International Journal of Paediatric Dentistry 2002; 12: 244 –254

Supernumerary teeth: review of the literature and a survey

Blackwell Science, Ltd

of 152 cases

L. D. RAJAB & M. A. M. HAMDAN

The University of Jordan, Faculty of Dentistry, Department of Paediatric Dentistry,
Amman, Jordan

Summary. Introduction. A review of the literature relating to supernumerary teeth is

presented along with a survey of 152 cases.
Methods. The study population consisted of 152 children who visited the department
of Paediatric Dentistry at the Jordan University Hospital. Patients ranged in age from
5 to 15 years. Supernumeraries were detected by clinical examination and radiographs.
Results. Males were affected more than females with a sex ratio of 2·2 : 1. Seventy-
seven percent of the patients had one supernumerary tooth, 18·4% had double teeth,
and 4·6% had three or more supernumeraries. Ninety percent of the supernumerary teeth
occurred in the premaxilla, of which 92·8% were in the central incisor region and of
these latter 25% were located in the midline. The other 10·4% of the supernumeraries
were located in the premolar, canine, molar, and lower central incisor regions. Two
cases were of non-syndrome supernumerary teeth. Seventy-five percent of the supernu-
meraries were conical, 83·1% were in the normal vertical position and 26·5% were
erupted. Conical-shaped supernumerary teeth had a significantly higher rate of eruption
compared to the tuberculate type.

Introduction Review of the literature

Supernumerary teeth are those that are additional
to the normal complement [1]. They have been
reported in both the primary and the permanent
dentition. The first report of supernumerary teeth
appeared between ad 23 and 79 [2]. Their aetiology
is still not clearly understood. They may occur in
any region of the dental arch with a particular
predilection for the premaxilla [3,4]. Supernumerary
teeth may occur singly, multiply, unilaterally or
bilaterally, and in one or both jaws. Classifications
of supernumerary teeth are based on their location
in the dental arches, or on their morphology.
This paper reviews the literature and investigates
the characteristics of supernumerary teeth among
children attended the Department of Paediatric
Dentistry at the Jordan University Hospital.
Correspondence: Dr L. D. Rajab, The University of Jordan,
Faculty of Dentistry, Department of Paediatric Dentistry, Amman,
Jordan. Email: lamisr@ju.edu.jo
The aetiology of supernumerary teeth remains unclear,
but several theories have been suggested for their
occurrence. The phylogenetic process of atavism
(evolutionary throwback) has been suggested to
explain the development of supernumerary teeth [5].
Primosch [3] has rejected this theory because of the
predominantly solitary occurrence and ectopic develop-
ment of the supernumerary tooth. Currently, environ-
mental factors are considered and dichotomy of the
tooth bud is suggested as a possible aetiological
factor in the development of supernumerary teeth
[6–8]. According to the dichotomy theory, Taylor [9]
stated that the tooth bud splits into two equal or
different-sized parts, resulting in two teeth of equal
size or one normal and one dysmorphic tooth, respect-
ively. The localized and independent hyperactivity
of the dental lamina is the most accepted cause
for the development of supernumerary teeth: it is
suggested that supernumerary teeth are formed
as a result of local, independent, conditioned

