condition of mixed numerical superiority and inferiority of human dentition in the mandibular incisor region prompted the authors to report the case.

 Case Report



An eight year old female child reported to the department of Pedodontics and Preventive Dentistry, Dr. R. Ahmed Dental College and Hospital, Kolkata with the chief complaint of spaces among lower front teeth. Her family, medical and dental history was non-contributory. General survey and extra oral examination did not reveal any abnormality [Figure 1]. Intra oral examination revealed a mixed dentition stage of developing dentition [Figure 2]. Teeth present in the oral cavity were:

[INLINE:1] Spacings evident in the mandibular anterior region. Presence of a midline supernumerary tooth and absence of permanent central incisor were particularly noted. An orthopantomogram was advised and impressions of both upper and lower arches were made for radiographic evaluation of clinical impressions and record keeping. Orthopantomogram revealed absence of central incisors in the mandibular arches and presence of a conical tooth with incomplete root formation. Other findings in the orthopantomogram were within normal limits considering age of the girl [Figure 3]. Impressions of upper and lower arches were made and casts poured for record [Figure 4].

To ensure optimum function and esthetics a multidisciplinary approach comprising Pedodontist, Orthodontist, Oral Surgeon and Prosthodontist were recommended for the case.

 Discussion



Supernumerary teeth in the labial segment can be classified into three types: Conical, tuberculate and supplemental types.[4] Supplemental types are those which closely simulate adjacent tooth. Incidence of mesiodens varies from 0.15% to 3.0% as studied by Kaler in 1985 among a large population of different ethnic origin.[4] The conical types are located near the midline, often erupt in childhood and have root formation chronologically matched with the teeth in the region.[3] Brook observed that microdontia and hypodontia are significantly associated.[5] The possibility of the conical tooth being microdont mandibular central incisor and associated with hypodontia of mandibular incisor should be considered. Distinct conical shape with no resemblance to an incisor tooth and slower root formation in comparison to adjacent teeth are the two prominent features suggesting that the tooth is not a normal central incisor tooth.

The incidence of hypodontia of the lower central incisor region is 0.41 to 0.5% as observed by Graphen in 1956.[3] In a survey of 2070 individuals he found only 3 cases where both lower central incisors were missing. However, only one report is found in the available literature where a midline supernumerary tooth has occupied the position of missing lower central incisor teeth.[3] An interesting finding in the present case and the only case noted in the available literature has one similarity that both the cases are from south-east Asia. The earlier case was from Kualalampur, Malaysia and the present case is from Kolkata, India. This finding of Geographic location matching may further be investigated in future researches on combined numeric anomalies of human dentition.

References

1Ratna R. Numeric anomalies of teeth in concomitant hypodontia and hyperdontia. J Craniofac Genet Develop Biol 1988;8:245-51.
2Sharma A. A rare non-syndrome case of concomitant multiple supernumerary teeth and partial anodontia. J Clin Pediatr Dent 2001;25:167-9.
3Low T. Hypodontia and Supernumerary Tooth: Report of a case and its Management. Br J Orthodont 1977;4:187-90.
4Randel Luten J Jr, The Prevalence of Supernumerary Teeth in Primary and Mixed Dentitions. J Dent Child 1967;34:346-52.
5Brook AH. Dental anomalies of number, form and size. The Prevalence in British school children. J Assoc Dentist Child 1974;5:37-53.