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Original Article

Prevalence of supernumerary teeth in permanent


dentition among patients attending a dental
college in South Kerala: A pilot study
Devi Gopakumar, Jincy Thomas, Prasanna Ranimol, Daniel Alex Vineet , Sunila Thomas, Vivek Velayudhan Nair
Department of Oral Medicine and Radiology, PMS College of Dental Science and Research, Trivandrum, Kerala, India

ABSTRACT

Background: Supernumerary teeth are excess number of teeth formed as a result of disturbances occurring during
odontogenesis. The objective of the study was to investigate the prevalence of supernumerary teeth in permanent dentition
among patients attending a dental college in South Kerala. Materials and Methods: In this study, 11,141 subjects attending
the out-patient department of PMS College of Dental Science and Research, Thiruvananthapuram, Kerala were examined for
supernumerary teeth like mesiodens, paramolars, distomolars, third premolars, second laterals, and odontomes during the
period May 2012-May 2013. Ethical clearance was obtained from the institutional ethical committee for the study. Results:
The study showed a prevalence of 0.39% and a sex distribution of M:F equal to 2:1. The incidence of supernumerary teeth
found was as follows: mesiodens (0.14%), paramolars (0.13%), third premolar (0.04%), distomolar (0.03%), extralateral
(0.02%), and odontome (0.03%). The male:female gender predilection was as follows: mesiodens (3:1), paramolars
(1.3:1), third premolar (4:1), distomolar (1:2), and odontome (2:1). Conclusion: This study showed a 0.39% prevalence
of supernumerary teeth in this population.
Key words: Pilot study, prevalence, supernumerary teeth

Introduction theory, dental lamina hyperactivity theory, and


genetic theory.[5] They can also occur as an abnormal

S
upernumerary teeth can be defined as those reaction to traumatic episodes or environmental
teeth which are in excess when compared to the factors.[5] Supernumerary teeth can be classified
normal series.[1] Previous studies have reported according to the morphology as conical, tuberculate,
prevalence rates ranging between 0.3% and 0.8% supplemental, and odontome.[6] They occur singly
in primary dentition and between 0.1% and 3.8% or in multiples, unilaterally or bilaterally, either in
in permanent dentition.[2-4] Reported male:female maxilla, mandible, or both.[2] They occur 10 times more
in maxilla, especially premaxilla, than mandible.[3,4,7]
ratio is 2:1.[1] Exact etiology is not known, but there
Multiple supernumerary teeth may be associated with
are several theories to justify their existence. The
conditions such as cleidocranial dysplasia, Gardner
various theories are phylogenetic theory, dichotomy syndrome, and cleft lip and cleft palate.[6] Clinically,
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it can cause disorders like retention of primary
teeth, delayed eruption of permanent teeth, ectopic
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eruptions, tooth displacements, follicular cysts, and
www.jiaomr.in other alterations which require surgical as well as
orthodontic treatments.[8,9]
DOI:
10.4103/0972-1363.141854
The objective of the study was to estimate the
prevalence of supernumerary teeth in permanent

Address for correspondence: Dr. V Vivek, Department of Oral Medicine and Radiology, PMS College of Dental Science and
Research, Golden Hills, Vattappara, PO - Venkode, Trivandrum - 695 028, Kerala, India. E-mail: vivekv@rediffmail.com
Received: 15-06-2014 Accepted: 08-08-2014

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Gopakumar, et al.: Prevalence of supernumerary teeth

dentition among patients attending the out-patient distomolar (0.03%), extralateral (0.02%), and odontome
department (OPD) of PMS College of Dental Science (0.03%). The male:female gender predilection was
and Research located at Vattappara, a rural area in as follows: mesiodens (3:1), paramolars (1.3:1), third
Trivandrum, Kerala state. premolar (4:1), distomolar (1:2), and odontome (2:1)
[Figures 6-8].
Materials and Methods
Discussion
A total of 11,141 patients attending the Department
of Oral Medicine and Radiology, PMS College of Supernumerary teeth are the developmental alterations
Dental Science and Research, Vattappara, Trivandrum, that can occur in any zone of dental arch and can
Kerala, India over a period of 1 year from May 2012 to involve any tooth. [10] Exact etiology is not known. [6]
May 2013, who consented to participate in the study, One theory suggests that they develop from a third
were examined clinically for supernumerary teeth tooth bud arising from dental lamina near the normal
[Figures 1-5]. When there was clinical presence of tooth. According to another theory, it is due to
supernumerary tooth/teeth, radiograph(s) were taken dichotomy of the tooth bud.[11] A third theory called
to rule out multiple unerupted supernumerary teeth. hyperactivity theory suggests that it is formed as a
Demographic data, number of supernumerary teeth, result of local, independent, conditioned hyperactivity
their location, position, type, and morphology were of dental lamina.[12] Heredity may also play a role in
recorded for each patient with this condition. Ethical the occurrence of supernumerary teeth.[13] They can be
clearance was obtained from the institutional ethical classified according to the time of appearance, position
committee for the study. in the arch, shape, and number of supernumerary teeth.
According to the morphology, they can be grouped as
Results conical, tuberculate, supplemental, and odontomas.[6]
Small, peg-shaped conical supernumerary is mostly
Among the 11,141 patients examined, 43 patients were found in permanent dentition. It can cause rotation or
identified with supernumerary teeth, with a prevalence of displacement of permanent incisor. Tuberculate variety
0.39%. The supernumerary teeth found were mesiodens has more than one cusp or tubercle. They may be barrel
(0.14%), paramolars (0.13%), third premolar (0.04%),

