SUPERNUMERARY PREMOLARS IN MAXILLA AND CONCRESCENCE OF ROOTS – case report
The presence of supernumerary teeth is not uncommon in the general population. Supernumerary teeth (hyperodontia) appear more in permanent dentition. Supernumerary teeth which are in the premolar region occur more often in the mandible with different shape and size. They might occur singly or in multiples, be erupted or impacted. The reason of hyperodontia is still unknown. There are a lot of theories. Various theories have been suggested to explain the etiology of supernumerary teeth in general including both, the genetic theory and environmental factors. Furthermore, it has been suggested that supernumerary premolar teeth belong to a third (postpermanent) series. Proliferation of dental lamina has been implicated. The presence of supernumerary teeth usually is connected with some disease or syndromes. Treatment of hyperodontia depends on the area where supernumerary teeth occur. This article presents a case report of an 11-year-old girl with hyperodontia of the first premolar, erupted palatinally in the left side of maxilla. This is supplemental tooth that looks like the permanent premolar. The orthopantomogram and 3D radiograph showed a big possibility of concrescence of both premolars. To make a definitive diagnosis and a plan for orthodontic treatment, OPG and 3D radiograph were crucial.
Keywords: supernumerary teeth, concrescence, OPG, 3D radiograph, orthodontic treatment
iterature. J Dent (Tehran) 2010 Winter; 7(1):41-9.
2 .Garvey MT, Barry HJ, Blake M. Supernumerary teeth -an overview of classification, diagnosis and management.
J Can Dent Assoc. 1999; 65:612-16.
3. Schmuckli R, Lipowsky C, Peltomaki T. Prevalence and morphology of supernumerary teeth in the population of
a Swiss community. Short communication. Schweiz Monatsschr Zahnmed. 2010; 120(11): 987- 93.
4. Howard RD. The unerupted incisor. A study of the postoperative eruptive history of incisors delayed in their
eruption by supernumerary teeth. Dent Pract Dent Rec1967; 17: 332-41.
5. Arathi R, Ashwin R. Supernumerary teeth: a case report. J Indian Soc. Pedod. Prev Dent. 2005 Jun; 23(2):103-5.
6. S. V. Hegde and A. K. Munshi. ”Late development of supernumerary teeth in the premolar region: a case
report”, Quintessence International, vol. 27, no.7, pp.479-481, 1996.
7. P.J. Scanlan and S.J. Hodges. Supernumerary premolar teeth in siblings. British Journal of Orthodontics, vol. 24,
no.4, pp. 24297-24300, 1997.
8. L. K. Rubenstein , S. J. Lindauer, R. J. Issacson and N. Germane, ”Development of supernumerary premolars in
an orthodontic population”, Oral Surgery, Oral Medicine ,Oral Pathology, vol. 71, pp. 392-395, 1991.
9. Bondemark L, Jepson M, Lindh - Ingildsen L, et al. Incidental findings of pathology and abnormality in
Pretreatment orthodontic panoramic radiographs. Angle Orthod.2006; 76: 98-102.
10. R.P.Anthonappa, N.M.King and A.B.M.Rabie. ”Aetiology of supernumerary teeth: a literature review”,
European Archives of Pediatric Dentistry, vol.14, no.5, pp.279-288, 2013.
11. K. Khalaf, “Supernumerary teeth- review of aetiology, sequel, diagnosis and management. Part II,
“International Journal of Advanced Research, vol.4, no.11, pp. 1363-1375, 2016.
12. E .C. Stafne, “Supernumerary teeth”, Dental Cosmos, vol. 74, pp. 653-659, 1932.
13. C. Price and G. S. Hoggins. “A category of supernumerary premolar teeth”. British Dental Journal, vol.126, pp.
14. F. A. C. Oehlers, “Postpermanent premolars”, British Dental Journal, vol.93, pp.157-158, 1952.
15. J .J. W. Breckon and S. P. Jones,” Late forming supernumeraries in the mandibular premolar region,” British
Journal of Orthodontics, vol.18, no.4, pp.329-331, 1991.
16. D. E. J. Bowden, “Post-permanent dentition in the premolar region,” vol.131, no.3, pp.113-116, 1971.
17. G. A. Morgan, P. R. Morgan, and S. A. Crouch,” Recurring mandibular supplemental premolars. Oral Surgery,”
Oral Surgery, Oral Medicine, Oral Pathology, vol.30, pp.501-504, 1970.
