Review of supernumerary teeth in the maxillary incisor region

The maxillary incisor region is the most frequently reported area for the location of supernumeraries.
When a supernumerary tooth is located in the midline of the maxillait is called mesiodens. The
prevalence of mesiodens has been reported to range from 0.15-4 percent and was found to be more
often in males than in females. The aetiology of supernumerary teeth in the maxillary incisor region is
yet to be substantiated, but there is a strong evidence of gene involvement. There are two types of
supernumerary teeth in the maxillary central incisor region, the conical and tuberculate type. It has
been shown that there were remarkable differences between these two types, especially regarding
their degree of root formation, their eruption and their effect on the eruption of the associated
permanent maxillary central incisors. The tuberculate type was usually unerupted, positioned palatal
to the maxillary central incisor and frequently delayed the eruption of the permanent maxillary central
incisor and with a lack of root formation, which was apparent much later in development than the
permanent maxillary central incisor and the supernumerary conical type. On the other hand, the
conical type was frequently erupted, most often situated between the maxillary central incisors,
although not always in the midline, and did not usually delay the eruption of the associated permanent
maxillary central incisors. Several squelae can be ascribed to the presence of supernumerary teeth in
the maxillary incisor region such as, external resorption of the crowns of supernumeraries, cyst
formation; delayed/ ectopic eruption, rotation, crowding, inclination of the neighbouring teeth, and
diastema. Early diagnosis of supernumerary teeth in the maxillary incisor region is important to aid
their management and prevent any iatrogenic effects on the permanent maxillary incisors.