Supernumerary teeth in patients with cleft lip and palate: the tooth germs do not separate

ABSTRACT Introduction: Supernumerary teeth in cases of cleft lip and palate do not result from the division of normal germs before the formation of hard tissue. Deciduous and permanent teeth odontogenesis begins after the face has formed, either with or without the cleft. Discussion: The most acceptable hypothesis to enable understanding of the presence of supernumerary teeth on one or both sides of the cleft palate is hyperactivity of the dental lamina in its walls. This hyperactivity, with the formation of more tooth germs, must be attributed to mediators and genes related to tooth formation, under strong influence of local epigenetic factors, whose developmental environment was affected by the presence of the cleft. Conclusion: The current concepts of embryology no longer support the fusion of embryonic processes for the formation of the face, but rather the leveling of the grooves between them. All human teeth have a dual embryonic origin, as they are composed of ectoderm and mesenchyme/ectomesenchyme, but this does not make it easy for them to be duplicated to form supernumerary teeth.

RESUMO Introdução: Os dentes extranumerários nas fissuras labiopalatinas não são resultado da divisão dos germes normais antes da formação do tecido duro. A odontogênese dos decíduos e permanentes inicia-se depois de formada a face, com ou sem fissuras. Discussão: A hipótese mais plausível para compreender a presença dos dentes extranumerários em um ou nos dois lados da fissura labiopalatina é a hiperatividade da lâmina dentária em suas paredes. Essa hiperatividade, com formação de mais germes dentários, deve ser atribuída aos mediadores e genes relacionados à formação dos dentes, sob forte influência de fatores epigenéticos locais, cujo ambiente de desenvolvimento foi afetado pela presença da fissura. Conclusão: Os conceitos atuais da embriologia não fundamentam mais a fusão de processos embrionários para a formação da face, e sim o nivelamento dos sulcos entre eles. Todos os dentes humanos têm uma dupla origem embrionária, pois se compõem de ectoderma e mesênquima/ectomesênquima, mas isso não facilita sua duplicação para formar dentes extranumerários.

Supernumerario invertido en paladar de un infante: reporte de un caso clínico

Introducción: La hiperdoncia, es una anomalía de número en la que se forman dientes o estructuras parecidas a dientes en exceso con respecto a la cantidad normal, teniendo como resultado órganos dentales llamados supernumerarios. Presentación del caso: Paciente masculino de 7 años 11 meses de edad con dentición mixta y retraso en la erupción de los incisivos centrales y laterales superiores. En la radiografía panorámica se observa una zona radiopaca entre el incisivo central superior permanente (OD 21) y el incisivo lateral superior permanente (OD 22) diagnosticando un diente supernumerario. Con ayuda de una radiografía oclusal y una periapical de la zona se valoró y se determinó su extracción bajo anestesia local. Se realizó la cirugía sin complicaciones y se derivó al paciente a la clínica de ortodoncia. Conclusiones: En el presente reporte se pudo observar que llevando un buen control del caso y con la ayuda de estudios radiográficos se puede lograr un avance significativo sin dañar la integridad bucal del paciente en un futuro. Significancia clínica: El diagnóstico precoz puede mejorar con ayuda de los diversos tipos de radiografías disponibles en odontología, así se evitan complicaciones al paciente infantil.

Introduction: Hyperdontia is a number anomaly in which teeth or structures similar to teeth are formed in excess of the normal amount, resulting in supernumerary dental organs. Case presentation: a male patient 7 years 11 months of age with mixed dentition and delayed eruption of the central and upper lateral incisors presented for evaluation. The panoramic radiograph showed a radiopaque area between the permanent upper central incisor (OD 21) and the permanent upper lateral incisor (OD 22). A supernumerary tooth was diagnosed. With the help of an occlusal and a periapical radiograph of the area, the tooth was evaluated and an extraction under local anesthesia was planned. The surgery was performed without complications and the patient was referred to the orthodontic clinic. Conclusions: In the present report, we note that time intervention and with the help of radiographic studies, a significant result can be achieved without damaging the patient's future oral integrity. Early diagnosis can be improved with the help of the various types of radiographs available in dentistry, thus avoiding complications in infants.

