Non-syndromic supernumerary premolars

Description

A 22-year-old male reported with the chief complaint of spacing between front teeth and unpleasant smile. Medical and dental history was non-contributory. Intra oral examination revealed Angle’s class I molar relationship with midline diastema. Bilateral supplementary mandibular premolars were noted in linguoversion (figure 1). Radiographic examination revealed an impacted supernumerary maxillary premolar between right first and second premolars (figure 2). Supernumeraries can appear in both deciduous (0.3%–0.6%) and permanent dentitions (1%–3.5%).¹ The male to female ratio is 2:1. The most common supernumerary tooth is mesiodens, followed by maxillary lateral incisor, maxillary fourth molar and mandibular third premolar supernumeraries. Supernumerary premolars constitute approximately 10% of the total supernumerary cases, and almost 75% of those are in the mandible.² Mandibular supernumerary premolars usually resemble the permanent premolars in both size and shape. Although this problem seems to be caused by genetic or environmental factors, the aetiology is unknown. Supernumerary teeth cause certain clinical problems such as failure to erupt, displacement of a permanent tooth, crowding, or dentigerous cyst formation. Treatment is aimed at extraction of supernumeraries before problems arise, or at minimising the effect if other teeth have already been displaced.³

Figure 1.

Intra oral view.

Figure 2.

Orthopantomograph.