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 Table of Contents  
ORIGINAL ARTICLE
Year : 2014  |  Volume : 26  |  Issue : 1  |  Page : 42-45

Prevalence of supernumerary teeth in permanent dentition among patients attending a dental college in South Kerala: A pilot study


Department of Oral Medicine and Radiology, PMS College of Dental Science and Research, Trivandrum, Kerala, India

Date of Submission15-Jun-2014
Date of Acceptance08-Aug-2014
Date of Web Publication26-Sep-2014

Correspondence Address:
Vivek Velayudhan Nair
Department of Oral Medicine and Radiology, PMS College of Dental Science and Research, Golden Hills, Vattappara, PO - Venkode, Trivandrum - 695 028, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-1363.141854

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   Abstract 

Background: Supernumerary teeth are excess number of teeth formed as a result of disturbances occurring during odontogenesis. The objective of the study was to investigate the prevalence of supernumerary teeth in permanent dentition among patients attending a dental college in South Kerala. Materials and Methods: In this study, 11,141 subjects attending the out-patient department of PMS College of Dental Science and Research, Thiruvananthapuram, Kerala were examined for supernumerary teeth like mesiodens, paramolars, distomolars, third premolars, second laterals, and odontomes during the period May 2012-May 2013. Ethical clearance was obtained from the institutional ethical committee for the study. Results: The study showed a prevalence of 0.39% and a sex distribution of M:F equal to 2:1. The incidence of supernumerary teeth found was as follows: mesiodens (0.14%), paramolars (0.13%), third premolar (0.04%), distomolar (0.03%), extralateral (0.02%), and odontome (0.03%). The male:female gender predilection was as follows: mesiodens (3:1), paramolars (1.3:1), third premolar (4:1), distomolar (1:2), and odontome (2:1). Conclusion: This study showed a 0.39% prevalence of supernumerary teeth in this population.

Keywords: Pilot study, prevalence, supernumerary teeth


How to cite this article:
Gopakumar D, Thomas J, Ranimol P, Vineet DA, Thomas S, Nair VV. Prevalence of supernumerary teeth in permanent dentition among patients attending a dental college in South Kerala: A pilot study . J Indian Acad Oral Med Radiol 2014;26:42-5

How to cite this URL:
Gopakumar D, Thomas J, Ranimol P, Vineet DA, Thomas S, Nair VV. Prevalence of supernumerary teeth in permanent dentition among patients attending a dental college in South Kerala: A pilot study . J Indian Acad Oral Med Radiol [serial online] 2014 [cited 2020 May 26];26:42-5. Available from: http://www.jiaomr.in/text.asp?2014/26/1/42/141854


   Introduction Top


Supernumerary teeth can be defined as those teeth which are in excess when compared to the normal series. [1] Previous studies have reported prevalence rates ranging between 0.3% and 0.8% in primary dentition and between 0.1% and 3.8% in permanent dentition. [2],[3],[4] Reported male:female ratio is 2:1. [1] Exact etiology is not known, but there are several theories to justify their existence. The various theories are phylogenetic theory, dichotomy theory, dental lamina hyperactivity theory, and genetic theory. [5] They can also occur as an abnormal reaction to traumatic episodes or environmental factors. [5] Supernumerary teeth can be classified according to the morphology as conical, tuberculate, supplemental, and odontome. [6] They occur singly or in multiples, unilaterally or bilaterally, either in maxilla, mandible, or both. [2] They occur 10 times more in maxilla, especially premaxilla, than mandible. [3],[4],[7] Multiple supernumerary teeth may be associated with conditions such as cleidocranial dysplasia, Gardner syndrome, and cleft lip and cleft palate. [6] Clinically, it can cause disorders like retention of primary teeth, delayed eruption of permanent teeth, ectopic eruptions, tooth displacements, follicular cysts, and other alterations which require surgical as well as orthodontic treatments. [8],[9]

The objective of the study was to estimate the prevalence of supernumerary teeth in permanent dentition among patients attending the out-patient department (OPD) of PMS College of Dental Science and Research located at Vattappara, a rural area in Trivandrum, Kerala state.


