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      Nonsyndromic Bilateral Posterior Maxillary Supernumerary Teeth: A Report of Two Cases and Review

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          Abstract

          Supernumerary tooth/hyperdontia is defined as those teeth which are present in excess of the usual distribution of twenty deciduous and thirty-two permanent teeth. It can be seen in both syndromic and nonsyndromic patients. In Nepalese population, prevalence of supernumerary tooth is documented to be 1.6%. To the best of our knowledge, no studies from Nepal have reported the incidence of bilateral maxillary paramolars or the combination of unilateral maxillary paramolar and distomolar till date. Hence, we are reporting these two cases with a brief review of literature to put emphasis on incidence, prevalence, proposed hypothesis for etiology, and management of supernumerary teeth.

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          Most cited references45

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          A unifying aetiological explanation for anomalies of human tooth number and size.

          Genetic and environmental factors are implicated in the aetiology of supernumerary teeth, hypodontia, megadontia and microdontia ; these anomalies tend to be associated. 1115 school children aged 11-14 years examined clinically and radiographically provided prevalence data. A further 703 children with dental anomalies were studied. 153 of these became probands for a family study and 327 of their first-degree relatives were examined. There were much higher frequencies (p less than 0.001) of all anomalies among the relatives of probands than in the general population. Males more often had supernumerary teeth and megadontia and females more frequently had hypodontia (p less than 0.05) and microdontia . For hypodontia, the proportion of relatives affected varied with the severity of the condition in the proband (p less than 0.05). In the prevalence study, there was an association between hypodontia and microdontia (p less than 0.001). These findings may be explained by a multifactorial model having a continuous scale, related to tooth number and size, with thresholds. Position on the scale usually depends upon the combination of numerous genetic and environmental factors, each with a small effect, but occasionally a chromosomal anomaly, a major single gene or a major environmental insult may have a large effect. The finding that the estimated difference between the means of the sexes was the same for each anomaly, within the limits of experimental error, supports the validity of the model.
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            Dental anomalies of number, form and size: their prevalence in British schoolchildren.

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              Molecular genetics of supernumerary tooth formation.

              Despite advances in the knowledge of tooth morphogenesis and differentiation, relatively little is known about the aetiology and molecular mechanisms underlying supernumerary tooth formation. A small number of supernumerary teeth may be a common developmental dental anomaly, while multiple supernumerary teeth usually have a genetic component and they are sometimes thought to represent a partial third dentition in humans. Mice, which are commonly used for studying tooth development, only exhibit one dentition, with very few mouse models exhibiting supernumerary teeth similar to those in humans. Inactivation of Apc or forced activation of Wnt/β(catenin signalling results in multiple supernumerary tooth formation in both humans and in mice, but the key genes in these pathways are not very clear. Analysis of other model systems with continuous tooth replacement or secondary tooth formation, such as fish, snake, lizard, and ferret, is providing insights into the molecular and cellular mechanisms underlying succesional tooth development, and will assist in the studies on supernumerary tooth formation in humans. This information, together with the advances in stem cell biology and tissue engineering, will pave ways for the tooth regeneration and tooth bioengineering. Copyright © 2011 Wiley-Liss, Inc.
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                Author and article information

                Contributors
                Journal
                Case Rep Dent
                Case Rep Dent
                CRID
                Case Reports in Dentistry
                Hindawi
                2090-6447
                2090-6455
                2018
                11 April 2018
                : 2018
                : 5014179
                Affiliations
                1Department of Orthodontics, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
                2Department of Oral Medicine and Radiology, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
                3Oral and Maxillofacial Radiology, Applied Oral Sciences, Faculty of Dentistry, University of Hong Kong, Pokfulam, Hong Kong
                4Department of Oral and Maxillofacial Surgery, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
                Author notes

                Academic Editor: Gavriel Chaushu

                Author information
                http://orcid.org/0000-0003-3573-3629
                Article
                10.1155/2018/5014179
                5925185
                29850278
                b66ee3a2-d7dd-44ed-a9e5-af6ac56c0e23
                Copyright © 2018 Ravi Kumar Mahto et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 January 2018
                : 18 March 2018
                Categories
                Case Report

                Dentistry
                Dentistry

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