Unilateral maxillary distomolar with multiple abnormalities in a young patient: A rare case report with mini systemic review

Supernumerary teeth are those teeth present in addition to the normal number of teeth and are mostfrequently seen in the maxillary incisors and molar regions. In the molar regions, supernumerary teethare divided into two types depending on their location: distomolars and paramolars. Distomolarsusually occur in the form of a fourth molar distal to the third molar. Distomolars are a developmentalanomaly and have been argued to arise from a combination of genetic and environmental factors.Therefore, distomolar management should be part of a comprehensive treatment plan. This articlepresents a case report of an unusual occurrence of a rare unilateral distomolar in the right of themaxilla with multiple abnormalities in a 21-year old healthy subject. In addition, a mini literaturereview includes the definition, types, prevalence, classification, etiology, complications, diagnosis,and therapeutic strategies, which may be adopted in the occurrence of distomolars.

Dientes supernumerarios suplementarios en un paciente adulto parcialmente dentado: reporte de caso / Supplementary supernumerary teeth in a partially edentulous adult patient: case report

Aquellos casos en que se excede la cantidad normal de dientes para la fórmula primaria o definitiva se conocen como dientes supernumerarios o hiperodoncia. Esta puede presentarse de manera aislada o múltiple, unilateral o bilateral y afectar tanto a la maxila como a la mandíbula. Es más prevalente en hombres, en dentición permanente y en el maxilar, siendo el mesiodens el supernumerario encontrado con mayor frecuencia. Su etiología aún no está del todo clara, sin embargo, una hiperactividad de la lámina dental junto a una asociación de factores genéticos y ambientales sería la teoría más aceptada. Pueden ser asintomáticos y detectados solo en radiografías o pueden presentar manifestaciones clínicas como apiñamiento, retardo en la erupción, reabsorción radicular, diastemas entre otros. El tratamiento depende del tipo de diente y de su relación con las estructuras adyacentes. En el siguiente reporte presentamos el caso de un paciente de sexo masculino, de 54 años de edad, no sindrómico, desdentado parcial superior e inferior que acude a una consulta dental privada (Temuco) para solicitar tratamiento rehabilitador. En la radiografía panorámica de rutina se observan dos dientes supernumerarios, uno a cada lado de la mandíbula y en la región premolar. Al examinar este hallazgo con tomografía computarizada cone beam se determina que el supernumerario del lado derecho corresponde a un premolar suplementario y el de la izquierda a un supernumerario de morfología molariforme. En este caso se decide extraer los dientes debido a la localización de estos y a las implicancias con el tratamiento rehabilitador posterior.

Cases in which the normal amount of teeth is exceeded for the primary or permanent dentition formula, are known as supernumerary teeth or hyperdontia. This can occur in single, or multiple form, unilaterally or bilaterally, and affect both maxilla and mandible. It is more prevalent in men, in permanent dentition and in the maxilla; the mesiodens type being the most common supernumerary. Its etiology is still not entirely clear, however, hyperactivity of the dental lamina associated to genetic and environmental factors is the most accepted theory. Supernumerary teeth can be asymptomatic and can only be detected in radiographs. They can also present various clinical manifestations such as dental malposition, delay in dental eruption, root resorption and diastemas. Treatment depends on the type of tooth and its relation with adjacent structures. In the following report we present the case of an asymptomatic, upper and lower partially edentulous 54-year-old male patient, who requested rehabilitation treatment at a private dental clinic in Temuco, Chile. In routine panoramic radiography, two supernumerary teeth were observed, one on each side of the mandible and in the premolar region. Upon reviewing these findings with cone beam computed tomography, it was determined that the supernumerary on the right side corresponded to a supplementary premolar and the supernumerary on the left side corresponded to a supernumerary of molariform morphology. In this case we determined to extract the teeth, due to their location and impact on subsequent rehabilitation treatment.

Supernumerary Teeth: An Overview

Supernumerary teeth (SNT) are extra teeth to the normal complement of teeth in both dentitions. These SNT could be appear in any region of both jaws. Males are commonly affected by SNT than the females. Most commonly seen SNT are mesiodens, very rarely seen SNT are distomolars. Identification and localization of SNT are very important for diagnosis and management. SNT may cause various complications that include delayed or impaired eruption of adjacent teeth to cyst formation, and eruption into nasal cavity. Hence, the early identification and appropriate management is essential to prevent the possible complications.

