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Bilateral supplemental deciduous canines with an associated unilateral supernumerary permanent canine
Exodontia
Bilateral supplemental deciduous canines with an associated unilateral supernumerary permanent canine Joseph W. Hayduk, Galveston, Texas DEPARTMENT
OF
B.S., D.D.S.,*
SURGERY,
USIVRRSITY
and Koy A. Stout, D.D.S., P.I.C.D.,*’ OF
TRXAS
T
MEDICAL
BRANCH
he development of extra teeth is a relatively common occurrence, and these excess teeth are often termed supernumerary. It has been suggested, however, that the term supernumerary be reserved for ill-formed extra teeth and that the word supplemental be used for teeth that are extra but have the shape and size of normal teeth.’ Supplemental teeth are most common in the maxillary incisor region, with the lower premolar region second in frequency, followed by the lower molar areas. On the other hand, supernumerary teeth are most cncountercd, in order of frequency, in the upper central incisor, upper third molar, and lower premolar regions.lz ” Nelson3 states that extra deciduous teeth are much less common than extra permanent teeth. It is generally accepted that extra teeth are probably due to hyperactivity of the dental lamina. Their presence may prevent eruption of the normal dentition or possibly cause eruption in an abnormal direction without there ever being any actual contact between them. It must be stressed that before an attempt is made to remove any such extra teeth a thorough radiographic examination is in order. me prefer stereoscopic periapical roentgenograms for this purpose. The following case report illustrates an unusual instance in which supplemental deciduous canines were associated with a supernumerary permanent canine. *Resident **Associate
24
in
Oral and Maxillofacial Professor of Surgery,
Oral
Surgery. and Maxillofacial.
Volume Number
ihpplemental
18 1
and supernumerary
canines
25
CASE REPORT A. R., an S-year-old girl of Latin-American origin, was brought to the Oral Surgery Clinic of John Sealy Hospital on Jan. 11, 1964. Her chief complaint was that the permanent right maxillary lateral incisor had failed to erupt; in addition, the permanent left maxillary lateral incisor had erupted in a rotated manner. Clinical examination showed fair occlusion with a moderate amount of overjet but, more important, four deciduous maxillary canine teeth. All four appeared grossly identical and in good alignment in the maxillary arch. Thus, by our previous definition, two were supplemental deciduous maxillary canines.
Fig. 2. Roentgenograms immediately pointing out the reason for the delayed eruption of the right. permanent lateral incisor and the rotated left permanent lateral incisor. The mesial right and left deciduous supplement.al canines (A) and (H) mere extracted, as was the permanent supernumerary canine (C) .
Fig. 2. l!he right supplemental canines
permanent following
supernumerary extraction.
canine
shown
with
the right
and
left
deciduous
O.S.,O.~l.d~ 0.1’. .I uly, 106~4
Aft,rr stereoscopic periapical rocntgenograrns were taken au11 viewed, wc decided to extract the mesial supplemental deciduous caninw as well as the right permanent supernumerary canine: under local infiltrative anesthesia ( Fig. 2). It has bwn our procedurc~ also to incise unerupted permanent lateral incisor follicles in such cases in order to facilitate, more rapid eruption following surgical intervention. Twenty days postoperatively the right permanout lateral incisor was seen to be erupting normally and the left permanent lateral incisor al’peared less rotated.
DISCUSSION
Bilateral deciduous supplemental maxillary canines are, indeed, quite rare. The word suppZementaZ is a more exact term in the identification of normal extra teeth than supernumerary, which we believe should he reserved for ahnormal extra teeth. Those described in this case report were replicas of the deciduous canine teeth, both clinically and radiographically. Their prompt removal at this time prevented a costly future orthodontic problem. The presence of supplemental canine teet,h disputes the theory of atavism in that there are never more than four canines in the mammalian progenitors. The atavistic theory claims a recurrence of teeth which had been eliminated in the process of evolution. SUMMARY
We have presented the case of an H-year-old girl of I,atin-American origin with bilateral supplemental deciduous canine teeth and also a unilateral supernumerary right permanent canine tooth. These extra teeth caused a rotation of the permanent left maxillary lateral incisor and prevented the eruption of the permanent right maxillary lateral incisor. REFERENCES
Principles. and Practice of Oral Radiologic 1 nterpretation, (S-ago, 1963, 1. Worth, H. M.: Year Book Publishers, Inc., pp. 101-105. 2. Thoma, Ii. H., and Goldman, II. M.: Oral Pathology, ed. 5, St. Louis, 1960, The C. V. Mosby Company, pp. 40-42. 3. Nelson, W. E.: Textbook of Pediatrics, ed. 7, Philadelphia, 1959, JV. 13. Saunders Company, p.