   Materials and Methods Top


A total of 11,141 patients attending the Department of Oral Medicine and Radiology, PMS College of Dental Science and Research, Vattappara, Trivandrum, Kerala, India over a period of 1 year from May 2012 to May 2013, who consented to participate in the study, were examined clinically for supernumerary teeth [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]. When there was clinical presence of supernumerary tooth/teeth, radiograph(s) were taken to rule out multiple unerupted supernumerary teeth. Demographic data, number of supernumerary teeth, their location, position, type, and morphology were recorded for each patient with this condition. Ethical clearance was obtained from the institutional ethical committee for the study.
Figure 1: Clinical photograph and periapical radiograph of conical variety of supernumerary tooth (mesiodens)

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Figure 2: Clinical photograph and periapical radiograph of extralateral supernumerary teeth

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Figure 3: Clinical photograph and periapical radiograph of supplemental variety of supernumerary tooth (third premolar)

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Figure 4: Panoramic radiograph of complex composite odontome (in mandible)

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Figure 5: Panoramic radiograph of complex composite odontome (in maxilla)

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   Results Top


Among the 11,141 patients examined, 43 patients were identified with supernumerary teeth, with a prevalence of 0.39%. The supernumerary teeth found were mesiodens (0.14%), paramolars (0.13%), third premolar (0.04%), distomolar (0.03%), extralateral (0.02%), and odontome (0.03%). The male:female gender predilection was as follows: mesiodens (3:1), paramolars (1.3:1), third premolar (4:1), distomolar (1:2), and odontome (2:1) [Figure 6], [Figure 7], [Figure 8].
Figure 6: Histogram showing M:F predilection for each variety of supernumerary teeth

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Figure 7: Pie diagram showing prevalence of each variety of supernumerary teeth

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Figure 8: Pie diagram showing prevalence of the morphological types of supernumerary teeth

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   Discussion Top


Supernumerary teeth are the developmental alterations that can occur in any zone of dental arch and can involve any tooth. [10] Exact etiology is not known. [6] One theory suggests that they develop from a third tooth bud arising from dental lamina near the normal tooth. According to another theory, it is due to dichotomy of the tooth bud. [11] A third theory called hyperactivity theory suggests that it is formed as a result of local, independent, conditioned hyperactivity of dental lamina. [12] Heredity may also play a role in the occurrence of supernumerary teeth. [13] They can be classified according to the time of appearance, position in the arch, shape, and number of supernumerary teeth. According to the morphology, they can be grouped as conical, tuberculate, supplemental, and odontomas. [6] Small, peg-shaped conical supernumerary is mostly found in permanent dentition. It can cause rotation or displacement of permanent incisor. Tuberculate variety has more than one cusp or tubercle. They may be barrel shaped and often paired, seen on the palatal aspect of central incisors. They do not erupt and can cause delayed eruption of central incisors. [6] Supplemental type is the duplication of teeth in the normal series. Most common are the permanent maxillary lateral incisors but premolars and molars can also occur (as the supplemental type of supernumerary teeth). [6] Odontome represents a hamartomatous malformation rather than a neoplasm. [6] Two types of odontomes are present; they are compound composite and complex composite odontomes. In complex composite type, there is diffuse mass of dental tissue which is totally disorganized, whereas in compound type, the malformation has superficial anatomical similarity to a normal tooth. [1],[6] Failure of eruption, displacement, and crowding of permanent teeth are the complications associated with supernumerary teeth. Another problem associated with supernumerary teeth is the occurrence of dentigerous cyst.

In the present study, among the 11,141 patients examined, 43 patients were having supernumerary teeth, with a prevalence of 0.39% which was within the range reported by previous studies. [2],[3],[4] The supernumerary teeth found were mesiodens (0.14%), paramolars (0.13%), third premolar (0.04%), distomolar (0.03%), extralateral (0.02%), and odontomes (0.03%). Mesiodens can be grouped under the conical type. Paramolars, distomolars, third premolars, and extralaterals come under supplemental type. The male:female gender predilection was: Mesiodens (3:1), paramolars (1.3:1), third premolar (4:1), distomolar (1:2), and odontome (2:1). Overall, the M:F ratio was 2:1 which coincides with the values reported in other studies. [5],[10],[14],[15],[16] Different studies on prevalence according to type and location show the following: upper lateral incisors represent 50%, mesiodens 36%, central upper incisor 11%, and premolars 3%; single supernumerary teeth represent 76-86%, double supernumerary teeth correspond to 12-23% of cases, and four supernumerary molars or distomolars account for 18% of cases. Multiple supernumerary teeth represent less than 1% of all cases. [16],[17],[18] Fernández Montenegro et al. reported that supernumerary teeth prevalence ranges from 0.5 to 3.8% in permanent dentition, and from 0.35 to 0.6% in primary dentition. [17]


   Conclusion Top


The prevalence of supernumerary teeth in the present study was 0.39%. The supernumerary teeth found were: Mesiodens (0.14%), paramolars (0.13%), third premolar (0.04%), distomolar (0.03%), extralateral (0.02%), and odontome (0.03%). The male:female gender predilection was: Mesiodens (3:1), paramolars (1.3:1), third premolar (4:1), distomolar (1:2), and odontome (2:1).

