Analysis of the disease status and morphological characteristics of patients with polydontia based on oral panorama and conical beam CT
Zhang Dong1, Lu Fengqi1, Sun Kairong2, Hua Xiuhong1, Gao Yu1
1Department of Radiology, Jiangnan University Medical Center, Wuxi 214002, China; 2Department of Radiology, the Affiliated Maternity Hospital of Jiangnan University, Wuxi 214002, China
Abstract：Objective This study aimed to investigate the incidence status and characteristics of patients with supernumerary teeth on the basis of oral panoramic radiographs and cone beam CT (CBCT). Method This study was a cross-sectional study. A total of 35 541 patients, including 14 460 males and 21 081 females aged 3-97 (43.3±18.6) years, who underwent oral panoramic radiographs at Jiangnan University Medical Center from August 2017 to July 2021, were included. Among them, 1 343 patients, including 708 males and 635 females aged 3-95 (42.3±18.8) years, with a confirmed diagnosis of supernumerary teeth were included. Simultaneous CBCT was performed in 64 of the 1343 patients. Observational items: (1) Based on age, patients were divided into five age groups: <20 years, 20-<40 years, 40-<60 years, 60-<80 years, and ≥ 80 years. The overall occurrence of supernumerary teeth was statistically compared between different genders and the occurrence of supernumerary teeth among different age groups and between different genders. (2) Differences in the type, location, and growth direction of supernumerary teeth between different ages and senders were compared. (3) The radiographic characteristics of different types of supernumerary teeth and complications, such as disturbed eruption of the adjacent teeth, root resorption of the adjacent teeth, and dentigerous cysts, were observed on CBCT, and the differences in the occurrence of complications between different genders were compared. Results (1) Among the 35 541 patients, 1 343 (1 667) were found to have supernumerary teeth, with an incidence of 3.8%. Among them, 4.9% (708/14 460) occurred in men and 3.0% (635/21 081) occurred in women. The male-to-female ratio was 1.1∶1 (708∶635). Of the 1 343 patients with 1 667 supernumerary teeth, those with one supernumerary tooth presented the most (1 084 patients), whereas those with four supernumerary teeth presented the least (14 patients), and no significant difference was found in the number of supernumerary teeth between different genders (χ2=0.83,P=0.842). Meanwhile, significant differences were observed in the proportion of supernumerary teeth of different genders among different age groups (χ2=17.08, P=0.002). (2) Among the 1667 supernumerary teeth, the percentage order of different types of supernumerary teeth in males from high to low was as follows: conical type, 38.0% (353/929); molar type, 29.2% (271/929); odontoma type, 19.5% (181/929); and incisor type, 13.3% (124/929). In females, the order from high to low was as follows: conical type, 42.3% (312/738); odontoma type, 27.5% (203/738); molar type, 20.2% (149/738); and incisor type, 10.0% (74/738). The supernumerary teeth were most frequently located in the upper jaw of both genders, and all had the largest percentage of the maxillary central incisor area [49.7% (462/929), 29.2% (216/738)]. For the growth direction of supernumerary teeth, males had the largest proportion of normal direction at 29.2% (271/929), followed by oblique direction at 24.5% (228/929). Meanwhile, females had the largest proportion of oblique direction at 28.5% (210/738), followed by normal direction at 26.8% (198/738). Significant differences were found on the type, location, and growth direction composition ratio of supernumerary teeth between genders (all P values < 0.001). (3) CBCT was performed in 64 cases, and supernumerary teeth were found in 64 cases (84), of which 44 had conical type. CBCT showed that the width of the crown was larger than the width of the neck, and the crowns were tapered. For molar type (24 teeth), CBCT showed an occlusal surface with the occlusal facing inward concavity and sulcus-like shape. For incisor type (nine teeth), CBCT showed a wedge-shaped crown with the thickest neck and gradual thinning towards the incisal end. For odontoma type (seven teeth), CBCT revealed numerous small tooth-like structures closely adapted to one another and united by a more or less complete connective capsule. CBCT also revealed four disturbed eruptions, 23 resorptions of adjacent roots, and 16 dentigerous cysts. While the overall incidence of any disturbed eruption, root resorption of adjacent teeth, and dentigerous cyst was 51.2% (43/84), no significant difference could be seen in any of the incidence of complications, such as disturbed eruption of supernumerary teeth, root resorption of adjacent teeth, and dentigerous cyst between genders (all P values >0.05). Conclusion The overall incidence of supernumerary teeth is 3.8%, and age and gender differences are found in the incidence of supernumerary teeth and the characteristics of supernumerary teeth.
张氡, 陆风旗, 孙凯容, 花修红, 高煜. 基于口腔全景片和锥形束CT多生牙发病状况及形态特点的分析[J]. 中华解剖与临床杂志, 2023, 28(8): 533-539.
Zhang Dong, Lu Fengqi, Sun Kairong, Hua Xiuhong, Gao Yu. Analysis of the disease status and morphological characteristics of patients with polydontia based on oral panorama and conical beam CT. Chinese Journal of Anatomy and Clinics, 2023, 28(8): 533-539.
