01 Settembre 2018

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Management of two supernumerary teeth in the aesthetic area in early mixed dentition

Clinical case

Giovanni Bruno, Alberto De Stefani, Sergio Mazzoleni, Antonio Gracco

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Objectives  This case report evaluates the management of two supernumerary teeth in the aesthetic area in early mixed dentition.

Materials and methods  An eight-years-old boy came for a supernumerary upper incisor. At the radiographic and cone beam computed tomography (CBCT) evaluation emerged the presence of a second supernumerary central incisor impacted in position 1.1.

Crown shape was analysed and emerged that the incisors with the better crown shape were the ectopic and the impacted one.

The supernumerary tooth in position 2.1 was extracted and the other permanent and deciduous teeth were bonded to start moving the upper left central incisor to its correct position. After four months of therapy a 0.019x0.025 inc. rectangular archwire was applied to continue the space closure and give to the incisors the correct inclination and angulation for nine months.

After five month of therapy supernumerary tooth in position 1.1 was extracted and the impacted upper right incisor was bonded. At the end of the treatment the patient was given a removable retention to wait the complete permanent dentition.

Results  At the end of the treatment a pleasant smile and a good upper arch form were obtained, the upper incisors showed a good position, inclination and angulation. The space for the permanent upper canine eruption was kept.

Conclusions  The management of hyperdontia requires an early diagnosis and the extraction of the supernumerary tooth should be made as soon as possible. CBCT is a valid radiographic exam to evaluate the impaction and to choose the teeth with the best crown and root aspects.

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doi: https://doi.org/10.19256/d.cadmos.07.2018.09