Application of digital positioning guide plates for the surgical extraction of multiple impacted supernumerary teeth:A case report and review of literature

BACKGROUND An extra tooth in the normal tooth sequence in any region of the dental arch is regarded as a supernumerary tooth(SNT).Due to the large variation in location and morphology,the extraction of impacted SNTs is an extensive and complex procedure with high risks of several complications.This report presents a rare case of seven impacted SNTs in the bilateral upper and lower arch that were successfully extracted with the use of digital positioning guide plates.CASE SUMMARY In January 2022,a 21-year-old male was referred to our department with a chief complaint of pain in relation to tooth#36.Clinical examination showed a deep carious lesion with pulpal involvement in tooth#36 and lingual swelling of the bilateral mandibular posterior area.Radiographic examination revealed seven deeply impacted SNTs in the bilateral posterior area and bilateral impacted mandibular third molars.Based on these findings,the patient was diagnosed with bilateral,multiple impacted SNTs and tooth#36 chronic pulpitis.A root canal treatment and an all-ceramic crown restoration for tooth#36 were performed.An individualized digital positioning guide plate was designed by computer-aided design/computer-aided manufacturing technology and cone-beam computed tomography for extraction of the impacted SNTs.During the operation,the digital positioning guide plate allowed rapid positioning and exposure of the SNTs while avoiding adjacent important anatomical structures.At 3-month follow-up,regeneration of bone and soft tissues was visible.CONCLUSION The application of digital positioning guide plates is useful for the individualized and minimalized extraction of impacted supernumerary teeth.

Prevalence and Pattern Occurrence of Supernumerary Teeth in the North-East Heilongjiang Population of China

Aims: The objective of the current research was to determine the prevalence of supernumerary teeth and investigate its characteristic and complications in the Chinese population from the North-East Heilongjiang region. Materials and Methods: It was a descriptive and retrospective study which used registered notes and panoramic radiographs of 12,984 patients who visited the Department of Oral and Maxillofacial Surgery in the 2nd Affiliated Hospital of Jiamusi University, China between June 2011 to November 2015. Patients diagnosed with any syndrome or hereditary diseases were excluded from the study. The features of supernumerary teeth were noted and the data were analyzed using SPSS program, (version 20, Inc., Chicago, USA). The Chi-square test was used to determine the differences in the distribution of supernumerary teeth. It was tested at the 5% level of significance. Results: The prevalence was 5.2% and the most prevalent supernumerary teeth was incisor with 3.39% (n = 441). The supernumerary teeth were seen more in maxilla than mandible. The male to female ratio was 2.9:1. Specifically, higher prevalence of supernumerary teeth in male gender was statistically significant (p = 0.03). The supernumerary teeth mostly occurred in children of 5 - 10 years (62.3%), followed by young adolescent between 11 - 16 years (26.5%). Conclusion: The prevalence of supernumerary teeth was widely seen in children and young adolescent of Chinese population. The occurrence was mostly seen in maxilla than mandible and significantly higher in male than female.