Thorough X-ray examination is a valuable adjunct in the clinical assessment of supernumerary teeth. Three cases of supernumerary teeth comprising paramolars and molars are presented with radiographic documentation. All the patients received surgical treatment after full clinical and radiographic evaluation. OverviewIn cases of supernumerary teeth (hyperdontia), there is an increase in the number of teeth present in the dentition, exceeding the normal number.The incidence of supernumerary teeth is reported to be between 1% and 2% in the general population [1,2], and the most frequent site for this phenomenon is the mesiodens. Other sites affected are, in decreasing order of frequency, maxillary fourth molar, maxillary paramolar, mandibular premolar and maxillary lateral incisor [1,3,4].The large majority of publications dealing with supernumerary teeth are case reports, but very few articles have covered this interesting phenomenon extensively. Supernumerary teeth have been reported in both the primary and permanent dentitions[2] and may occur singly, multiply, bilaterally or unilaterally, in the maxilla, mandible or both [5]. Among various opinions about the development of supernumerary teeth, there are the theory of atavism [6], and the idea that supernumerary teeth develop from the remnants of the epithelium that converts into tooth formation subsequent to splitting of the tooth band [7]. Foley etal. [8] and Saarenma[9] hold the view that supernumerary teeth result from abnormal activity of the dental lamina . This process expresses itself by additional formation or division of the existing buds into supernumerary tooth buds. The possibility of sex-linked inheritance is supported by Bruning et al.[10], who observed a predilection of males over females in the incidence of supernumerary teeth. The association of heredity has been suggested previously [1,11,12].Stafne [1] reported that 80% of supernumerary teeth were unerupted, and that the maxilla was a more common site for supernumerary teeth than the mandible, with a ratio of 8.2/1. He also reported that out of 441 cases, 54 involved bilateral occurrence. Yusuf[13] stated a 9/2 male/female ratio in the occurrence of supernumerary teeth, and in contrast to Stafne, reported that the mandible was a more frequent site of occurrence (60.9%) than the maxilla (39.1%). He further stated that the premolar region had the highest frequency of occurrence when both jaws were compared. In his series, 10.3% of cases were localized in the anterior area, 62.1% in the premolar area and 27.6% in the molar area.