244 © 2002 BSPD and IAPD


hyperactivity of the dental lamina [3,7,10–13].
According to this theory, the lingual extension of an
additional tooth bud leads to a eumorphic tooth,
while the rudimentary form arises from proliferation
of epithelial remnants of the dental lamina induced
by pressure of the complete dentition [3]. Heredity
was believed to be an important aetiological factor
in the occurrence of supernumerary teeth. Many
published cases of supernumerary teeth mentioned
recurrence within the same family [14–16]. Sedano
and Gorlin [15] indicated the possibility of an
autosomal dominant trait with lack of penetrance in
some generations and Bruning et al. [17] has even
suggested the possibility of sex-linked inheritance
to explain the existence of a sex predominance of
males over females. Cadenat et al. [18] pointed out
the presence of a recessive gene on an autosome
and a gene on the inhibiting X chromosome. Many
authors suggested inheritance as a key factor in the
development of supernumerary teeth [8,15,17–19].
Brook [20] proposed a combination of genetics and
environmental factors to explain the occurrence of
supernumerary teeth. Niswander et al. [21] noted
that supernumerary teeth are associated with an
autosomal recessive gene with lesser penetrance in
females. Human tooth eruption is known to be
a dynamic interaction between genetics and the
environment, each one affecting and being affected
by the other. Therefore, the available data, which
confirms that the supernumerary traits have a
strongly hereditary component without following
a simple Mendelian pattern, has led some authors
to consider environmental factors and to conclude
that hyperdontia is a disorder with a pattern of
multifactorial inheritance originating from hyper-
activity of the dental lamina [22].
The presence of supernumerary teeth may be part
of developmental disorders. The most common syn-
dromes that show a significant incidence of multiple
supernumerary teeth are cleft lip and palate [23],
cleidocranial dysostosis [24] and Gardner’s syndrome
[25]. Less common developmental disorders are Fabry
Anderson’s syndrome [26], Chondroectodermal
dysplasia (Ellis–Van Creveld syndrome) [27], Ehlers–
Danlos syndrome [28], incontinentia pigmenti and
Trico–Rhino–Phalangeal syndrome [29,30].
Methodology used for detection, the population
studied and the age of subjects could account for the
wide range of prevalence of supernumerary teeth
seen in previous studies. Studies conducted without
the use of radiographs would have underestimated
© 2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 244–254
Supernumerary teeth 245
the incidence, as unerupted supernumeraries would
not have been detected. Supernumerary teeth have
been reported in both the primary and the permanent
dentitions. The reported prevalence of supernumerary
teeth in the general Caucasian population for the
permanent dentition ranges from 0·1 to 3·8%
[1,3,8,13,14,31–33]. Supernumerary teeth seem to
be more common in Mongoloid racial groups, with
a frequency higher than 3% being reported [21,34].
The prevalence of supernumerary teeth is lower
in the primary dentition and is said to be 0·3–0·8%
[4,9,31,33]. Hyperdontia in the primary dentition is
often overlooked because supernumerary teeth are
often of normal shape, erupt normally and appear
to be in proper alignment; and can be mistaken for
gemination or fusion anomalies [35]. Other possible
explanations for the less frequent reporting of pri-
mary supernumerary teeth include difficulty in
detection by parents, as the spacing in the primary
dentition may be utilized to allow the teeth to erupt
with reasonable alignment, and the timing of the
initial dental examination. For many children this is
only following eruption of permanent anterior teeth,
so that anterior primary supernumerary teeth would
have erupted and exfoliated normally prior to detec-
tion [9].
Sexual dimorphism has been reported by most
authors [36,37], with males being more commonly
affected. Although there appear to be no difference
in the sex distribution for the primary dentition
[32,33], supernumeraries occur more frequently in
the permanent dentition of boys than girls. Differ-
ent sex ratios have been reported in the general
Caucasian population; many authors have reported
a sex ratio of 2 : 1 [32,33,36,38], and Luten [37]
recorded 1·3 : 1 in favour of males. In a study con-
ducted by Zilberman et al. [39], the sex ratio was
2·5 : 1, again favouring males. Saito [40] reported
a sex ratio as high as 5·5 : 1 favouring males for
Japanese school children and Davis [34] found a
higher ratio, 6·5 : 1, for supernumeraries of children
in Hong Kong.
Supernumerary teeth may occur singly, in mul-
tiples, unilaterally or bilaterally, in the maxilla, in
the mandible or both. Although cases of multiple
supernumerary teeth have been reported [41–43],
they are rare, as are multiple supernumerary teeth