Displasia cleidocraniana: descrição com ênfase nos aspectos radiográficos de três casos em uma família / Cleidocranial dysplasia: description with emphasis on the radiographic aspects of three cases in a family

Descrevemos três casos de displasia cleidoclavicular em uma família, uma síndrome genética rara, apresentando comportamento autossômico dominante, porém com 20-40% dos casos esporádicos, com incidência estimada em 1-9/1.000.000. O estudo se baseia em uma família constituída pelo o casal progenitor, duas filhas e um filho. Dentre esse grupo, a mãe e as duas filhas apresentavam baixa estatura, com região frontotemporal craniana abaulada, sutura sagital proeminente principalmente no aspecto anterior, braquicefalia, discreta exoftalmia, pescoço largo e redução do diâmetro laterolateral da porção superior do tórax. Nas radiografias do crânio e tórax, foram observados em todas as três principalmente a presença de ossos wormianos na calota craniana, dentes supranumerários, anomalias de erupção dentária e clavículas ausentes ou rudimentares. Diante dos achados, o diagnóstico de displasia cleidocraniana foi estabelecido (AU)

We describe three cases of cleidoclavicular dysplasia in a family, a rare genetic syndrome, presenting autosomal dominant behavior, but with 20-40% of sporadic cases, with an estimated incidence of 1-9/ 1.000.000. The study is based on a family consisting of the parent couple, two daughters and one child. In this group, the mother and the two daughters presented a short stature, with a frontal cranial frontotemporal region, prominent sagittal suture mainly in the anterior region, brachycephaly, mild exophthalmia, broad neck and reduction of the laterolateral diameter of the upper portion of the thorax. In the radiographs of the skull and chest, the presence of Wormian bones in the skull cap, supernumerary teeth, anomalies of tooth eruption and absent or rudimentary clavicles were observed in all three. In view of the findings, the diagnosis of cleidocranial dysplasia was established.(AU)

Non-syndromic Supplemental Permanent Maxillary Lateral Incisor: A Rare Case Series.

Supernumerary teeth, or hyperdontia, are the additional teeth to the normal series and are seen in all quadrants of the jaw. They have been reported to occur in both primary and permanent dentition. The supplemental supernumerary refers to duplication of teeth in the normal series and is found at the end of the tooth series. The majority of supernumeraries found in primary dentition are of the supplemental type. It is rare and was overlooked because of their normal size and shape. Hereby, we report three cases of supplemental maxillary permanent lateral incisor which resulted in crowding and poor esthetics. This case series reports unilateral supplemental teeth and its management.

Bilateral maxillary fourth and fifth molars: An unusual radiographic appearance.

Distomolars are supernumerary teeth present distal to third molars. Although many cases of bilateral fourth molars are reported, very few cases having bilateral fifth molars are described in literature. Here, we present a case having bilateral impacted maxillary fourth and fifth molars with the fifth molar on the left side having an unusually small appearance.

Supernumerary Molars: A Rare Finding.

Panoramic radiographs of a female patients aged twenty one years without any associated syndromic or systemic medical history, revealed the presence of the two supernumerary molars, right upper and left lower fourth molars. Both the teeth were disto-molars. The right upper fourth molar had normal tooth morphology with regard to its crown and root but was slightly smaller than the existing third molars. The left lower disto-molar had somewhat different morphology as compared to adjacent third molar and smaller in size as compared to the fourth right upper disto-molar. Their crowns were tuberculated and both had single root (2D radiographic morphology).

Facial and Palatal Talon Cusp on a Mesiodens Associated with Hyperdontia- A Rare Occurrence.

Supernumerary teeth or hyperdontia are those that are additional to the normal complement of teeth. Mesiodens is an extra tooth most commonly seen in the premaxillary region, while talon cusp is a well demarcated additional cusp extending form cingulum or cemento- enamel junction to the incisal edge. It is usually present on labial or palatal surface of primary and permanent anterior teeth. Occurrence of talon cusp on a mesiodens is an uncommon phenomenon. This paper presents a rare case of facial and palatal talon cusp on a mesiodens in association with hyperdontia, reported in a 12-year old girl.

Supernumerary teeth in the premolar area:A case report / 实用口腔医学杂志

A case of several ambushed bicuspoid supernumerary teeth in the premolar area was reported.The size,shape and the ratio of crown to root of the supernumerary teeth are similar to those of the premolar.The abnormity of tooth germ division and proliferation may lead the supernumerary teeth.

