Prevalence, Radiographic Characteristics, and Clinical Outcomes of Impacted Supernumerary Teeth in an Institutional CBCT Cohort

Nor Hidayah Reduwan; Siti Nabilah Aisyah Sanadi; Shirley Sangan Anak Jantai; Nawwal Alwani Mohd Radzi

doi:10.24191/cos.v13i2.12430

Authors

Nor Hidayah Reduwan Faculty of Dentistry , MARA University of Technology
Siti Nabilah Aisyah Sanadi Faculty of Dentistry , MARA University of Technology
Shirley Sangan Anak Jantai Faculty of Dentistry , MARA University of Technology
Nawwal Alwani Mohd Radzi Faculty of Dentistry , MARA University of Technology

DOI:

https://doi.org/10.24191/cos.v13i2.12430

Keywords:

impacted supernumerary tooth, clinical outcome, cone beam computed tomography, prevalence, radiographic characteristics

Abstract

Objectives: To determine the prevalence of impacted supernumerary teeth (ST) detected on cone-beam computed tomography (CBCT) in patients attending the Faculty of Dentistry, Universiti Teknologi MARA (UiTM), to describe their three-dimensional radiographic characteristics, and to examine their association with clinical outcomes.

Methods: This retrospective cross-sectional study reviewed 2,589 CBCT examinations acquired between 2016 and 2025. Sixty-eight patients with impacted ST were identified. Dentition stage, number of ST, shape, position, and direction were recorded, together with associated clinical outcomes, including delayed eruption, displacement, spacing, and adjacent root resorption. Descriptive statistics were generated. Associations with clinical outcome were assessed using the chi-square test and binary logistic regression at a significance level of p < 0.05.

Results: The prevalence of impacted ST on CBCT was 2.63%. Most impacted ST occurred in permanent dentition (63.2%) and presented as single (73.5%), conical (44.1%), and maxillary (69.2%) teeth. Clinical outcomes were observed in 73.5% of patients. Dentition stage was significantly associated with clinical outcome (χ² = 4.253, p = 0.039), and logistic regression identified primary dentition as an independent predictor of clinical outcome (OR = 5.769, 95% CI: 1.346-24.720; p = 0.018).

Conclusion: Impacted ST demonstrates a substantial burden of complications, particularly in the primary dentition. CBCT provides comprehensive three-dimensional assessments that support early diagnosis and informed treatment planning.

References

Allison, S., Zhang, H., Kim-Berman, H., Benavides, E., Hardy, N. C., & Hu, J. C.-C. (2020). Management of two cases of supernumerary teeth. Pediatr Dent, 15(42), 58-61.

Bahoudela, N., Roslan, H., & Noor, S. N. F. M. (2022). Prevalence and Distribution of Hypodontia and Supernumerary Teeth among Dental Patients in the Northern Region of Malaysia. Mal J Med Health Sci, 18(1), 156-161.

Ballikaya, E., Koç, N., & Kasikci, M. (2022). Prevalence and Characteristics of Supernumerary Premolars in a Group of Non-Syndromic Turkish Children Between 6-18 Years of Age: A Retrospective CBCT Study. Selcuk Dent, 9, 471-478. https://doi.org/J10.15311/selcukdentj.991041.

Bereket, C., Çakır‑Özkan, N., Şener, İ., Bulut, E., & Baştan, A. (2015). Analyses of 1100 supernumerary teeth in a nonsyndromic Turkish population: A retrospective multicenter stud. Nigerian Journal of Clinical Practice, 18(6), 731-738. https://doi.org/10.4103/1119-3077.154213.

Chen, K.-C., Huang, J.-S., Chen, M.-Y., Cheng, K.-H., Wong, T.-Y., & Huang, T.-T. (2019). Unusual supernumerary teeth and treatment outcomes analyzed for developing Improved diagnosis and management plans. Journal of Oral and Maxillofacial surgery, 77(5), 920-931. https://doi.org/https://doi.org/10.1016/j.joms.2018.12.014.