in individuals with no other associated diseases or
syndromes [44,45]. Cases involving one or two
supernumerary teeth most commonly involve the
anterior maxilla [14], followed by the mandibular
246 L. D. Rajab & M. A. M. Hamdan
premolar region [4,14]. There is a slight difference
in the relative frequency reported in the literature
of other supernumerary teeth. Luten’s study [37]
suggested, in order of decreasing frequency: upper
lateral incisors (50%), mesiodens (36%), upper cen-
tral incisors (11%), followed by bicuspids (3%).
Shapira and Kuftinec [6] stated the order of decreas-
ing frequency as: upper central incisors, molars
(especially upper molars), premolars, followed by
lateral incisors and canines. Yousof [45] reviewed
most of the published cases of > 5 supernumerary
teeth occurring without any associated systemic con-
ditions or syndromes in the English language liter-
ature, and found that there was a predilection
for non-syndrome multiple supernumerary teeth to
occur in the mandible. For both jaws, multiple
supernumerary teeth predominantly occurred in the
premolar region, followed by the molar and the ante-
rior regions, respectively. The mandibular premolar
region had the highest frequency of occurrence in
both jaws combined. Although supernumerary teeth
have been reported in the incisor region of the
mandible [46,47], they are very rare. Stafne [14]
found that only 2% of supernumerary teeth occurred
in the lower incisor region. The number of super-
numerary teeth is usually one, and the incidence of
eruption is low. Supernumerary teeth are also rare
in the canine region [13], but when they do occur,
their form is usually supplemental [36]. Single
supernumeraries occur in 76–86% of cases, double
supernumeraries in 12–23% of cases and mul-
tiple supernumeraries in less than 1% of cases
[14,21,48,49]. Other studies recorded multiple
supernumerary teeth in approximately 14% of the
subjects studied [3,4,13,35].
Supernumerary teeth may be classified according
to morphology and location [11,32,50,51]. In the
primary dentition, the morphology is usually normal
or conical. The morphology of supernumerary teeth
presenting in the permanent dentition is more vari-
able, with the following four morphological types
being described:
• Conical: This small peg-shaped conical tooth is
the most common supernumerary found in the
permanent dentition. It develops with root forma-
tion ahead of, or at an equivalent stage to, that of
permanent incisors and usually presents as a
mesiodens between the maxillary central incisors,
but rarely erupts labially. It may occasionally be
found high and inverted into the palate or in a
© 2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 244–254
horizontal position. In most cases, however, the
long axis of the tooth is normally inclined.
• Tuberculate: This type of supernumerary, that is
larger in size than the conical tooth, possesses
more than one cusp or tubercle. It is frequently
described as barrel-shaped and may be invagi-
nated. It develops later than the conical tooth, with
incomplete (stunted) or totally absent root forma-
tion. Tuberculate supernumeraries are often paired
and are commonly located on the palatal aspect
of the maxillary central incisors.
• Supplemental: The supplemental supernumerary
refers to duplication of teeth in the normal series
and is found at the end of a tooth series. The most
common supplemental tooth is the permanent
maxillary lateral incisor, but supplemental pre-
molars and molars also occur. The majority of
supernumeraries found in the primary dentition are
of supplemental type and are seldom impacted.
• Odontoma: Despite not being universally accepted,
most authors agree that odontoma represent a
hamartomatous malformation.
Primosch [3] classified supernumeraries into two
types according to their shape: supplemental and
rudimentary. Supplemental (or eumorphic) refers to
supernumerary teeth of normal shape and size, and
may also be termed incisiform. Rudimentary (or
dysmorphic) defines teeth of abnormal shape and
smaller size, including conical, tuberculate and
molariform types.
Supernumeraries may also be categorized into
three types according to their locations:
• Mesiodens: a typical conical supernumerary tooth
located between the upper central incisors. It may
be single or multiple; unilateral or bilateral;
erupted or impacted, vertical, horizontal or
inverted.
• Paramolar: A supernumerary molar, usually small
and rudimentary situated buccally or lingually to
one of the maxillary molars or in the interproxi-
mal space buccal to the second and third molar.
• Distomolar: Located distal to the third molar,
usually small and rudimentary, rarely delays or
impedes eruption of the normal tooth.
Supernumerary teeth may develop in the direction
of normal eruption, appear inverted, transverse,
assume an ectopic position, or follow an abnormal
path of eruption. Tay et al. [52] observed that 16·8%

