Triad of Bilateral Duplicated Permanent Teeth, Persistent Open Apex, and Tooth Malformation: A Case Report

Abstract

Aim The aim of this article is to report a case of bilateral multiple impacted supernumerary teeth. A discussion of possible mechanisms of development is also presented along with a concise review of the literature. Background Supernumerary teeth occur in the context of various scenarios in the primary and the permanent dentition. Multiple supernumerary teeth are a rare finding especially in the absence of associated syndrome or disease. Report A case of bilateral multiple impacted supernumerary teeth localized to the mandibular premolar region is reported. Some of the supernumerary teeth as well as the erupted premolars had persistent open apices. Coronal malformation of the right maxillary first premolar was another interesting finding. There was an absence of any concomitant disease. Summary The aforementioned combination of findings has not been reported previously. The anatomical, geometrical, and spatial relationships of supernumerary teeth with their erupted equivalents may shed light on some controversial aspects of the etiology. Citation Farahani RMZ, Zonuz AT. Triad of Bilateral Duplicated Permanent Teeth, Persistent Open Apex, and Tooth Malformation: A Case Report. J Contemp Dent Pract 2007 November; (8)7:094-100.

Bilaterally impacted mandibular supernumerary premolars associated with unusual clinical complications

“…[10] The phylogenetic theory of atavism, dichotomy theory, heredity, hyperactivity of dental lamina, aberrations during embryologic formation, progress zone, and unified etiological explanation are various theories for the developmental of supernumerary teeth. [4511] The etiology appears to multifactorial being a combination of environment and genetic factors. [12] Supplemental premolars were formed from the extension of dental lamina in region.…”

“…Non-syndromic multiple supernumeraries are rare and majority of these occur in mandible, especially mandibular anterior region. [56] Although mandibular supernumerary premolars are common, their bilateral occurrence and its association with clinical complication are uncommon.…”

Multiple bilateral supernumerary mandibular premolars in a non-syndromic patient with associated orthokeratised odontogenic cyst- A case report and review of literature

“…These include phylogenetic theory of atavism (evolutionary throwback), dichotomy theory (cleavage of a single tooth bud to two homologous or heterologous parts),[2] morphogenetic field theory,[1] and heredity (an autosomal dominant trait,[8] sex-linked inheritance. [10]) The most widely accepted hypothesis is the hyperactivity theory suggesting supernumeraries are the result of localized, independent, and conditional hyperactivity of dental lamina.…”

“…According to morphology, supernumery teeth may be categorized as: Conical (a small peg-shaped tooth), tuberculate (barrel-shaped with incomplete root formation and often paired), supplemental (morphology similar to a tooth of the normal dentition), or odontoma (hamartomatous malformation). [2] In most cases, SP tend to be supplemental. [3] In the present case also, supernumeraries are of the supplemental type.…”

“…[1] These teeth may be single or multiple, unilateral or bilateral, erupted or impacted, and in one or both jaws. [2] The prevalence of supernumerary teeth varies between 0.3% to 1.9% in primary dentition and 0.1% to 3.6% in permanent dentition. [1] Even though the majority of supernumerary teeth appear in the premaxillary region (mesiodens), supernumerary premolars (SP) have a predisposition for the mandible.…”