What is a hyperdontia?As part of a therapy in existing hypertension, the supernumerary teeth in the upper jaw are usually removed, otherwise a shift of the midline may occur. However, a supernumerary incisor, which is normally formed, usually does not stand out and can therefore be left if the surplus tooth does not cause a dentition.
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A hyperdontia is understood to mean an excess of teeth which can occur as a multiple or double formation, as a twin tooth, as a fusion or as an adhesion. Mergers or adhesions can look like a big tooth. Double formations occur due to merging of adjacent teeth in the cement or dentin.
If a tooth fuses with a surplus of teeth, this is called a gemination. Mostly, these structures occur in the anterior region, which also leads to aesthetic problems. An accumulation of hyperdontia can be found especially in palate, jaw or cleft lip. In the deciduous dentition, hyperdontia rarely occurs and is then localized predominantly in the upper jaw. Most of these are additional incisors.
It is more common to have an excess of teeth in the permanent dentition, whereby it often occurs here in the male sex. Supernatural teeth can have a natural tooth shape. In this case they are called eumorphic. If their shape is atypical, they are called dysmorphic. These include paramolars, distomolars or mesiodentes.
Mesiodentes are very often in the form of a pin and can be found between the roots of the upper central incisors. This can affect the natural tooth breakdown. Paramolars and distomolar teeth are molars that can occur behind the wisdom teeth or between the molars.
The cause of the hyperdontia is not clear, but it could be a splitting tooth, an overproduction of the dental arch, atavism or local developmental disorders responsible for it. Sometimes, hyperdontia is also familial or common with other diseases such as Klippel-Feil syndrome and dysostosis (disorder of bone formation).
In hyperdontia, the following forms can be distinguished:
- Mesiodentes : The most common form of tooth overdosage, which often occurs frequently in the family. Mesiodentes are usually teeth that are atypical in shape and mostly occur due to overproduction of the dental arch. These are peg teeth with a peg-shaped or conical or smooth crown. The root is normally completely formed and not split. Inflammatory processes or pain are rare. Mesiodentes break through only in a quarter of the cases.
- Paramolars : Additional, one-rooted teeth found mainly in the upper jaw. Paramolars are often fused with the molar, and a palatal cusp is formed. Paramolaren and Distomolaren are frequently peg-shaped teeth, which can grow together with the molars in the area of the root. For orthodontic reasons and due to the increased caries risk, early extraction is required.
- Distomolar : Additional teeth that grow behind the wisdom teeth. Distomolar teeth are supernumerary teeth that are mostly found in the upper jaw. These push like the wisdom teeth into the oral cavity, but are usually in the jaw bone, whereby a tooth breakage is prevented.
- Dress cranial dysplasia : Multiple supernumerary tooth systems occur here. Typical is also a defect of the clavicles, whereby the shoulders can be led very far forward.
- False Hyperdontia : A permanent tooth breaks through without the deciduous tooth being lost.
Symptoms, complaints and signs
In the context of hyperdontia cysts may occur, and it is not uncommon for the dissolution or degradation of the tooth root of adjacent teeth before. Different proportions of mandibular or maxillary size as well as breakthrough obstruction may also be symptoms. Occasionally there may also be local teeth or the development of an unusually enlarged jaw segment.
Due to the hyperdontia no normal biting or chewing is possible. In addition, asymmetries - such as a crossbite - occur and easily inflammable dirt niches arise. A hyperdontia can not always be recognized immediately, mostly disruption of the permanent teeth indicates this.
But also a radiological examination or pain can lead to the discovery of an excess of teeth. For clarification, a radiological image of the upper jaw is predominantly carried out; in complicated cases, a cephalometric side image can also be used for the diagnosis.
Therapy and treatment
As part of a therapy in existing hypertension, the supernumerary teeth in the upper jaw are usually removed, otherwise a shift of the midline may occur. However, a supernumerary incisor, which is normally formed, usually does not stand out and can therefore be left if the surplus tooth does not cause a dentition. Normally, a mesiodens is also removed, otherwise a gap may arise between the upper central incisors.
The teeth should be pulled as early as possible, so that a gap closure can be achieved. If there are already damaged teeth in the vicinity of the surplus tooth, a removal is also recommended here. After a part of the active treatment time then usually takes a holding phase, so that a complete row of teeth and a stable bite can be obtained.
These are plastic splints, removable appliances or so-called lingual retainers that should be worn for at least a year. An extraction therapy usually begins at the age of ten. It should be noted that the extraction also has effects on the aesthetics or the soft tissue profile. A therapy is much more complex if the dental anomaly is based on a genetic disease.
Prescription drugs for gingivitis
Since the exact causes of hyperdontia are not known, it is not possible to prevent tooth overdosage.
In the case of hyperdontia, in most cases the person concerned has no or only very few measures of aftercare available. The disease can only be treated in a very limited way, so the focus is on early detection followed by treatment. The sooner the hyperdontia is recognized, the better is usually the further course of this disease.
As a rule, hyperdontia does not negatively affect the life expectancy of the person affected. The treatment of this disease takes place in most cases by an operation on the oral cavity. This should be carried out already in the early years, so that parents with their children should visit a doctor at the first signs and symptoms.
Those affected should rest after such an intervention in any case and protect the body. Efforts or stressful activities should be avoided to speed healing. Also, the person affected after the procedure can first only eat very soft food. Only after the healing of the wounds the ordinary food can be adjusted again. In general, hyperdontia can be completely cured if it is detected early.