of supernumerary teeth were normally-orientated,
77·6% were inverted and 5·6% were transverse in
relation to the permanent teeth. Supernumerary teeth
could erupt normally or remain impacted. It has
been found that approximately 25% of permanent
supernumerary teeth are erupted, and the remainder
are unerupted, whereas 73% of primary
supernumerary teeth are erupted [13,14,35]. In
contrast, Tay et al. [52] recorded a lower figure, of
approximately 15%, of permanent supernumeraries
erupted and Liu [7] reported a higher figure, of 34%.
Supernumerary teeth are not necessarily accom-
panied by malocclusion. An unerupted supernumer-
ary tooth may found by chance during routine
radiographic examination, with no discernable effect
upon adjacent teeth. Supernumerary teeth are also
frequently discovered when a normal tooth is either
delayed in its eruption or displaced. In general,
supernumerary teeth, particularly in the maxillary
anterior region, may cause the following clinical
problems [3,10,11,22,32,36,39,50,51]:
• Failure of eruption. The presence of a super-
numerary tooth is the most common cause for failure
of eruption of maxillary incisors [53]. It has been
stated that the tuberculate type was more likely
to impede eruption because of its palatal position
relative to the maxillary incisors [50,54]. The
problem is usually noticed with the eruption of the
maxillary lateral incisors together with the failure
of eruption of one or both central incisors.
Delayed eruption of the central incisors may result
in medial movement of the lateral incisors, reduc-
tion in the dental arch space and diminished
development of the dentoalveolar height with
failure of the central incisors to erupt fully. Super-
numeraries in other locations may also prevent or
delay eruption of adjacent teeth.
• Displacement or rotation. The presence of a
supernumerary tooth may cause any degree of
displacement of a permanent tooth, from mild
rotation to bodily displacement. Displacement of the
crown of the incisor is a common feature in the
majority of cases associated with delayed eruption
[39,55]. In the upper labial segment, Mitchell [36]
advises to check for the presence of a supernu-
merary tooth before embarking on treatment for
any rotated incisor or diastema.
• Crowding. Erupted supplemental teeth most often
cause crowding. A supplemental lateral incisor
may increase the crowding potential and may
© 2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 244–254
Supernumerary teeth 247
cause an aesthetic problem in the upper anterior
region.
• Abnormal diastema or premature space
closure.
• Dilaceration, delayed or abnormal root devel-
opment of permanent teeth. Resorption of roots
adjacent to a supernumerary may also occur
[38,39].
• Cystic formation.
• Eruption into the nasal cavity.
Detection
Detection of supernumeraries is achieved with a
meticulous clinical and radiographic examination.
An anterior occlusal or periapical radiograph is
helpful in showing the incisor region in detail. The
bucco-lingual position of the unerupted supernumer-
ary can be located using the parallax technique [56].
This technique is also called the horizontal tube
shift technique or the buccal object rule and utilizes
two periapical radiographs of the same tooth taken
using two different horizontal tube positions but
maintaining the vertical direction. If the supernu-
merary moves in the same direction as the tube shift
it is located in a palatal position, but if it moves in
the opposite direction it is placed buccally.
Methods
The study sample comprised 152 children (105 boys
and 47 girls) ranging in age from 5 to 15 years with
diagnosed supernumerary teeth in different regions
of the dental arches. All patients in this study
attended the Paediatric Dentistry Department at the
Jordan University Hospital between 1996 and 2000;
all data were collected from patient’s records held
in the department. Reasons for attendance included
caries, malocclusion, lack of eruption of permanent
teeth and routine dental check ups. Diagnosis of one
or more supernumerary teeth was made during the
clinical examination and from occlusal, periapical
or panoramic radiographs. The horizontal shift
technique was used to determine the sagittal position
of the impacted supernumerary teeth. Characteristics
of the supernumeraries were confirmed upon
surgical removal of the teeth. None of the patients
entered in this study suffered from syndromes
known to predispose to supernumerary teeth. Data
were gathered and analysed using the SPSS
statistical package.
248 L. D. Rajab & M. A. M. Hamdan

