Hyperdontia (also known as hyperodontia ) is the name given to a surplus of teeth, with over 32 teeth in the permanent dentition and over 20 teeth in the milk dentition.
What is hyperdontia?
If hypertension is present, the supernumerary teeth in the upper jaw are usually removed as part of therapy, as otherwise the center line can be displaced. However, a supernumerary incisor that is normally formed is usually not noticeable and can therefore be left in place if the supernumerary tooth does not cause crowding. See AbbreviationFinder for abbreviations related to Hyperdontia.
Hyperdontia is understood to mean an excess of teeth, which can appear as multiple or double formations, as twin teeth, as fusions or as adhesions. Fusions or adhesions can then look like a large tooth. Double formations are caused by fusions of neighboring teeth in the cement or in the dentine.
If a tooth fuses with a supernumerary tooth germ, this is referred to as gemination. These formations mostly occur in the front teeth area, which also leads to aesthetic problems. An accumulation of hyperdontia can be found especially with cleft palate, jaw or lip. Hyperdontia occurs rarely in the primary dentition and is then predominantly localized in the upper jaw. Most often these are additional incisors.
Too many teeth is more common in the permanent dentition, although it is more common in males. Supernatural teeth can have a natural tooth shape. In this case they are called eumorphic. On the other hand, if their shape is atypical, they are called dysmorphic. These include paramolars, distomolars and mesiodentes.
Mesiodentes are very commonly cone-shaped and are found between the roots of the upper central incisors. This can impair the natural eruption of teeth. Paramolars and distomolars are molars that can appear behind the wisdom teeth or between the molars.
The cause of hyperdontia is not exactly clear, but tooth germ splitting, overproduction of the dental ridge, atavism or local developmental disorders could be responsible. Sometimes hyperdontia also occurs in families or together with other diseases such as the Klippel-Feil syndrome and dysostosis (disorder of bone formation).
The following forms of hyperdontia can be distinguished:
- Mesiodentes : The most common form of excess teeth, which often occurs in families. Mesiodentes are usually teeth that are atypically shaped and most often occur due to overproduction of the dental ridge. These are peg teeth with a peg-like, cone-like or smooth crown. The root is normally fully developed and not split. Inflammatory processes or pain occur only rarely. Mesiodentes erupt in only a quarter of cases.
- Paramolars : Additional, single-rooted teeth found primarily in the upper jaw. Paramolars are very often fused with the molars, and a palatal cusp is also formed. Paramolars and distomolars are often cone-shaped teeth that can grow together with the molars in the root area. Early extraction is required for orthodontic reasons and due to the increased risk of caries.
- Distomolars : Extra teeth that grow behind the wisdom teeth. Distomolars are supernumerary teeth mostly found in the upper jaw. Like wisdom teeth, these slide into the oral cavity, but are usually located in the jawbone, which prevents the tooth from erupting.
- Dressocranial dysplasia : Multiple supernumerary tooth buds occur here. A defect in the collarbones is also typical here, as a result of which the shoulders can be pushed very far forward.
- False hyperdontia : A permanent tooth erupts without losing the deciduous tooth.
Symptoms, Ailments and Signs
Cysts can occur as part of hyperdontia, and it is not uncommon for the roots of adjacent teeth to dissolve or degrade. Different proportions of the lower or upper jaw size as well as an eruption obstruction can also be symptoms. Sometimes there can also be local tooth crowding or the formation of an unusually enlarged jaw segment.
Normal biting or chewing is not possible due to hyperdontia. In addition, asymmetries – such as a crossbite – can occur and easily flammable dirt niches can develop. Hyperdontia cannot always be recognized immediately; it is usually indicated by problems with the eruption of permanent teeth.
However, a radiological examination or pain can also lead to the discovery of excess teeth. For clarification, a radiological recording of the upper jaw is primarily carried out; in complicated cases, a lateral x-ray image can also be used to make the diagnosis.
Treatment & Therapy
In the course of therapy, if hypertension is present, the supernumerary teeth in the upper jaw are usually removed, since otherwise the midline can be shifted. However, a supernumerary incisor that is normally formed is usually not noticeable and can therefore be left in place if the supernumerary tooth does not cause crowding. Normally, a mesiodens is also removed, as otherwise a gap can arise between the upper central incisors.
The teeth should be extracted as early as possible so that the gap can be closed. If there are already damaged teeth in the vicinity of the supernumerary tooth, removal is also recommended here. After part of the active treatment time, there is usually a holding phase so that a complete row of teeth and a stable bite can be maintained.
Plastic splints, removable appliances or so-called lingual retainers, which should be worn for at least a year, are suitable for this. Extraction therapy usually begins around the age of ten. It should be noted that the extraction also has an impact on the aesthetics and the soft tissue profile. Therapy is much more complex if the dental anomaly is due to a genetic disease.
Since the exact causes of hyperdontia are not known, excess teeth cannot be prevented.
In most cases, the affected person with hyperdontia has no or only very few follow-up measures available. The disease can only be treated to a very limited extent, so the focus is on early detection and subsequent treatment. The earlier the hyperdontia is detected, the better the further course of this disease is in most cases.
As a rule, hyperdontia does not have a negative effect on the life expectancy of the person affected. In most cases, this disease is treated by surgical intervention in the oral cavity. This should be done in the early years, so parents and their children should consult a doctor at the first signs and symptoms.
Those affected should definitely rest after such an operation and take care of their bodies. Efforts or stressful activities should be avoided to speed healing. Also, after the procedure, the affected person can initially only eat very soft food. Normal food can only be resumed after the wounds have healed. As a rule, hyperdontia can be completely cured if it is detected early.