18. R. Ranta and P. Ylipaavalniemi,” Developmental course of supernumerary premolars in childhood: report of
two cases” Journal of Dentistry for Children, vol.48, no.5, pp.385-388, 1981.
19. M. L. Kantor, C. S. Bailey and E.J.Burkes,”Duplication of the premolar dentition”. Oral Surgery, Oral Medicine,
Oral Pathology, vol.66, no.1, pp. 62-64, 1988.
20. F. N. Hattab, O. M. Yassin, and M. A. Rawashdeh,” Supernumerary teeth: report of three cases and review of
the literature,” Journal of Dentistry for Children, vol.61, no.5-6, pp.382-393, 1994.
21. S. M. Cochrane, J. R. Clark and N. P. Hunt,” Late developing supernumerary teeth in the mandibule,” British
Journal of Orthodontics, vol.24, no.4, pp.293-296, 1997.
22. Romito L (2004).Concrescence: Report of a rare case. Oral.Surg. Oral.Med. Oral.Pathol. Oral.Radiol. Endod.
23. N. K.Vijayavergia, P.K.Dayal, and M.R Joshi, “Bilateral functioning premolar –form supernumerary teeth distal t
o the maxillary permanent first molars,” Journal of Dentistry, vol.5, no.1, pp. 76-78, 1977.
24. D. M. Raphael,” Transposed supernumerary premolars”. Oral Surgery, Oral Medicine, Oral Pathology, Oral
Radiology, vol.46, no.4, pp.598, 1978.
25. F .C. Loh and J. F. Yeo,” Paramolar with bifid crown,” Oral Surgery, Oral Medicine, Oral Pathology, vol.76, no.2,
26. E. Nunes, I. G. de Moraes, P. M. de Novaes, and S.M.de Sousa,” Bilateral fusion of mandibular second molars
with supernumerary teeth: case report,” Brazilian Dental Journal, vol.13, no.2, pp.137-141, 2002.
27. J. W. Zvolanek and T. M. Spotts,” Supernumerary mandibular premolars, report of case”. Journal of the
American Dental Association, vol. 110, pp.721-723, 1985.
28. C. Turner and C. J. Hill.” Supernumerary mandibular premolar: the importance of radiographic i
nterpretation,” Journal of Dentistry for Children, vol.53, no.5, pp.375-377, 1986.
29. D. E. J. Bowden,” Post-permanent dentition in the premolar region,” British Dental Journal, vol.131, no.3,
30. N. Gibson,” A late developing mandibular premolar supernumerary tooth,” Australian Dental Journal, vol.45,
no.4, pp. 277-278, 2000.
31. R. S. Jamwal, P. Sharma, and R. Sharma,” Late-developing supernumerary mandibular premolar: a case
report,” World Journal of Orthodontics, vol.11, no.4, pp. 94-98, 2010.
32. S.Yassaei, M.Goldani Moghadam, and S. M. Tabatabaei,” Late developing supernumerary premolars: reports
of two cases”. Case Reports in Dentistry, vol.2013, Article ID 969238, 4 pages, 2013.
33. C. A. Frank,” Treatment options for impacted teeth,” Journal of the American Dental Association, vol.131,
no.5, pp.623-632, 2000.
34. A.Shah, D.S.Gill, C.Tredwin, and F.B.Naini,”Diagnosis and management of supernumerary teeth,” Dental
Update, vol.35, no.8, pp. 510-520, 2008.
35. Rajab LD, Hamdan MA. Supernumerary teeth: review of the literature and a survey of 152 cases. Int. J.
Paediatr Dent 2002; 12:244-254.
36. Diaz A, Orozco J, Fonseca M. Multiple hyperodontia: report of a case with 17 supernumerary teeth with non -
syndromic association. Med Oral Patol Oral Cir Bucal 2009; 14:E229-E231.
37. Fernandez Montenegro P, Valmaseda Castellon E, Berini Aytes L, Gay Escoda C. Retrospective study of 145
supernumerary teeth .Med Oral Patol Oral Cir Bucal 2006;11:E339-E344.
38. Takahashi ,M.; Hosomichi K.; Yamaguchi, T.; Yano, K.; Funatsu, T.; Adel, M.;Haga, S.;Maki, K.;Tajima, A. Whole-
exome sequencing analysis of supernumerary teeth occurrence in Japanese individuals. Hum. Genome Var.
2017, 4, 16046.