 
   References Top

1.Shah A, Gill DS, Tredwin C, Naini FB. Diagnosis and management of supernumerary teeth. Dent Update 2008;35:510-2, 514-6, 519-20.  Back to cited text no. 1
    
2.Rajab LD, Hamdan MA. Supernumerary teeth: Review of the literature and a survey of 152 cases. Int J Paediatr Dent 2002;12:244-54.  Back to cited text no. 2
    
3.Yusof WZ. Non-syndrome multiple supernumerary teeth: Literature review. J Can Dent Assoc 1990;56:147-9.  Back to cited text no. 3
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4.Stafne EC. Supernumerary teeth. Dent Cosmos 1932;74:653-9.  Back to cited text no. 4
    
5.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:e575-8.  Back to cited text no. 5
    
6.Rajendran R, Sivapathasundaram B. Shafers Textbook of Oral Pathology. 6 th ed. Noida, India: Elsevier; 2009. p. 46-8.  Back to cited text no. 6
    
7.Açikgöz A, Açikgöz G, Tunga U, Otan F. Characteristics and prevalence of non-syndrome multiple supernumerary teeth: A retrospective study. Dentomaxillofac Radiol 2006;35:185-90.  Back to cited text no. 7
    
8.Zilberman Y, Malron M, Shteyer A. Assessment of 100 children in Jerusalem with supernumerary teeth in the premaxillary region. ASDC J Dent Child 1992;59:44-7.  Back to cited text no. 8
    
9.De Oliveira Gomes C, Drummond SN, Jham BC, Abdo EN, Mesquita RA. A survey of 460 supernumerary teeth in Brazilian children and adolescents. Int J Paediatr Dent 2008;18:98-106.  Back to cited text no. 9
    
10.Leco Berrocal MI, Martin Morales JF, Martínez González JM. An observational study of the frequency of supernumerary teeth in a population of 2000 patients. Med Oral Patol Oral Cir Bucal 2007;12:E134-8.  Back to cited text no. 10
    
11.Çandýrlý C, Dayýsoylu E, Coskun G, Taskesen F, Kilkis D. Prevalence and characteristics of supernumerary teeth in east-northern Turkish population. Cumhuriyet Dent J 2012;15:335-39.  Back to cited text no. 11
    
12.Wang XP, Fan J. Molecular genetics of supernumerary tooth formation. Genesis 2011;49:261-77.  Back to cited text no. 12
    
13.Finn SB. Anomalies of tooth numbers including peg-shaping. Birth Defects Orig Artic Ser 1971;7:185-93.  Back to cited text no. 13
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14.Ferrés-Padró E, Prats-Armengol J, Ferrés-Amat E. A descriptive study of 113 unerupted supernumerary teeth in 79 pediatric patients in Barcelona. Med Oral Patol Oral Cir Bucal 2009;14: E146-52.  Back to cited text no. 14
    
15.Garvey MT, Barry HJ, Blake M. Supernumerary teeth- an overview of classification, diagnosis and management. J Can Dent Assoc 1999;65:612-6.  Back to cited text no. 15
    
16.Ballesteros GB. Dientes multiples supernumerarios no relacionados a UN sindrome: Reporte de UN caso. Revista Estomatologia 2005;13:13-9.  Back to cited text no. 16
    
17.Fernández-Montenegro P, Valmaseda-Castellón E, Berini-Aytés L, Gay-Escoda C. Estudio retrospectivo de 145 dientes supernumerarios. Med Oral Patol Oral Y Cir Bucal 2006;11:240-5.  Back to cited text no. 17
    
18.Gopakumar D, Sunil S, Gini M. Non-syndrome multiple supernumerary teeth. Kerala Dent J 2008;31:41-2.  Back to cited text no. 18
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8]



 

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