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      Cone-beam computed tomography exploration and surgical management of palatal, inverted, and impacted mesiodens

      case-report

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          Abstract

          Supernumerary teeth are extra teeth or toothlike structures which may have either erupted or unerupted in addition to the 20 deciduous teeth and the 32 permanent teeth. Mesiodens is one of these located in the midline between the two central incisors. Their presence may give rise to a variety of clinical problems. This paper describes a rare case of palatal placed, inverted and impacted mesiodens associated to two supernumerary teeth which were detected during a radiographic examination for delayed eruption of permanent central incisors in the case of a healthy 8-year-old girl monitored at the oral surgery service while discussing the usefulness of cone beam computed tomography for accurate diagnosis and management.

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          Most cited references31

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          Supernumerary teeth: review of the literature and a survey of 152 cases.

          A review of the literature relating to supernumerary teeth is presented along with a survey of 152 cases. The study population consisted of 152 children who visited the department of Paediatric Dentistry at the Jordan University Hospital. Patients ranged in age from 5 to 15 years. Supernumeraries were detected by clinical examination and radiographs. Males were affected more than females with a sex ratio of 2.2 : 1. Seventy-seven percent of the patients had one supernumerary tooth, 18.4% had double teeth, and 4.6% had three or more supernumeraries. Ninety percent of the supernumerary teeth occurred in the premaxilla, of which 92.8% were in the central incisor region and of these latter 25% were located in the midline. The other 10.4% of the supernumeraries were located in the premolar, canine, molar, and lower central incisor regions. Two cases were of non-syndrome supernumerary teeth. Seventy-five percent of the supernumeraries were conical, 83.1% were in the normal vertical position and 26.5% were erupted. Conical-shaped supernumerary teeth had a significantly higher rate of eruption compared to the tuberculate type.
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            Supernumerary teeth--an overview of classification, diagnosis and management.

            Most supernumerary teeth are located in the anterior maxillary region. They are classified according to their form and location. Their presence may give rise to a variety of clinical problems. Detection of supernumerary teeth is best achieved by thorough clinical and radiographic examination. Their management should form part of a comprehensive treatment plan. This article presents an overview of the clinical problems associated with supernumerary teeth and includes a discussion of the classification, diagnosis and management of this difficult clinical entity.
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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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                Author and article information

                Journal
                Contemp Clin Dent
                Contemp Clin Dent
                CCD
                Contemporary Clinical Dentistry
                Medknow Publications & Media Pvt Ltd (India )
                0976-237X
                0976-2361
                September 2015
                : 6
                : Suppl 1
                : S289-S293
                Affiliations
                [1] Department of Medicine and Oral Surgery, University Dental Clinic, Monastir, Tunisia
                Author notes
                Correspondence: Dr. Mounir Omami, Department of Medicine and Oral Surgery, University Dental Clinic, Monastir, Tunisia. E-mail: mounir.omami@ 123456gmail.com
                Article
                CCD-6-289
                10.4103/0976-237X.166815
                4632240
                f3925ee8-66a4-4938-ba92-05e39bdf4f86
                Copyright: © Contemporary Clinical Dentistry

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                Categories
                Case Report

                Dentistry
                cone-beam computed tomography,inverted,mesiodens,palatal impaction,supernumerary tooth
                Dentistry
                cone-beam computed tomography, inverted, mesiodens, palatal impaction, supernumerary tooth

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