The Prevalence and the Characteristics of Supernumerary Teeth of Children and Young Adolescents from North-Western Region of Turkey.

Aim: The objective of the following research is to study the prevalence by evaluating a large group of children and young adolescent patients from the north-western region of Turkey and investigate the characteristics of supernumerary teeth. Methodology: This descriptive and retrospective study was performed on 6535 non-syndromic children and adolescent patients (4077 females and 2458 males) ranging in age from 5 to 18 years old. The characteristics of supernumerary teeth were noted and diagnosed during the clinical and radiographic examination. For each patient we recorded the demographic variables including age and gender. During statistical analysis Chi-squared test was used to determine potential differences in the distribution of supernumerary teeth when stratified by gender. p value of less than .05 was considered statistically significant. Results: 177 supernumerary teeth were detected in 141 patients (2.2%). 58 patients were females and 83 patients were males with a 1.4:1 male/female ratio (p<.001) among them. In 78.0% (n=110) of patients, one supernumerary tooth was observed. A total of 177 supernumerary teeth were observed, of which 84.2% (n=149) were located in the maxillary arch, while 15.8% (n=28) were determined in the mandible. 78 teeth (44.1%) of all supernumerary teeth were found in the maxilla midline (mesiodens). Regarding their status within the arch, 65 supernumerary teeth (36.7%) had erupted. 100(56.5%) supernumerary teeth did not cause any complications whereas 77(43.5%) teeth caused a complication. 119 supernumerary teeth (67.2%) were extracted and most of them were the complication source, however periodical observation was chosen as a treatment option for 58 teeth (32.8%). Conclusion: The frequency of supernumerary teeth was 2.2% in the following research and we found out that supernumerary teeth are not a very rare case among children and young adolescents and clinicians should take measures and examine all patients carefully even at early ages.

Multiple Supernumerary Teeth in a Non Syndromic Patient: Case Report.

Supernumerary teeth, also known as hyperdontia, is a term used to describe extra teeth that develop in addition to the 20 primary and 32 permanent teeth that we are predisposed to have. Hyperdontia is seen more commonly in the permanent dentition than primary teeth. Th e incidence in the permanent dentition is reported to vary between 0.1% and 3.8%, and its frequency in the primary dentition is found to be 0.3-0.8%. A 32-year-old male patient reported to the department of oral medicine and radiology with the chief complaint of stains and deposits, his clinical examination revealed 9 supernumerary teeth and panoramic radiographic revealed 3 more extra making a total of 12 supernumerary teeth.

Multiple Supernumerary Teeth in a Nonsyndromic 12-Year-Old Female Patient - A Case Report

Supernumerary teeth (ST) are uncommon alterations of development that may appear in either of the dental arches and that are frequently associated with syndromes such as cleidocranial dysplasia and Gardner syndrome. Multiple ST in individuals with no other disease or syndrome are very rare. In view of this situation, correct diagnosis, treatment and evaluation of ST with the use of appropriate imaging techniques are highly important. This case report presents radiographic images of a nonsyndromic 12-year-old female patient who presented with 14 supernumerary teeth and was treated under general anesthesia, with the extraction of all ST in a single surgical intervention. During the postoperative period, the patient did not complain of pain nor did she present any signs or symptoms of infection. During late follow-up period, due to difficulty in traction of the maxillary right canine and mandibular left first premolar towards the dental arch, it was necessary to extract these teeth under local anesthesia. Radiographic examination 3 years after surgery revealed the absence of ST and of diseases related to the existence of these teeth.

Os dentes supranumerários (DS) são alterações de desenvolvimento pouco frequentes, que podem aparecer em qualquer das arcadas dentárias e estão frequentemente associadas a síndromes como a displasia cleidocraniana e síndrome de Gardner. Múltiplos DS em indivíduos com nenhuma outra doença ou síndrome são muito raros. Diante dessa situação, o correto diagnóstico, tratamento e avaliação dos DS com estudo de imagens apropriadas são de significativa importância. No presente relato de caso, os autores apresentam imagens radiográficas de uma paciente não sindrômica de 12 anos de idade, gênero feminino, com 14 dentes supranumerários, em que o tratamento cirúrgico foi instituído sob anestesia geral, com extração de todos os DS em uma única intervenção cirúrgica. Durante o período pós-operatório, a paciente não se queixou de dor, como também não houve quaisquer sinais ou sintomas de infecção. Durante o acompanhamento, devido à dificuldade de tração do canino superior direito e primeiro pré-molar inferior em direção ao arco dental, foi necessário remover estes dentes sob anestesia local. O exame radiográfico de 3 anos após a cirurgia revelou a ausência dos DS e de doenças relacionadas com a existência desses dentes.

