INVESTIGATION OF IMPACTED SUPERNUMERARY TEETH: A CONE BEAM COMPUTED TOMOGRAPH (CBCT) STUDY

Year 2017, Volume: 51 Issue: 3, 18 - 24, 02.10.2017

Çağrı Delilbaşı , Gökhan Gürler , Evren Delilbaşı

Abstract

Purpose: The purpose of this study was to investigate the impacted supernumerary teeth which were initially detected on panoramic radiographs by using cone beam computed tomography (CBCT).

Materials and Methods: In this retrospective study, supernumerary teeth diagnosed on panoramic radiographs taken from patients who had admitted for routine dental treatment were evaluated using CBCT. Patients’ age, gender, systemic conditions as well as number of supernumerary teeth, unilateral-bilateral presence, anatomical localization (maxilla, mandible, anterior-premolar-molar, mesiodens-lateral-canine, parapremolar-paramolar-distomolar) shape (rudimentary, supplemental, tuberculate, odontoma), position (palatal-lingual-buccal-labial-central), shortest distance between the tooth and adjacent cortical plate, complications and treatment were assessed.

Results: A total of 47 impacted supernumerary teeth in 34 patients were investigated in this study. Of these, 33 (70.2%) were unilateral and 14 (29.8%) were bilateral. Only 1 supernumerary tooth was found in 27 patients (79.4%) whereas 7 patients (20.6%) had 2 or more supernumerary teeth. Most of the teeth located in the anterior region (74.4%) of the jaws and maxilla (74.4%). Twenty teeth (42.5%) were mesiodens, 11 (23.4%) were lateral or canine, 14 (29.7%) were parapremolar and 2(4.4%) were distomolar. Twenty-seven teeth (57.4%) were rudimentary, 15 (31.9%) supplemental and 5 (10.7%) odontoma in shape. The shortest distance between the supernumerary tooth and adjacent cortical plate varied between 0 to 2.5 mm with a mean of 0.66 mm. The most common clinical complaint was the non-eruption of permanent teeth (42.5%). All supernumerary teeth were removed under local anesthesia. Orthodontic traction was performed for those impacted permanent teeth if necessary.

Conclusion: Impacted supernumerary teeth are usually in close proximity to cortical bone. Although this may facilitate surgical access, there is a risk of damaging surrounding anatomical structures. Therefore, CBCT evaluation of impacted supernumerary teeth for accurate planning is recommended. 