620.
Bilateral supplemental deciduous canines with an associated unilateral supernumerary permanent canine Joseph W. Hayduk, Galveston, Texas DEPARTMENT
OF
B.S., D.D.S.,*
SURGERY,
USIVRRSITY
and Koy A. Stout, D.D.S., P.I.C.D.,*’ OF
TRXAS
T
MEDICAL
BRANCH
he development of extra teeth is a relatively common occurrence, and these excess teeth are often termed supernumerary. It has been suggested, however, that the term supernumerary be reserved for ill-formed extra teeth and that the word supplemental be used for teeth that are extra but have the shape and size of normal teeth.’ Supplemental teeth are most common in the maxillary incisor region, with the lower premolar region second in frequency, followed by the lower molar areas. On the other hand, supernumerary teeth are most cncountercd, in order of frequency, in the upper central incisor, upper third molar, and lower premolar regions.lz ” Nelson3 states that extra deciduous teeth are much less common than extra permanent teeth. It is generally accepted that extra teeth are probably due to hyperactivity of the dental lamina. Their presence may prevent eruption of the normal dentition or possibly cause eruption in an abnormal direction without there ever being any actual contact between them. It must be stressed that before an attempt is made to remove any such extra teeth a thorough radiographic examination is in order. me prefer stereoscopic periapical roentgenograms for this purpose. The following case report illustrates an unusual instance in which supplemental deciduous canines were associated with a supernumerary permanent canine. *Resident **Associate
24
in
Oral and Maxillofacial Professor of Surgery,
Oral
Surgery. and Maxillofacial.
Volume Number
ihpplemental
18 1
and supernumerary
canines
25
CASE REPORT A. R., an S-year-old girl of Latin-American origin, was brought to the Oral Surgery Clinic of John Sealy Hospital on Jan. 11, 1964. Her chief complaint was that the permanent right maxillary lateral incisor had failed to erupt; in addition, the permanent left maxillary lateral incisor had erupted in a rotated manner. Clinical examination showed fair occlusion with a moderate amount of overjet but, more important, four deciduous maxillary canine teeth. All four appeared grossly identical and in good alignment in the maxillary arch. Thus, by our previous definition, two were supplemental deciduous maxillary canines.
Fig. 2. Roentgenograms immediately pointing out the reason for the delayed eruption of the right. permanent lateral incisor and the rotated left permanent lateral incisor. The mesial right and left deciduous supplement.al canines (A) and (H) mere extracted, as was the permanent supernumerary canine (C) .
Fig. 2. l!he right supplemental canines
permanent following
supernumerary extraction.
canine
shown
with
the right
and
left
deciduous
O.S.,O.~l.d~ 0.1’. .I uly, 106~4
Aft,rr stereoscopic periapical rocntgenograrns were taken au11 viewed, wc decided to extract the mesial supplemental deciduous caninw as well as the right permanent supernumerary canine: under local infiltrative anesthesia ( Fig. 2). It has bwn our procedurc~ also to incise unerupted permanent lateral incisor follicles in such cases in order to facilitate, more rapid eruption following surgical intervention. Twenty days postoperatively the right permanout lateral incisor was seen to be erupting normally and the left permanent lateral incisor al’peared less rotated.
DISCUSSION
Bilateral deciduous supplemental maxillary canines are, indeed, quite rare. The word suppZementaZ is a more exact term in the identification of normal extra teeth than supernumerary, which we believe should he reserved for ahnormal extra teeth. Those described in this case report were replicas of the deciduous canine teeth, both clinically and radiographically. Their prompt removal at this time prevented a costly future orthodontic problem. The presence of supplemental canine teet,h disputes the theory of atavism in that there are never more than four canines in the mammalian progenitors. The atavistic theory claims a recurrence of teeth which had been eliminated in the process of evolution. SUMMARY
We have presented the case of an H-year-old girl of I,atin-American origin with bilateral supplemental deciduous canine teeth and also a unilateral supernumerary right permanent canine tooth. These extra teeth caused a rotation of the permanent left maxillary lateral incisor and prevented the eruption of the permanent right maxillary lateral incisor. REFERENCES
Principles. and Practice of Oral Radiologic 1 nterpretation, (S-ago, 1963, 1. Worth, H. M.: Year Book Publishers, Inc., pp. 101-105. 2. Thoma, Ii. H., and Goldman, II. M.: Oral Pathology, ed. 5, St. Louis, 1960, The C. V. Mosby Company, pp. 40-42. 3. Nelson, W. E.: Textbook of Pediatrics, ed. 7, Philadelphia, 1959, JV. 13. Saunders Company, p.
620.