Supernumerary teeth – detailed

Clinical Assessment & Presentations

Intra-oral Features

Types of supernumeraries

There are several types of supernumeraries and these are defined by their morphology.

Conical supernumeraries often present in the anterior maxilla as mesiodens.
A tuberculate supernumerary is one which presents with multiple cusps and often deficient root development.
Supplemental supernumerary teeth are duplicates of normal teeth, in this case the lower premolars.
Odontomes can present as complex (disorganized round mass of dentine, pulp and enamel) or compound (discreet denticles which dentine, pulp and enamel). Compound odontomes are 4 x more common than complex. The above image is of a surgically removed compound odontome.

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Unerupted or erupted supernumeraries

Supernumeraries can be unerupted or erupted. The majority fail to erupt and are usually asymptomatic. These supernumeraries are normally only found on routine radiographic imaging. For example the above occlusal film shows a erupted mesioden between the central incisors and another supernumerary above the left central and lateral incisors.

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Ectopic or impacted teeth

A supernumerary can prevent permanent teeth from erupting. This is particularly evident with impacted incisors. These supernumeraries should be removed to allow for the permanent teeth to erupt freely. In some cases, active orthodontic traction is required to erupt the impacted tooth.

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