Keywords

Supernumerary tooth, hyperdontia; CBCT; impacted teeth; cortical bone

References

• Altuğ HA, Altuğ H, Sarı E, Şençimen M, Altun C. Süt ve daimi dentisyonda süpernümere dişlerin teşhisi, cerrahi ve ortodontik olarak tedavileri. GÜ Diş Hek Fak Derg 2010;27(2):77-82.
• Erdem MA, Çankaya B, Güven G, Kasapoğlu Ç. Artı dişler (süpernümerer dişler). İst Üni Dis Hek Fak Derg 2011;45(1):15-18.
• Kaya GS, Yapici G, Omezli MM, Dayi E. Non-syndromic supernumerary premolars. Med Oral Patol Oral Cir Bucal 2011;16(4):e522-525.
• Masih S, Sethi HS, Singh N, Thomas AM. Differential expressions of bilaterally unerupted supernumerary teeth. J Indian Soc Pedod Prev Dent 2011;29(4):320-322.
• Acikgoz A, Acikgoz G, Tunga U, Otan F. Characteristics and prevalence of non-syndrome multiple supernumerary teeth: A retrospective study. Dentomaxillofac Radiol 2006;35(3):185-190.
• Bereket C, Çakır Özkan N, Şener İ, Tek M, Çelik S. Sürnümerer molar dişlerin retrospektif olarak incelenmesi: Klinik ve radyolojik bir çalışma. Atatürk Üniv Diş Hek Fak Derg 2010;20(3):176-180.
• Brauer HU. Case report: Non-syndromic multiple supernumerary teeth localized by cone beam computed tomography. Eur Arch Paediatr Dent 2010;11(1):41-43.
• Scheiner MA, Sampson WJ. Supernumerary teeth: A review of the literature and four case reports. Aust Dent J 1997;42(3):160-165.
• Celikoglu M, Kamak H, Oktay H. Prevalence and characteristics of supernumerary teeth in a non-syndrome turkish population: Associated pathologies and proposed treatment. Med Oral Patol Oral Cir Bucal 2010;15(4):e575-578.
• Cevidanes LH, Styner MA, Proffit WR. Image analysis and superimposition of 3-dimensional cone-beam computed tomography models. Am J Orthod Dentofacial Orthop 2006;129(5):611-618.
• Jeremias F, Fragelli CM, Mastrantonio SD, Dos Santos-Pinto L, Dos Santos-Pinto A, Pansani CA. Cone-beam computed tomography as a surgical guide to impacted anterior teeth. Dent Res J (Isfahan) 2016;13(1):85-89.
• Liu DG, Zhang WL, Zhang ZY, Wu YT, Ma XC. Three-dimensional evaluations of supernumerary teeth using cone-beam computed tomography for 487 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(3):403-411.
• Sawamura T, Minowa K, Nakamura M. Impacted teeth in the maxilla: Usefulness of 3d dental-ct for preoperative evaluation. Eur J Radiol 2003;47(3):221-226.
• Ziegler CM, Klimowicz TR. A comparison between various radiological techniques in the localization and analysis of impacted and supernumerary teeth. Indian J Dent Res 2013;24(3):336-341.
• Ashkenazi M, Greenberg BP, Chodik G, Rakocz M. Postoperative prognosis of unerupted teeth after removal of supernumerary teeth or odontomas. Am J Orthod Dentofacial Orthop 2007;131(5):614-619.
• Biradar V, Angadi S. Supernumerary teeth: Review of case series. Journal of Interdisciplinary Dentistry 2012;2(2):113-115.
• Ezirganlı Ş, Ün E, Kırtay M, Özer K, Köşger H. Sivas bölgesinde artı dişlerin yaygınlığının araştırılması. Atatürk Üniv Diş Hek Fak Derg 2011;21(3):189-195.
• Cantekin K GH, Aydınbelge M. Üst çene keserler bölgesinde bulunan süpernümerer dişlerin neden olduğu komplikasyonlar ve tedavi yaklaşımları. Erciyes Üniversitesi Sağlık Bilimleri Dergisi 2014;23(1):54-58.
• Nurko C. Three-dimensional imaging cone bean computer tomography technology: An update and case report of an impacted incisor in a mixed dentition patient. Pediatr Dent 2010;32(4):356-360.
• Tatlı U, Evlice B, Damlar İ, Arslanoğlu Z, Altan A. Çukurova bölgesinin süpernümerer diş karakteristikleri: Çok merkezli retrospektif bir çalışma. Acta Odontol Turc. 2014;31(2):84-88.
• Yague-Garcia J, Berini-Aytes L, Gay-Escoda C. Multiple supernumerary teeth not associated with complex syndromes: A retrospective study. Med Oral Patol Oral Cir Bucal 2009;14(7):E331-336.
• Cochrane SM, Clark JR, Hunt NP. Late developing supernumerary teeth in the mandible. Br J Orthod 1997;24(4):293-296.
• Peker I, Kaya E, Darendeliler-Yaman S. Clinic and radiographical evaluation of non-syndromic hypodontia and hyperdontia in permanent dentition. Med Oral Patol Oral Cir Bucal 2009;14(8):e393-397.
• Santos AP, Ammari MM, Moliterno LF, Junior JC. First report of bilateral supernumerary teeth associated with both primary and permanent maxillary canines. J Oral Sci 2009;51(1):145-150.
• Cho SY, So FH, Lee CK, Chan JC. Late forming supernumerary tooth in the premaxilla: A case report. Int J Paediatr Dent 2000;10(4):335-340.
• Yassaei S, Goldani Moghadam M, Tabatabaei SM. Late developing supernumerary premolars: Reports of two cases. Case Rep Dent 2013;2013:969238.
• Hegde SV, Munshi AK. Late development of supernumerary teeth in the premolar region: A case report. Quintessence Int 1996;27(7):479-481.
• Mittal M, Sultan A. Clinical management of supernumerary teeth: A report of two cases. J Indian Soc Pedod Prev Dent 2010;28(3):219-222.
• Patchett CL, Crawford PJ, Cameron AC, Stephens CD. The management of supernumerary teeth in childhood--a retrospective study of practice in Bristol Dental Hospital, England and Westmead Dental Hospital, Sydney, Australia. Int J Paediatr Dent 2001;11(4):259-265.
• Vahid-Dastjerdi E, Borzabadi-Farahani A, Mahdian M, Amini N. Supernumerary teeth amongst iranian orthodontic patients. A retrospective radiographic and clinical survey. Acta Odontol Scand 2011;69(2):125-128.
• Nematolahi H, Abadi H, Mohammadzade Z, Soofiani Ghadim M. The use of cone beam computed tomography (CBCT) to determine supernumerary and impacted teeth position in pediatric patients: A case report. J Dent Res Dent Clin Dent Prospects 2013;7(1):47-50.
• Romano N, Souza-Flamini LE, Mendonca IL, Silva RG, Cruz-Filho AM. Geminated maxillary lateral incisor with two root canals. Case Rep Dent 2016;2016:3759021.
• Katheria BC, Kau CH, Tate R, Chen JW, English J, Bouquot J. Effectiveness of impacted and supernumerary tooth diagnosis from traditional radiography versus cone beam computed tomography. Pediatr Dent 2010;32(4):304-309.
• Nogami S, Miyamoto I, Yamauchi K, Kataoka Y, Morimoto Y, Saeki K, Maki K, Takahashi T. Supernumerary decidious teeth with multiple maxillary impacted mesiodens: A case report. Pediatric Dental Journal 2012;22(2):193-197.