Cholavoka, R., & Georgiev, K. (2024). Effect of maxillary anterior supernumerary tooth extraction on the underlying malocclusion. Journal of Orthodontics, 51(1), 63-69. https://doi.org/10.1177/14653125231172211.

Dalessandri, D., Laffranchi, L., Tonni, I., Zotti, F., Piancino, M. G., Paganelli, C., & Bracco, P. (2011). Advantages of cone beam computed tomography (CBCT) in the orthodontic treatment planning of cleidocranial dysplasia patients: a case report. Head & Face Medicine, 7(1), 6. https://doi.org/10.1186/1746-160x-7-6.

Davidson, C. L., Smit, C., & Nel, S. (2025). Supernumerary teeth: A pictorial review and revised classification. Journal of Oral Biology and Craniofacial Research, 15(3), 454-462. https://doi.org/https://doi.org/10.1016/j.jobcr.2025.03.005.

Delilbaşı, Ç., Gürler, G., & Delilbaşı, E. (2017). Investigation of impacted supernumerary teeth: A Cone Beam computed tomograph (CBCT) Study [Investigation of impacted supernumerary teeth: A cone beam computed tomograph (cbct) study]. Journal of Istanbul University Faculty of Dentistry, 51(3), 18-24. https://doi.org/10.17096/jiufd.20098.

Demiriz, L., Durmuslar, M. C., & Misir, A. F. (2015). Prevalance and characteristics of supernumerary teeth: A survey on 7348 people. Journal of International Society of Preventive Community Dentistry, 5(Suppl 1), S39-S43. https://doi.org/https://doi.org/10.4103/2231-0762.156151.

Gurung, D., Sun, J. H., Xie, N. N., Sun, T. Z., & Shrestha, M. (2021). Supernumerary Teeth and Their Complications: A Cone Beam Computed Tomography Study. J Nepal Dent Assoc., 21(32), 46-51.

Hamada, A., Mukasa, H., Taguchi, Y., Akagi, E., Obayashi, F., Yamasaki, S., Kanda, A., Koizumi, K., Toratani, S., & Okamoto, T. (2021). Identification of a familial cleidocranial dysplasia with a novel RUNX2 mutation and establishment of patient‑derived induced pluripotent stem cells. Odontology, 110, 444-451. https://doi.org/https://doi.org/10.1007/s10266-021-00674-5.

He, L., Que, G., Yang, X., Yan, S., & Luo, S. (2023). Prevalence, clinical characteristics, and 3-dimensional radiographic analysis of supernumerary teeth in Guangzhou, China: a retrospective study. BMC Oral Health, 23(1). https://doi.org/10.1186/s12903-023-03032-9.

Henein, C., Bhatia, S. K., & Drage, N. (2021). The Use of Cone Beam Computed Tomographic Imaging in a Paediatric Dentistry Department. Paediatric Dentistry Department. Oral., 1, 45-55. https://doi.org/10.3390/oral1020006.

Katanaki, N., Makrygiannakis, M. A., & Kaklamanos, E. G. (2025). The Prevalence of Supernumerary Teeth in a Sample of Non-Syndromic Young Patients from Greece. Dent. J., 13, 317. https://doi.org/10.3390/dj13070317.

Kolarkodi, S. H., & Alshawy, E. (2026a). Prevalence and radiographic characteristics of supernumerary teeth in a Saudi population: A retrospective CBCT-based study. Pak J Med Sci, 42(1), 66-76. https://doi.org/https://doi.org/10.12669/pjms.42.1.12457.

Kolarkodi, S. H., & Alshawy, E. (2026b). Prevalence and radiographic characteristics of supernumerary teeth in a Saudi population: A retrospective CBCT-based study. Pakistan Journal of Medical Sciences, 42(1), 66-76.

Kolawole, K. A., & Folayan, M. O. (2019). Association between malocclusion, caries and oral hygiene in children 6 to 12 years old resident in suburban Nigeria. BMC Oral Health, 19(1). https://doi.org/10.1186/s12903-019-0959-2.

