Case Report - (2020) Volume 10, Issue 5
Received: 15-Apr-2020
Published:
22-May-2020
, DOI: 10.37421/2165-7920.2020.10.1344
Citation: Soha M. Basha, Bashayer S. Helaby and Manar H. Alhefdhi. “An Unusual Case of Double Mandibular Parapremolars: A Cone Beam Computed Tomography Assessed Case Report.” Clin Case Rep 10 (2020): 1344
Copyright: © 2020 Basha SM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Extra teeth number in the patient’s mouth is scientifically known as supernumerary teeth. Multiple supernumerary teeth are frequently seen in patients with developmental disorders. Cone-Beam Computed Tomography (CBCT) is a three-dimensional imaging tool that can provide a precise case planning. The purpose of this paper is to present a rare case of double parapremolars in on single quadrant and investigate these teeth by using Cone-Beam Computed Tomography (CBCT).
Case Description: A 28-year-old, Filipino female patient came to PNU dental clinics. She was medically fit, not on medications and no allergies were detected. Intraoral examination revealed presence of two supernumerary teeth at the area between #35 and #36. The Parapremolars located in quadrant three, both are with normal shape and color. Regarding the position, the first supernumerary has erupted lingually, the second is in the arch line but slightly tilted to the lingually. As a result of the extra teeth number, moderate crowding found in the area. The patient denied any family history of similar findings.
Discussion: Extraction of the first supernumerary tooth was carried out after radiographic analysis using CBCT, to facilitate proper oral hygiene, to prevent food impaction, and to eliminate its possible effects on the adjacent teeth. Extraction was performed cautiously without causing any damage to the anatomical structures. Regarding the anatomical position of the tooth, we prepared splint for teeth stabilization in case of adjacent teeth mobility. Extraction was done under local anesthesia. The patient was followed up after the extraction, no complications were reported.
Conclusion: Double parapremolar teeth were found in a non-syndromic patient. CBCT precisely locate malposed supernumerary teeth and help in getting proper treatment plan without complications.
Parapremolar • Supernumerary teeth • CBCT
Extra number of teeth is an odontostomatological phenomenon known as supernumerary teeth. They Can be found either in primary or permanent dentition [1]. Maxillary supernumerary teeth have shown tendency over mandibular supernumeraries. The incisor region is the most prevalent region followed by the molar region. Often, multiple supernumerary teeth are observed in patients with developmental disorders like cleft lip and palate, cleidocranial dysostosis, and Gardner's syndrome. Moreover, Supernumerary teeth are influenced by hereditary and environmental factors, and presented with clinical variations such as location, number, and morphology [2-5]. Several studies revealed that supernumerary observed more frequent in males than females [6,7]. Regarding the occurrence site, Scheiner MA et al. reported that supernumerary teeth are commonly found in upper lateral incisor area (50%), mesiodens (36%), upper central incisors (11%), and bicuspids (3%) [8]. While different results presented by Yusof WZ, et al. showed that there was a tendency to non-syndrome multiple supernumerary teeth to occur in the mandible [7]. Morphologically, the parapremolar resembles one of the premolars. Parapremolar can be seen as a single supernumerary tooth or multiple teeth, occasionally in combination with other types of supernumerary teeth. Cone-Beam Computed Tomography (CBCT) imaging allows a threedimensional visualization of teeth and their adjacent anatomical structures.
Nowadays, CBCT has been extensively used to accurately detect impacted and supernumerary teeth. CBCT evaluation of supernumerary teeth for accurate case planning is recommended. The purpose of this paper is to present a rare case of double parapremolars in on single quadrant that were initially detected clinically followed by radiographic analysis using CBCT.
This study has been done in Princess Nourah Bint Abdulrahman University (PNU). The appropriate patient consent form was taken. In the form, the patient has given her consent for her images and other clinical information to be reported in this article. The patient understands that her name and initials will not be published. Data collected clinically, radiographically and photographically about the patient's teeth and oral conditions. CBCT was used to assess the treatment plan and minimize the complications that may happen during performing any procedure.
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