Supernumerary premolars: A case report

Supernumerary teeth are defined as any teeth or tooth substance in excess of the normal dental formula. Their incidence is approximately 1 per 110 children. Premolars account for approximately 8.4% of all supernumerary teeth. The occurrence of multiple supernumeraries in the absence of an associated systemic condition (as in our case) is nevertheless a much rarer phenomenon with only a few examples reported in the literature. Most associated problems are due to their potential to interfere with the normal occlusal development or orthodontic mechanics. Decision of their extraction vs. retention and periodic monitoring should include the potential risk of leaving them in place weighed against the possible complications of surgical removal. A 30-year-old non-syndromal Caucasian male patient was referred to the Orthodontic private practice being concerned about the appearance of his supernumerary premolar's cusp within the mouth cavity between #35 and #36. Intraoral assessment showed presence of spaces between lower teeth, especially between #33 and #34, and supra-eruption of #47 due to the long absence of its antagonists. Radiographic assessment showed a satisfactory degree of root development of the supernumerary (beyond two thirds). Treatment aimed at mandibular space closure, submergence of #47 and occlusal detailing.