Kouri, D., Bertaia, C. A. V., Santos, R. C. D. F., Costa-Nobre, P. X. D., Garcia-Leite, E. S., Araujo, F. B. D., & Moi, G. P. (2014). Aesthetic and functional rehabilitation of a supernumerary peg-shaped tooth in the primary dentition. RGO - Revista Gaúcha de Odontologia, 62(2), 191-195. https://doi.org/10.1590/1981-86372014000200000151592.

Lustmann, J., & Bodner, L. (1988). Dentigurous cyst associated with supernumerary teeth. Int J Oral Maxillofac Surg., 17(2), 100-102. https://doi.org/10.1016/s0901-5027(88)80159-0.

Mossaz, J., Suter, V. G. A., Katsaros, C., & Bornstein, M. M. (2016). Supernumerary teeth in the maxilla and mandible: an interdisciplinary challenge: Part 1: epidemiology, aetiology, classification and possible complications. Swiss Dent J, 126(2), 131-149. https://doi.org/https://doi.org/10.61872/sdj-2016-02-04.

Nematolahi, H., Abadi, H., Mohammadzade, Z., & Ghadim, M. S. (2013). The Use of Cone Beam Computed Tomograph (CBCT) to Determine Supernumerary and Impacted Teeth Position in Paediatrics Patient: Case Study. Journal of Dental Research, Dental Clinics, Dental Prospects, 7(1), 47-50. https://doi.org/10.5681/joddd.2013.008.

Park, S.-Y., Jang, H.-J., Hwang, D.-S., Kim, Y.-D., Shin, S.-H., Kim, U.-K., & Lee, J.-Y. (2020). Complications associated with specific characteristics of supernumerary teeth. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 130(2), 150-155. https://doi.org/https://doi.org/10.1016/j.oooo.2020.03.002.

Singh, S., Gupta, K., Kumaresan, R., Pendalya, S. K., Kondreddy, K., & Karthikeyan, P. (2019). Prevalence of Supernumerary Teeth in Non-Syndromic Northern Malaysia Population. EAS Journal of Dentistry and Oral Medicine, 1(4), 58-61. https://doi.org/10.36349/easjdom.2019.v01i04.002.

Suchetana, G. (2023). Prevalence and characteristics of supernumerary teeth in pediatric patients: A retrospective study. J Prim Care Dent Oral Health, 4, 99-102. https://doi.org/10.4103/jpcdoh.jpcdoh_28_23.

Sukmadewi, P. M., & Dananjaya, A. A. A. G. (2023). Incidental finding of impacted supernumerary teeth in cone-beam computed tomography 3D. Jurnal Radiologi Dentomaksilofasial Indonesia (JRDI), 7(2), 79-82. https://doi.org/10.32793/jrdi.v7i2.1059.

Tumen, E. C., Yavuz, I., Tumen, D. S., Hamamci, N., Berber, G., Atakul, F., & Uysal, E. (2010). The Detailed Evaluation of Supernumerary Teeth with the Aid of Cone Beam Computed Tomography. Biotechnology & Biotechnological Equipment, 24(2), 1886-1892. https://doi.org/10.2478/v10133-010-0023-5.

Tworkowski, K., Gąsowska, E., Baryła, D., & Gabiec, K. (2020). Supernumerary Teeth – Literature Review. Journal of Pre-Clinical and Clinical Research, 14(1), 18-21. https://doi.org/10.26444/jpccr/119037.

Zhao, L., Liu, S., Zhang, R., Yang, R., Zhang, K., & Xie, X. (2021). Analysis of the distribution of supernumerary teeth and the characteristics of mesiodens in Bengbu, China: a retrospective study. Oral Radiol, 37(2), 218-223. https://doi.org/DOI: 10.1007/s11282-020-00432-3.

Zhu, F., Hou, D., Zhou, C., Chen, Z., Cao, Y., Ji, L., Zou, J., & Xu, Y. (2022). Precise extraction of impacted supernumerary tooth in the maxillary anterior region with a digital guide plate. A case report. Medicine (Baltimore), 101(20), e29275. https://doi.org/https://doi.org/10.1097/md.0000000000029275.