Table 1. Age of patients. Table 2. Distribution of supernumerary teeth by gender and

number.
Gender
Age
Number (%) of supernumerary teeth
(Years) Male Female Total
Gender One Two Three Four Six
5–6 2 – 2
7–8 13 12 25 Male 77 21 3 2 2
9–10 44 24 68 (73·3%) (20%) (2·9%) (1·9%) (1·9%)
11–12 28 10 38 Female 40 7 – – –
13–14 16 1 17 (85·1%) (15·2%)
15–16 2 – 2 Total 117 28 3 2 2
Total 105 47 152 (77%) (18·4%) (2%) (1·3%) (1·3%)
% 69·1% 30·9% 100%

Table 3. Type of supernumerary tooth.

Type Number %
Results Conical 151 74·8
Tuberculate 24 11·9
Of 152 patients, 105 (69·1%) were male and 47 Supplemental 14 6·9
(30·9%) were female; the sex ratio was 2·2 : 1. The Odontoma 13 6·4
Total 202 100
mean age was 10·1 ± 1·9 years, with a range from
5 to 15 years (age at last birthday). A complete age
breakdown is given in Table 1.
The total number of supernumerary teeth among in Table 2. Classification of the supernumerary teeth
the 152 patients was 202, with an average number according to morphologic type is given in Table 3
of supernumerary teeth per person of 1·3 ± 0·8. A (Fig. 2). A total of 181 (89·6%) of the supernumer-
total of 148 supernumerary teeth were found in ary teeth were located in the premaxilla, of which
males and 54 in females, with an average of 168 (92·8%) of the supernumeraries were in the
1·4 ± 0·9 and 1·2 ± 0·4 per person, respectively. A central region and of these, 25% were located in
total of 117 patients (77%) had one supernumerary the midline. The remaining teeth were located in the
tooth, 28 patients (18·4%) had two supernumeraries, premolar region (6·5%), the canine region (2·5%),
and the remaining seven patients had three or more the mandibular central region (1%) and the max-
supernumeraries (4·6%) (Fig. 1). The distribution of illary molar region (0·5%). Figure 3 summarizes the
supernumerary teeth by gender and number is shown location of supernumerary teeth in the jaws in order

Fig. 1. Radiographs demonstrating the

presence of supernumerary teeth in four
patients; arrows show the number of
supernumeraries.

© 2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 244–254

Fig. 2. Radiographic and clinical appearance of supernumerary
teeth. From top to bottom: conical, tuberculate, supplemental and
odontoma.
of decreasing frequency (Fig. 4). Two patients had
six supernumeraries each, one had four in the man-
dibular premolar region (two in each quadrant) and
two in the maxillary incisor region (Fig. 5), whereas
Fig. 3. Location of supernumerary teeth
in the jaws in order of decreasing
frequency.
© 2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 244–254
Supernumerary teeth 249
Fig. 4. Radiographs showing the location of supernumerary
teeth. From top to bottom and from left to right: central region,
midline, lower canine, upper canine, upper premolars and lower
central incisors.
the other had two supernumeraries in the maxillary
incisor region, two in the maxillary canine region,
one between the mandibular canine and premolar,
and one between the maxillary first and second molar.
The orientation (Fig. 6) and sagittal position of
the supernumerary teeth are shown in Table 4 and
Table 5, respectively. Fifty supernumerary teeth
(26·5%) were erupted and 139 (73·5%) unerupted;
odontomas were omitted from the analysis. The
250 L. D. Rajab & M. A. M. Hamdan

Fig. 5. Panoramic view of nonsyndrome

multiple supernumerary teeth: four in the
mandibular premolar region and two in the
maxillary incisors region.

Fig. 6. Radiographs demonstrating the

orientation of supernumerary teeth. From top
to bottom and then to the right: vertical,
transverse and inverted.

Table 4. Orientation of supernumerary teeth (odontomas Table 6. Relationship between eruption rate and type of
excluded). supernumerary tooth.
Orientation Number % Type of supernumerary teeth
Normal 157 83·1 Conical Tuberculate Supplemental
Inverted 19 10·1
No % No % No %
Transverse 13 6·8
Total 189 100 Erupted 42 27·8 2 8·3 6 42·9
Unerupted 109 72·2 22 91·7 8 57·1
Total 151 100 24 100 14 100

Table 5. Sagittal position of supernumerary teeth. relationship between eruption rate and type of super-
Sagittal position Number % numerary teeth is given in Table 6. All the inverted
Labial/Buccal 2 1 and transverse supernumerary teeth were unerupted;
Palatal/Lingual 172 85·2 31·8% of the normally-orientated supernumerary
Within arch 28 13·9 teeth were erupted (50 teeth). Of the normally-
Total 202 100
orientated supernumerary teeth, 68.2% (107 teeth),

