Bilateral maxillary and mandibular fourth molars: a case report and literature review

Supernumerary teeth are those present in addition to the normal set of teeth. These teeth are found in both the primary and the permanent dentitions, and are most frequently seen in the maxillary anterior and molar regions. Supernumerary molars are divided into two types, depending on their location: distomolars and paramolars. Distomolars usually occur in the form of a fourth molar distal to the third molar, while paramolars are rudimentary supernumerary teeth that might develop buccally or lingually to the molar series. The management of a supernumerary tooth should be part of a comprehensive treatment plan. This paper reports a rare case of a male patient with bilateral maxillary and mandibular fourth molars, and reviews the literature on supernumerary teeth.     

Orthodontic treatment for an unerupted and severely rotated maxillary central incisor. A case report.

BACKGROUND: Many reports have indicated the treatment for permanent teeth with disturbed eruption due to the presence of supernumerary teeth. However, successful treatment for an unerupted maxillary incisor with severe rotation and another maxillary incisor with disturbed eruption by a supernumerary tooth is quite rare. CASE REPORT: We treated a 7-year-old Japanese male with an unerupted and severely rotated maxillary right incisor, along with a maxillary left incisor due to interference with eruption by an inverted supernumerary tooth. Orthodontic treatment using surgical exposure, traction and guidance of the rotated right incisor, and maxillary expansion following extraction of the supernumerary tooth were performed. FOLLOW-UP: At 27 months following extraction of the supernumerary tooth, and comprehensive orthodontic treatment led the malposititioned central incisors to a functional position and stable occlusion.     

22颗第四磨牙临床分析

目的 探讨第四磨牙的临床特点。方法 通过查阅2013年6月30日—2016年6月30日长沙市中心医院口腔科所有拍摄了曲面断层片的患者资料,选取位于第三磨牙远中的多生牙患者,并调取患者病历资料,记录他们的姓名、性别、年龄、就诊原因、多生牙数目、位置和形态以及是否萌出,作简要分析。结果 发现第四磨牙21例22颗,男女比例8∶13,其中左上8颗,右上11颗,左下3颗,右下0,萌出5颗,未萌出17颗,锥形牙10颗,结节型6颗,补充型4颗,融合牙2颗,第四磨牙位于上颌与下颌比较,两者差别有显著意义（P＜0.01）;第四磨牙未萌出与萌出比较,两者差别有显著意义（P＜0.05）。结论 第四磨牙在上颌发生率更高,未萌出状态更常见,对于埋伏于骨内且无主观症状的患者,我们主张观察。     

上颌窦底与正畸牙移动关系的研究进展

上颌窦底与上后牙关系十分密切.在正畸临床中,由于上颌窦的存在,使得上颌拔牙间隙的关闭及间隙两侧牙根平行变得困难,同时牙根吸收的风险增加;对后牙萌出过度、后牙牙槽嵴发育过度需压低后牙的开骀患者及下后牙缺失对颌磨牙伸长需压入的患者,上颌窦的存在同样也增加了上后牙压人的困难.笔者综合国内外学者已有的研究,系统性总结了上颌窦底与正畸牙移动的关系.     

Supernumerary tooth in the maxillary sinus: Case report

The ectopic development of teeth has been reported in many locations including the nasal cavity, maxillary sinus and the chin. Ectopic teeth may be permanent, deciduous or supernumerary. A case is presented in which a supernumerary tooth erupted into the maxillary sinus of an 11 year old boy.     

Supernumerary tooth in the maxillary sinus: Case report

The ectopic development of teeth has been reported in many locations including the nasal cavity, maxillary sinus and the chin. Ectopic teeth may be permanent, deciduous or supernumerary. A case is presented in which a supernumerary tooth erupted into the maxillary sinus of an 11 year old boy.     

Multiple dens invaginatus affecting maxillary lateral incisors and a supernumerary tooth

Abstract Dens invaginatus is a developmental variation resulting from an alteration in the normal growth pattern of the dental papilla of a tooth. This anomaly occurs predominantly in maxillary permanent lateral incisors. Multiple occurrence in maxillary incisor teeth in the same patient has frequently been reported, and examination of bilateral teeth for the anomaly is often carried out routinely. This paper reports an unusual case of multiple invaginations, including dens invaginatus affecting maxillary lateral incisors and a supernumerary tooth and minor imaginations of the upper canines. Moreover, the case illustrates the importance of examining all the teeth in patients who present with dens invaginatus and palatal pits in incisors and canines. The possibility that the supernumerary tooth had resulted from gemination of the lateral incisor tooth germ is discussed.     