Figure 2: Clinical photograph and periapical radiograph of extralateral


Figure 1: Clinical photograph and periapical radiograph of conical variety supernumerary teeth
of supernumerary tooth (mesiodens)

Figure 3: Clinical photograph and periapical radiograph of supplemental Figure 4: Panoramic radiograph of complex composite odontome (in
variety of supernumerary tooth (third premolar) mandible)

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Gopakumar, et al.: Prevalence of supernumerary teeth

Figure 5: Panoramic radiograph of complex composite odontome


(in maxilla)

Figure 6: Histogram showing M:F predilection for each variety of


supernumerary teeth

Figure 7: Pie diagram showing prevalence of each variety of


supernumerary teeth

Figure 8: Pie diagram showing prevalence of the morphological types


shaped and often paired, seen on the palatal aspect of supernumerary teeth
of central incisors. They do not erupt and can cause
delayed eruption of central incisors.[6] Supplemental teeth found were mesiodens (0.14%), paramolars
type is the duplication of teeth in the normal series. (0.13%), third premolar (0.04%), distomolar (0.03%),
Most common are the permanent maxillary lateral extralateral (0.02%), and odontomes (0.03%). Mesiodens
incisors but premolars and molars can also occur (as can be grouped under the conical type. Paramolars,
the supplemental type of supernumerary teeth). [6] distomolars, third premolars, and extralaterals come
Odontome represents a hamartomatous malformation under supplemental type. The male:female gender
rather than a neoplasm. [6] Two types of odontomes predilection was: Mesiodens (3:1), paramolars (1.3:1),
are present; they are compound composite and third premolar (4:1), distomolar (1:2), and odontome
complex composite odontomes. In complex composite (2:1). Overall, the M:F ratio was 2:1 which coincides with
type, there is diffuse mass of dental tissue which is the values reported in other studies.[5,10,14-16] Different
totally disorganized, whereas in compound type, the studies on prevalence according to type and location
malformation has superficial anatomical similarity to show the following: upper lateral incisors represent
a normal tooth.[1,6] Failure of eruption, displacement, 50%, mesiodens 36%, central upper incisor 11%, and
and crowding of permanent teeth are the complications premolars 3%; single supernumerary teeth represent
associated with supernumerary teeth. Another problem 76-86%, double supernumerary teeth correspond
associated with supernumerary teeth is the occurrence to 12-23% of cases, and four supernumerary molars
of dentigerous cyst. or distomolars account for 18% of cases. Multiple
supernumerary teeth represent less than 1% of all
In the present study, among the 11,141 patients examined, cases.[16-18] Fernández Montenegro et al. reported that
43 patients were having supernumerary teeth, with supernumerary teeth prevalence ranges from 0.5 to
a prevalence of 0.39% which was within the range 3.8% in permanent dentition, and from 0.35 to 0.6% in
reported by previous studies.[2-4] The supernumerary primary dentition.[17]

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Gopakumar, et al.: Prevalence of supernumerary teeth

Conclusion 9. De Oliveira Gomes C, Drummond SN, Jham BC, Abdo EN,


Mesquita RA. A survey of 460 supernumerary teeth in Brazilian
children and adolescents. Int J Paediatr Dent 2008;18:98-106.
The prevalence of supernumerary teeth in the present
10. Leco Berrocal MI, Martin Morales JF, Martínez González JM. An
study was 0.39%. The supernumerary teeth found were: observational study of the frequency of supernumerary teeth
Mesiodens (0.14%), paramolars (0.13%), third premolar in a population of 2000 patients. Med Oral Patol Oral Cir Bucal
(0.04%), distomolar (0.03%), extralateral (0.02%), and 2007;12:E134-8.
odontome (0.03%). The male:female gender predilection 11. Çandırlı C, Dayısoylu E, Coskun G, Taskesen F, Kilkis D.
was: Mesiodens (3:1), paramolars (1.3:1), third premolar Prevalence and characteristics of supernumerary teeth in east-
northern Turkish population. Cumhuriyet Dent J 2012;15:335-39.
(4:1), distomolar (1:2), and odontome (2:1).
12. Wang XP, Fan J. Molecular genetics of supernumerary tooth
formation. Genesis 2011;49:261-77.
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