Multiple supernumerary teeth in a child with Rubinstein-Taybi syndrome: a rare feature

Rubinstein-Taybi syndrome is a multiple anomalies congenital disorder characterised by broad thumb and halluces, facial dysmorphism with mental and growth retardation. Oral features include small mouth, retro and micronagthic jaws, highly arched and narrow palate. Dental anomalies such as teeth with talon cusps and screwdriver shaped permanent incisors together with crowded teeth are common features in these patients. Although hyperdontia is said to be one of the features of this condition, nevertheless, presence of multiple supernumerary teeth has never been documented. This report highlighted a case of an eleven-year-old boy with Rubinstein-Taybi syndrome referred for unerupted permanent incisors who exhibited multiple supernumerary teeth radiographically.

Herencia autosómica recesiva en paciente no sindrómico con múltiples dientes supernumerarios / Autosomal recessive inheritance in a non-syndromic patient with multiple supernumerary teeth

La hiperdoncia es una condición caracterizada por la presencia de un número de dientes superior al normal en el arco dentario. Su etiología es incierta, aunque factores genéticos y ambientales así como varias teorías han sido propuestas para explicarlo. Describir las características clínicas y radiográficas presentes en un paciente no sindrómico con múltiples supernumerarios, heredados de manera autosómica recesiva. Se presenta el caso de un hombre de 27 años de edad que acudió a consulta para evaluación odontológica. Al examen físico y extrabucal no reveló deformidades, retardo mental ni presencia de ningún síndrome. Al examen intrabucal se evidenció la presencia de irritantes locales y maloclusión dentaria, ocasionada por el aumento del número dientes en los arcos dentarios. Radiográficamente se observaron múltiples imágenes radiopacas compatibles con 9 unidades dentarias incluidas y 2 erupcionadas. Los exámenes de laboratorio no revelaron alteraciones ni relación con algún síndrome. Se solicitaron radiografías panorámicas a los padres, hermanos e hija del paciente, para descartar la presencia de dientes supernumerarios, encontrándose 9 dientes supernumerarios incluidos en un hermano varón, determinándose la trasmisión del rasgo de manera autosómica recesiva. El hallazgo de la trasmisión de manera autosómica recesiva de múltiples supernumerarios en un paciente no sindrómico encontrado en este caso, no es común, lo cual indica que el examen clínico y estudio de cada paciente debe ser llevado a cabo de manera exhaustiva, para determinar este tipo de trastorno o cualquier otro sin evidencias o manifestaciones clínicas.

Hyperdontia is a condition characterized by the presence of a higher number of teeth than normal in the dental arch. Even though genetic and environmental factors as well as a series of theories have been proposed to explain hyperdontia, its etiology is uncertain. To describe clinical and radiographical characteristics found in a non-syndromic patient with multiple supernumerary teeth by autosomal recessive inheritance. A 27-year-old male referred for dental assessment. Physical and extraoral examinations did not reveal deformities, mental retardation or the presence of syndromes. Intraoral examination evidenced the presence of local irritants and dental malocclusion produced by the increased number of teeth in both dental arches. Radiographs revealed multiple radiopaque images compatible with 9 unerupted and 2 erupted teeth. Laboratory tests did not show alterations or a connection to any syndromes. Panoramic radiographs were requested from parents, siblings and daughter of the patient to rule out the presence of supernumerary teeth. Nine supernumerary unerupted teeth were found in one brother, which determined the transmission of characteristics by autosomal recessive inheritance. The incidental finding of the autosomal recessive transmission of multiple supernumerary teeth in a non-syndromic patient observed in this case is not a common result, indicating that clinical examinations and the study of each patient must be carried out thoroughly in order to determine this or any other type of disorders without evidence or clinical manifestations.

Concomitant hypo-hyperdontia: Report of two cases.