Analysis of dental anomalies in the Siberian mole, Talpa altaica (Insectivora, Talpidae)

We re-examined tooth variation in specimens of the Siberian mole, Talpa altaica, from the collection of the Siberian Zoological Museum and discuss the mechanisms of dental evolution. The number of teeth counted in 1789 specimens ranged from 34 to 47, and supernumerary, absent, and connate teeth were observed. The most frequent tooth anomaly was an absent tooth in the premolar region (200 maxillary first premolars and 190 mandibular third premolars), which does not support Fujita and Kirino's terminal reduction hypothesis in the mandible [Fujita T, Kirino T. Ha No Kaibougaku. 21st ed. Tokyo: Kanehara Publishers Inc.; 1976 (in Japanese)]. Supernumerary teeth were found in premolar rows and in the incisor and molar regions. An maxillary fourth molar, positioned distal to the normal third molar, was thought to result from a genetically programmed atavistic event during the natal stages. Connate teeth were observed only in the premolar rows and were thought to have developed with the fusion of two independent tooth germs. Connate premolars appeared to result from an expression of an incomplete division of tooth germ at an early developmental stage or a reunion of independent tooth germs, based on the morphological similarity of the normal and supernumerary premolars. These extraordinarily frequent tooth anomalies of T. altaica are of much interest both in terms of tooth development and classification.     

Multiple supernumerary teeth in the maxillary canine and mandibular premolar regions: a case in the postpermanent dentition

BACKGROUND: A supernumerary tooth is an extra tooth above the normal number, of which approximately 90% occur in the premaxillary region and show rudimentary forms of crown morphology. Most cases occur singly, with bilateral occurrence in the maxillary canine regions very rare in children with no other associated diseases or syndromes. CASE REPORT: A case of a 14-year-old boy with bilateral supernumerary teeth with normal crown shapes in both the maxillary canine and mandibular premolar regions. The supernumerary teeth in the maxilla were diagnosed at 12.2 years of age and in the mandible at 14.1 years of age. CONCLUSION: Four supernumerary teeth in the maxillary and mandibular canine-premolar region is a rare finding.     

A Case of Impacted Supernumerary Fourth Molar in the Bilateral Mandibular Ramus

The occurrence of multiple supernumerary teeth in individuals without any associated syndrome is rare. In this report, a rare case of a 48-year-old woman who had an impacted supernumerary fourth molar in the bilateral mandibular ramus is described. She presented with a swelling in the left cheek region. Radiographic examination revealed an impacted supernumerary tooth in the left mandibular ramus with pericoronal resorption of the bone, suggesting peripheral inflammation. She also had an impacted supernumerary tooth on the right side. After administering an antibiotic and antiinflammatory drug, tooth extraction was performed under general anesthesia.     

冷光源反角涡轮机在上颌埋伏多生牙微创拔除中的应用体会

目的通过分析微创拔除上颌埋伏多生牙,探讨微创理念、提高临床技术应用。 方法应用X线偏心投照法或锥形束CT（CBCT）定位埋伏多生牙;采用局部麻醉、唇颊侧或腭侧个性化手术进路;使用冷光源反角涡轮机+微创拔牙刀,拔除21例上颌埋伏多生牙。 结果麻醉效果良好,手术过程顺利,无邻牙及邻近结构损伤,无并发症或后遗症发生,切口愈合良好。 结论埋伏多生牙好发于上颌前部腭侧;CBCT图像可从任意角度直观地显示埋伏多生牙在颌骨内的位置,对麻醉和手术方案制定、微创手术实施有益,可作为术前常规检查;精确定位、个性化手术进路、冷光源反角涡轮手机及微创拔牙刀的应用,可降低手术创伤、缩短手术时间,对低龄儿童在局麻下完成手术有益;同时降低手术对儿童牙槽骨、颌骨发育影响的风险。     

上颌埋伏第三磨牙与多生牙融合1例

融合牙是由2个牙胚间的釉质或牙本质融合在一起而形成.上颌牙融合多发生在侧切牙和尖牙间,极少发生在第三磨牙和多生牙之间.本文报道1例发生在左上颌埋伏第三磨牙与多生牙之间的融合牙.     

Concrescence of a mandibular third molar and a supernumerary fourth molar: report of a rare case

Concrescence represents a rare developmental anomaly in which two fully formed teeth are joined along the root surfaces by cementum. Maxillary molars are the teeth most frequently involved, especially a third molar and a supernumerary tooth. Very few cases have been reported about the concrescence of a third molar and a supernumerary tooth. According to our current knowledge, this case report is the first in the literature in which concrescence is observed between a third molar and a supernumerary fourth molar in the mandible.     