Anthonappa RP, King NM, Rabie AB.Aetiology of supernumerary teeth: a literature review[J]. Eur Arch Paediatr Dent, 2013,14(5):279-288. DOI: 10.1007/s40368-013-0082-z
[2]
Lu X, Yu F, Liu J, et al.The epidemiology of supernumerary teeth and the associated molecular mechanism[J]. Organogenesis, 2017,13(3):71-82. DOI: 10.1080/15476278.2017.1332554
[3]
Díaz A, Orozco J, Fonseca M.Multiple hyperodontia: report of a case with 17 supernumerary teeth with non syndromic association[J]. Med Oral Patol Oral Cir Bucal, 2009,14(5):E229-E231
[4]
Wang XP, Fan J.Molecular genetics of supernumerary tooth formation[J]. Genesis, 2011,49(4):261-277. DOI: 10.1002/dvg.20715
[5]
Yassin OM, Hamori E.Characteristics, clinical features and treatment of supernumerary teeth[J]. J Clin Pediatr Dent, 2009,33(3):247-250. DOI: 10.17796/jcpd.33.3.0j1227k74883531n
[6]
Liu DG, Zhang WL, Zhang ZY, et al.Three-dimensional evaluations of supernumerary teeth using cone-beam computed tomography for 487 cases[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007,103(3):403-411. DOI: 10.1016/j.tripleo.2006.03.026
[7]
Ma X, Jiang Y, Ge H, et al.Epidemiological, clinical, radiographic characterization of non-syndromic supernumerary teeth in Chinese children and adolescents[J]. Oral Dis, 2021,27(4):981-992. DOI: 10.1111/odi.13628
[8]
He D, Mei L, Wang Y, et al.Association between maxillary anterior supernumerary teeth and impacted incisors in mixed dentition[J]. J Am Dent Assoc, 2017,148(8):595-603. DOI: 10.1016/j.adaj.2017.05.017
[9]
Zhao L, Liu S, Zhang R, et al.Analysis of the distribution of supernumerary teeth and the characteristics of mesiodens in Bengbu, China: a retrospective study[J]. Oral Radiol, 2021,37(2):218-223. DOI: 10.1007/s11282-020-00432-3
Leyland L, Batra P, Wong F, et al.A retrospective evaluation of the eruption of impacted permanent incisors after extraction of supernumerary teeth[J]. J Clin Pediatr Dent, 2006,30(3):225-231. DOI: 10.17796/jcpd.30.3.60p6533732v56827
[12]
Esenlik E, Sayin MO, Atilla AO, et al.Supernumerary teeth in a Turkish population[J]. Am J Orthod Dentofacial Orthop, 2009,136(6):848-852. DOI: 10.1016/j.ajodo.2007.10.055
[13]
Demiriz L, Durmuşlar MC, Mısır AF.Prevalence and characteristics of supernumerary teeth: a survey on 7348 people[J]. J Int Soc Prev Community Dent, 2015,5(Suppl 1):S39-43. DOI: 10.4103/2231-0762.156151
[14]
Chaudhary S, Chaitra TR, Sultan S, et al.Supernumerary teeth in primary dentition[J]. BMJ Case Rep, 2013,2013:bcr2013200029.DOI: 10.1136/bcr-2013-200029
[15]
Bereket C, Çakır-Özkan N, Şener İ, et al. Analyses of 1100 supernumerary teeth in a nonsyndromic Turkish population: a retrospective multicenter study[J]. Niger J Clin Pract, 2015,18(6):731-738. DOI: 10.4103/1119-3077.154213
[16]
Fernández Montenegro P, Valmaseda Castellón E, Berini Aytés L, et al.Retrospective study of 145 supernumerary teeth[J]. Med Oral Patol Oral Cir Bucal, 2006,11(4):E339-E344
[17]
Anegundi RT, Tegginmani VS, Battepati P, et al.Prevalence and characteristics of supernumerary teeth in a non-syndromic South Indian pediatric population[J]. J Indian Soc Pedod Prev Dent, 2014,32(1):9-12. DOI: 10.4103/0970-4388.127041
[18]
Jiang Y, Ma X, Wu Y, et al.Epidemiological, clinical, and 3-dimentional CBCT radiographic characterizations of supernumerary teeth in a non-syndromic adult population: a single-institutional study from 60,104 Chinese subjects[J]. Clin Oral Investig, 2020,24(12):4271-4281. DOI: 10.1007/s00784-020-03288-3
[19]
McBeain M, Miloro M. Characteristics of supernumerary teeth in nonsyndromic population in an urban dental school setting[J]. J Oral Maxillofac Surg, 2018,76(5):933-938. DOI: 10.1016/j.joms.2017.10.013
[20]
Singh VP, Sharma A, Sharma S.Supernumerary teeth in Nepalese children[J]. ScientificWorldJournal, 2014,2014:215396. DOI: 10.1155/2014/215396
[21]
Anthonappa RP, Omer RS, King NM.Characteristics of 283 supernumerary teeth in southern Chinese children[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2008,105(6):e48-e54. DOI: 10.1016/j.tripleo.2008.01.035
[22]
Ata-Ali F, Ata-Ali J, Peñarrocha-Oltra D, et al.Prevalence, etiology, diagnosis, treatment and complications of supernumerary teeth[J]. J Clin Exp Dent, 2014,6(4):e414-e418. DOI: 10.4317/jced.51499
[23]
Chou ST, Chang HP, Yang YH, et al.Characteristics of supernumerary teeth among nonsyndromic dental patients[J]. Journal of Dental Sciences, 2015, 10(2):133-138. DOI:10.1016/j.jds.2013.12.004
[24]
Mossaz J, Kloukos D, Pandis N, et al.Morphologic characteristics, location, and associated complications of maxillary and mandibular supernumerary teeth as evaluated using cone beam computed tomography[J]. Eur J Orthod, 2014,36(6):708-718. DOI: 10.1093/ejo/cjt101
2023, Vol. 28 
