Multiple Bilateral Supplemental Premolars in Non-Syndromic Patients- Report of Two Cases

Supernumerary teeth are superfluous teeth present in the oral cavity. They represent only a small percentage, prevalence rates being 0.1 -6.9% in permanent dentition and 0.4-0.8% in deciduous dentition. ^[1]. Supplemental teeth are a type of supernumerary teeth that has a normal, shape and size, resembling the natural tooth it is associated with.  Etiopathogenesis usually are developmental anomalies caused by either dental lamina hyperactivity or explained by dichotomy theory where the tooth germ divides into two equal or different-sized parts, resulting in the formation of two teeth of equal size or one normal and one dysmorphic tooth. Supernumeraries can lead to problems like delayed eruption of teeth, malocclusions, crowding, or cyst formation, requiring diagnosis via radiographs and potential surgical removal ^[2].

Case report 1–

A male patient aged 31 years reported to the department with the chief complaint of pain in his upper and lower right back tooth region since 1month.His medical and family history were non contributary. On intraoral examination, a carious lesion was present in #46 and the tooth was tender on palpation, root-stump in #17 and grossly decayed # 37. Maxillary arch showed palatally erupted supernumerary tooth in the interdental region of #24/#25 and mandibular arch showed lingually erupted and buccally rotated supernumerary in the region of # 34/35 (Figure 1A). A panoramic radiograph revealed 2 impacted and 2 erupted supernumerary premolars in maxillary and mandibular arches.1 impacted supernumerary teeth was present in the region of #14/#15 and 1 impacted supernumerary in the region of #44 and 1 erupted premolar in the region of # 24/#25 and 1 premolar in region of # 34/35 (Figure 1B). #46 showed periapical abscess and internal resorption in #11. Endodontic treatment was advised for #46.