Dentigerous cyst associated with an impacted anterior maxillary supernumerary tooth

A dentigerous cyst is a developmental odontogenic cyst which develops from the reduced enamel epithelium in an impacted permanent tooth and is rarely associated with supernumerary teeth. The purpose of this article was to report the case of an 8-year-old Korean boy with a dentigerous cyst associated with an impacted anterior maxillary supernumerary tooth and its dental management.     

成人双侧上颌后牙区对称性多生牙1例

多生牙在临床上多见,恒牙对称性多生牙的病例相对较少,该文报道对称性上颌后牙区多生牙1例,     

Ectopic eruption of a maxillary third molar tooth in the maxillary sinus: a case report

Ectopic eruption of teeth into regions other than the oral cavity is rare although there have been reports of teeth in the nasal septum, mandibular condyle, coronoid process, palate, chin, and maxillary sinus. Occasionally, a tooth may erupt in the maxillary sinus and present with local sinonasal symptoms attributed to chronic sinusitis. We present a case of an ectopic maxillary third molar tooth that caused chronic sinusitis in the maxillary sinus.     

Supernumerary deciduous teeth with multiple maxillary impacted mesiodens: A case report

Maxillary impacted mesiodens are frequently encountered in pediatric dentistry. Much research has been conducted concerning their incidence, position, and form. Supernumerary teeth erupting in the primary dentition with maxillary impacted mesiodens are very rare. In January 2011, a nine-year-old boy presented for dental treatment and was found to have supernumerary deciduous teeth. Upon panoramic radiography, multiple impacted mesiodens were found; therefore, computed tomography (CT) was performed for further examination. One month later, the boy was referred to our department for extraction of the deciduous supernumeraries and impacted mesiodens. We suspected that these supernumeraries, mesiodens, and remaining primary teeth would lead to problems with the eruption of the permanent teeth. Therefore, by ascertaining the exact position of the mesiodens and the successional permanent teeth using CT, extraction was performed under general anesthesia in March 2011 without any error. Six months postoperatively, panoramic radiographs showed no superfluous structure that appeared to be a tooth. We suggest that when multiple maxillary impacted mesiodens are found, their exact positions can be located using CT before extraction.     

Endodontic management of maxillary supplementary premolar using cone-beam computed tomography

Extra teeth in dentition is termed as 'supernumerary teeth' and is a very well-known dental developmental anomaly. Supernumerary premolars are a rare anomaly in the maxillofacial complex. Its rarity and complex characteristics often makes it difficult to treat. Radiographs play an important role in assessment of both the location and the typing of supernumerary teeth. This article reports the rare case of 'nonsyndromic bilateral maxillary supernumerary premolars' in which the endodontic management of supernumerary premolar tooth is described. In this case the value of cone-beam computerized tomography is also emphasized. CLINICAL SIGNIFICANCE: Developmental anomalies can occur in any tooth and supplementary premolars are no exception. The complexity of such teeth has to be considered for planning endodontic treatment to increase the chances of success.     

A case of bilateral supplemental maxillary central incisors

Summary. A case of bilateral supplemental maxillary central incisors is presented. Treatment comprised of extraction of one supplemental and two lateral incisors, preservation of one supplemental incisor, finishing with a 'Cyclops' arrangement of the teeth. The handling of supernumerary teeth in general is discussed.     

A retrospective study of unerupted maxillary incisors associated with supernumerary teeth

We retrospectively reviewed the clinical records and radiographs of 100 patients who had had supernumerary teeth removed. Their mean (SD) age was 9 years 3 months (2). The 100 patients had a total of 127 unerupted maxillary incisors associated with supernumerary teeth. The supernumerary tooth was removed without exposure of the permanent tooth more often among the 79 younger children (aged 10 years or less) (SND=3.52, P<0.01), and when the incisors were less mature (Cvek classification 1, 2, and 3) (SND=5.27, P<0.01). Of these incisors with immature roots that were treated conservatively, 60 (72%) erupted and 24 (28%) required further operation. Of the mature incisors treated conservatively, 10 (63%) required further operation. In this study, almost three-quarters of immature incisors erupted spontaneously after removal of the associated supernumerary teeth. Over half of the mature teeth required further operation. Mature teeth should be exposed with or without bonding at the time of removal of the supernumerary teeth.