© 2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 244–254

and all those in inverted or transverse position,
were unerupted. The unerupted, normally orientated
supernumerary teeth included 77 conical shaped,
22 tuberculate shaped and eight supplemental teeth.
Of the 119 normally positioned conical-shaped
supernumerary teeth, 35·3% were erupted, and 8·3%
of the 24 normally positioned, tuberculate-shaped
supernumerary teeth were erupted, the difference in
rate of eruption between these two types was statis-
tically significant (P = 0·04).
Discussion
In this study, the sex ratio was 2·2 : 1 in favour of
males, a value that falls between the sex ratios
reported for Caucasian populations [32,33,36,38]
and that reported in Israel [39]. The difference in
sex ratio may be due to racial differences or possible
sampling differences.
Supernumerary teeth may occur singly, or in mul-
tiples, in any region of the jaws in the same person.
In this study, 18·4% of the supernumerary teeth were
bilateral and this falls within the range of 12–23%
reported in other studies [14,21,48,49]. In this study,
the occurrence of multiple supernumerary teeth
(three or more) was found in 4·6% of cases, which
is higher than in a number of other studies, where
less than 1% was recorded [14,21,48,49], but lower
than the 14% reported for others [3,4,13,35].
In agreement with other studies [4,13,14,32,33,37],
supernumerary teeth most commonly involved the
premaxilla; which has also been established as the
predominant location by others [6,37]. As reported
previously [14], the rare occurrence of the super-
numerary teeth in the mandibular incisor region was
confirmed in this study. The molar region has been
reported as a common site for supernumerary teeth
[4,6,13], but this was not the case in this study,
where only 0·5% of the supernumerary teeth were
found in the molar region. Only 2·5% of the super-
numeraries were found in the canine region, which
is consistent with the findings of other studies where
the presence of supernumerary teeth in the canine
region was reported to be rare [13,36].
Though not a common occurrence, two cases in
this study fell into the category of non-syndrome
multiple supernumerary teeth (> 5). Yousof [45]
stated that non-syndrome multiple supernumerary
teeth tended to occur in the mandibular premolar
region. One of the cases in this study was affected
in this region.
© 2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 244–254
Supernumerary teeth 251
Supernumeraries appear in a variety of shapes, the
most common in this study was conical, followed by
tuberculate, then by supplemental and odontomatous.
Koch et al. [57] registered 56% conical, 12% tuber-
cular, 11% supplemental, and 12% other configura-
tion among the study population.
Most of the supernumerary teeth were orientated
normally. This finding differed from that reported by
Tay et al. [52], who found most of the supernumer-
ary teeth in an inverted position, but agreed with the
findings of the Liu study [7].
In this study, 26·5% of the supernumerary teeth
were erupted, which is similar to other reported
eruption rates [13,14,35,39]. All erupted teeth were
normally-orientated; none of the transverse or
inverted supernumerary teeth were erupted. Foster
[50] stated that tuberculate supernumerary teeth
rarely erupt and are frequently associated with
delayed eruption of the incisors, whereas conical-
shaped teeth frequently erupt and do not delay erup-
tion of the permanent adjacent teeth. This study
showed that although tuberculate-shaped supernu-
merary teeth may erupt, a significantly higher pro-
portion of the conical-shaped teeth had erupted
(P < 0·05). Foster [50] found a highly significant
difference in the degree of root formation of these
two types of supernumerary teeth. Liu [7] reported
that tuberculate supernumerary teeth do erupt in the
same way and at a similar rate as conical supernu-
merary teeth but that eruption may be delayed.
Supernumerary teeth are detected through clinical
and radiographic examination. Early diagnosis and
treatment of patients with supernumerary teeth are
important to prevent or minimize complications.
Treatment depends on the type and position of the
supernumerary tooth and on its effect on adjacent
teeth. Immediate removal of the supernumerary
tooth is indicated if eruption of the adjacent tooth
has been delayed or inhibited, altered eruption or
displacement of the adjacent tooth is evident, the
supernumerary tooth interferes with active ortho-
dontic treatment, there is associated pathology, or if
spontaneous eruption of the supernumerary has
occurred. Munns [58] stated that the earlier the
offending supernumerary tooth is removed, the
better the prognosis.
The best time for removal of an unerupted
maxillary anterior supernumerary is controversial.
Whereas some authors recommend immediate
removal of the supernumerary teeth following the
initial diagnosis, others prefer postponement of the