Concomitant hypo-hyperdontia is a rare condition of coexisting missing teeth and supernumerary teeth in the same subject. Its etiology is still not exactly known. Permanent dentition is usually affected. Presented here are two uncommon cases of bimaxillary concomitant hypo-hyperdontia during the mixed dentition period. Early diagnosis of the condition and multidisciplinary approach for management of such cases is recommended.

Prevalencia de agenesia dental en niños con dentición mixta de las clínicas odontológicas docente asistencial de la Universidad de La Frontera / Prevalence of dental agenesis in children with mixed dentition of teaching assistant dental clinics at the Universidad de La Frontera

El objetivo de este estudio (corte transversal y descriptivo) es determinar la prevalencia de agenesia (hipodoncia) dental en niños con dentición mixta que asisten a las Clínicas Odontológicas Docente Asistencial de La Universidad de La Frontera, durante el año 2009. Se examinaron 307 niños entre 6 y 11 años, que cumplían con los criterios de inclusión. La prevalencia de agenesia en la población estudiada fue de 4.2 por ciento (13/307), resultando más afectados los individuos de sexo femenino 5,9 por ciento (9/153). De acuerdo al orden de frecuencia, el diente más afectado por agenesia fue el segundo premolar inferior, con un valor de 4,2 por ciento (13/307). Le siguen, el segundo premolar superior, cuyo valor fue de 3,3 por ciento (10/307), 1,3 por ciento (4/307) del incisivo lateral inferior y 0,33 por ciento (1/307) del primer premolar superior. No se encontraron hallazgos radiográficos de agenesia en incisivo lateral superior y primer premolar inferior. Este estudio nos permitió obtener indicadores significativos de la población estudiada, como además señalar la importancia del diagnóstico precoz de esta anomalía, que conlleva a interceptar alteraciones de maloclusión.

The purpose of this study (cross sectional and descriptive) was to determine the prevalence of dental agenesis (hypodontia) in children with mixed dentition attending the teaching assistant dental clinics at the Universidad de La Frontera, 2009. We examined 307 children between 6 and 11 years, who met the inclusion criteria. The prevalence of agenesis in the studied population was 4.2 percent (13/307), with female individuals being the most affected, 5.9 percent (9/153). According to the order of frequency, the most affected by tooth agenesis was the second premolar, with a value of 4.2 percent (13/307). Followed by the second premolar, the value was 3.3 percent (10/307), 1.3 percent (4/307) of the lateral incisor and 0.33 percent (1/307) of the first premolar. There were no radiographic findings of agenesis of upper lateral incisor and first premolar. This study allowed us to obtain significant indicators of the population studied, and also note the importance of early diagnosis of this anomaly, which leads to intercept alterations in the occlusion.

Macrodoncias e hiperdoncias bilaterales en mandíbula: reporte de un caso clínico / Mandibular bilateral macrodontia and hyperdontia: a clinical case report

La macrodoncia es una anomalía dental con etiología desconocida, que se manifiesta en el aumento del tamañonormal comparado con el resto de la fórmula dental. La hiperdoncia es una anomalía que se manifiesta con la presencia de dientes que aumentan el número de la fórmula dental. Aunque es poco común, en algunos casos han sido reportados conjuntamente y estánasociados o no a un síndrome. Se presenta un paciente masculino de 12 años de edad que en consulta odontológica de rutina se le encuentra como hallazgo radiográfico 34, 35 y 45 impactados, macrodoncias de 34, 35 y 45 e hiperdoncias en oclusal de 34, 35 y45, sin ningún otro hallazgo patológico de importancia. Las múltiples macrodoncias y múltiples hiperdoncias son unas anomalías dentales poco frecuentes, que pueden causar patologías y desórdenes a los dientes permanentes vecinos.

Macrodontia is a dental size anomaly of unknown etiology, characterized by abnormal tooth size when comparedto the rest of the dental formula. Hyperdontia is the presence of an increased number of teeth in the dental formula. Although it is rare, in some cases both anomalies have been reported simultaneously, and they might be associated or not with a syndrome.A 12-year-old male patient who was scheduled for a routine dental exam revealed at the radiographic examination impaction of teeth 34, 35 and 45 with macrodontia of the same teeth and multiple hyperdontia (three extra teeth, located occlusal to 34, 35 and 45); no other relevant pathology was found. Multiple macrodontias and hyperdontias are rare dental anomalies that may cause pathologies and alterations to adjacent permanent teeth.