252 L. D. Rajab & M. A. M. Hamdan
surgical intervention until the age of eight to 10
years, when the root development of the central and
lateral incisor is nearly complete [3,4]. The time
taken by the unerupted tooth to appear, following
removal of the supernumerary tooth, varied between
six months and three years [11,22,58]. Several
factors influence the time taken by an impacted tooth
to erupt following removal of the supernumerary,
including the type of supernumerary tooth, the
distance the unerupted tooth was displaced at the
time of the surgical intervention, the space available
within the dental arch for the unerupted tooth and
the stage of root development.
Extraction is not always the treatment of choice
for supernumerary teeth. Unerupted supernumerary
teeth that are symptomless, do not appear to be
affecting the dentition in any way and are found by
chance are sometimes best left in place and kept
under observation. Garvey [51] recommended mon-
itoring without removal where satisfactory eruption
of the related teeth has occurred, no active ortho-
dontic treatment is envisaged, there is no associated
pathology, and where removal would prejudice the
vitality of the related teeth.
Résumé. Cet article présente une revue de littéra-
ture sur les dents surnuméraires associée à un suivi
de 152 cas.
Méthodes. La population étudiée a consisté en 152
enfants du département de Dentisterie Pédiatrique à
l’Hôpital Universitaire jordanien. Les patients étaient
âgés de 5 à 15 ans. Les dents surnuméraires ont été
détectées par examen clinique et radiographique.
Résultats. Les garçons étaient plus affectés que les
filles, le rapport inter sexes étant de 2,2 : 1. Soixante-
dix-sept pour cent des patients avaient une dent sur-
numéraire, 18,4% deux dents et 4,6% trois ou plus.
89,6% des dents surnuméraires étaient situées dans
le prémaxillaire, parmi lesquelles 92,8% dans la
région incisive centrale dont 25% en position médiane.
Les 10,4% restant étaient situés dans les régions
prémolaire, canine, molaire et incisive centrale
inférieure. 74,8% des surnuméraires étaient coniques,
83,1% étaient en position verticale et 26,5% avaient
fait leur éruption. Les dents surnuméraires de forme
conique avaient un taux d’éruption significativement
supérieur à celui des dents de type tuberculé.
Zusammenfassung. In dieser Arbeit werden Fall-
berichte der Literatur eine Analyse von insgesamt
152 überzähligen Zähnen gegenübergestellt.
© 2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 244 –254
Methoden. Die Studienpopulation bestand aus 152
Kindern, welche mit überzähligen Zähnen in der
Abteilung für Kinderzahnheilkunde der jordanischen
Universitätsklinik vorgestellt worden waren. Das
Alter der Patienten reichte von fünf bis fünfzehn
Jahren. Die überzähligen Zähne wurden klinisch und
röntgenologisch untersucht.
Ergebnisse. Männliche Patienten überwogen in einer
Relation von 2.2:1. Bei 77% wurde ein einzelner
überzähliger Zahn diagnostiziert, bei 18.4% zwei
und 4.6% drei oder mehr überzählige Zähne. 89.6%
der überzähligen Zähne wurden im Oberkiefer-
Frontzahngebiet beobachtet, davon 92.8% in der
Region der mittleren Schneidezähne und von diesen
wiederum 25% in der Mittellinie. Die verbleibenden
10.4% der überzähligen Zähne verteilten sich auf
Prämolaren, Eckzähne, Molaren und mittlere
Unterkiefer-Schneidezähne. Zwei Fälle waren
nichtsyndromale überzählige Zähne. 74.8% der
überzähligen Zähne waren konisch. 83.1% waren in
normaler vertikaler Position, 26.5% waren durchge-
brochen. Konische überzählige Zähne waren häufiger
durchgebrochen als Zähne mit Höckern.
Resumen. Se presenta una revisión de la literatura
relacionada con los dientes supernumerarios con-
juntamente con un examen de 152 casos.
Metodos. La población estudiada consistió en 152
niños que visitaron el departamento de Odontología
Pediátrica en el Hospital Universitario de Jordania.
Las edades de los pacientes estaban entre 5 y 15
años. Los dientes supernumerarios se detectaron por
examen clínico y radiográfico.
Resultados. Los niños estaban más afectados que las
niñas con una proporción de 2,2 : 1. El 77% de los
pacientes tenía un diente supernumerario, el 18,4%
tenía dos dientes y el 4,6% tenía tres o más super-
numerarios. El 89,6% de los dientes supernumerarios
se encontraba en la premaxila, de los cuales el 92,8%
estaba en la región de los incisivos centrales y de esos,
el 25% estaban localizados en la línea media. El otro
10,4% de los supernumerarios estaba localizado en
las regiones premolar, canina, molar y de los incisivos
centrales inferiores. Dos casos no fueron de un
síndrome de dientes supernumerarios. El 74,8% de
los supernumerarios eran de forma cónica, el 83,1%
estaban en una posición vertical normal y un 26,5%
de los supernumerarios habían erupcionado. Los
dientes supernumerarios de forma cónica tenían un
porcentaje de erupción significativamente más alta
comparada con los de la forma tuberosa.

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