Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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On Aug 2018




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Dr. Rajendra Kumar Ghritlaharey

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Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
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Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Dentistry
Year : 2011 | Month : June | Volume : 5 | Issue : 3 | Page : 665 - 668

Hyperdontia- 3 Cases Reported

SUJATA.M.BHYATTI

Department of Oral medicine and Radiology, Maratha Mandals N.G.Halgekar institute of dental sciences and reaserch centre,Belgaum,India

Correspondence Address :
Sujata.M.Byahatti, Plot no 49, sector # 9, Malmaruti Extn,
Belgaum-590016. E-mail address: sujatabyahatti@rediffmail.com
Phone: 9731589981, 08312456931

Abstract

A supernumerary tooth may closely resemble the teeth of the group to which it belongs, i.e molars, premolars, or anterior teeth or it may bear little resemblance in size or shape to the teeth with which it is associated. It has been suggested that supernumerary teeth develop from a third tooth bud which arises from the dental lamina near the permanent tooth bud or possibly from the splitting of the permanent tooth bud itself. In some cases, there appears to be a hereditary tendency for the development of supernumerary teeth. A supernumerary tooth is an additional entity to the normal series and is seen in all quadrantsof the jaw.

The incidence of these teeth is not uncommon. Different variants of supernumerary teeth are discussed and reviewed in detail in the following article.

Keywords

Supernumerary Teeth, Mesiodens, Upper Distomolar

How to cite this article :

SUJATA.M.BHYATTI. HYPERDONTIA- 3 CASES REPORTED. Journal of Clinical and Diagnostic Research [serial online] 2011 June [cited: 2019 Sep 16 ]; 5:665-668. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2011&month=June&volume=5&issue=3&page=665-668&id=1290

A supernumerary tooth (or hyperodontia) is defined as an increase in the number of teeth in a given individual, i.e., more than 20 deciduous or temporary teeth and over 32 teeth in the case of the permanent dentition (1), (2).

Supernumerary teeth are a rare alteration in the development of the maxillas which can appear in any part of the maxillas and can affect any tooth. They can be associated with a syndrome or they can be found in nonsyndromic patients (3), (4).

The aetiology of hyperdontia is still uncertain. A hereditary component has been suggested (5)(6)(7) and current genetic studies have revealed the possible intervention of ectodine as an inhibitor protein against the third dentition (8)(9)(10). The incidence of supernumerary teeth varies between 0.45-3%, depending on the literature source and is more common in females than in males (proportion 2:1) (11), (12).

While such teeth may be found in any region of the dental arch, they are more commonly located in the maxillary midline where they are referred to as mesiodens, representing 80% of all the supernumerary teeth(13), (14).

This location is followed in the decreasing order of frequency by four molars or the upper distomolars, the upper paramolars and proportionately far behind by the lower premolars, the upper lateral incisors, the lower fourth molars and the lower central incisors. The upper premolars are exceptional as are the upper and lower canines and the lower lateral incisors(15).

Regarding the aetiology of the supernumerary teeth, most authors point to phylogenetic factors specifically hyperactivity within the dental lamina which causes the appearance of additional dental buds (16), (17). Clinically, supernumerary teeth are able to cause different local disorders, including retention of the primary tooth, delayed eruption of the permanent tooth, ectopic eruptions, tooth displacements, follicular cysts and other alterations which require surgical or orthodontic intervention (18), (19).

The extraction of these teeth is a general rule for avoiding complications(15). Nevertheless, some authors such as Koch et al (20) do not recommend the extractions of impacted teeth in children under 10 years of age since in this particular age group, such procedures often require general anaesthesia. Kruger (21) considers that the extraction of supernumerary teeth should be postponed until the apexes of the adjacent teeth have sealed. According to Donado (22), treatment should be provided as soon as possible in order to avoid the displacement and delayed eruption of the permanent teeth.

CASE HISTORY 1
A 17 year old apparently healthy male patient visited our department with a history of deposits on his teeth and wanted to get them cleaned. On intraoral examination, the entire soft tissues appeared to be normal. The hard tissue examination revealed the presence of an extra tooth (suplementary tooth) distal to lateral incisor, but on the buccal side on both sides of the (Table/Fig 1) in the upper jaw. (Table/Fig 1)The lateral incisors on both the sides were found to be palatally erupting (Table/Fig 2).

The upper right side quadrant showed that the first molar was missing. The upper left quadrant showed retained canine. When the tooth number was counted from canine to canine, there should be 6 teeth but here, 8 teeth were there. Then, the patient was subjected to radiography to differentiate this extra tooth from the fusion or the gemination. Orthopantomography (Table/Fig 3) showed that the extra supplementary teeth appeared single and that they were not related to the adjacent tooth but resembled the adjacent canine; hence, they were called as supplementary teeth. Again, as both the teeth were asymptomatic, they were kept under observation. (Table/Fig 3)

CASE HISTORY 2
A 52 year old apparently healthy male patient visited our department with a history of decayed tooth. On intraoral examination, the entire soft tissues appeared to be normal. The hard tissue examination revealed the presence of an extra tooth (suplementary tooth) distal to lateral incisor (Table/Fig 4), (Table/Fig 5) on both sides of the upper anterior quadrant. Here also the number of teeth from canine to canine, was 8.i.e Hperdontia noted here also. (Table/Fig 4), (Table/Fig 5).

Then, the patient was subjected to radiography to differentiate this from the fusion or the gemination. Orthopantomography (Table/Fig 6) showed that the extra supplementary teeth appeared single and that they were not related to the adjacent tooth but resembled the adjacent lateral incisor; hence, they were called supplementary teeth. Again, as both the teeth were asymptomatic, they were kept under observation. (Table/Fig 6)

CASE HISTORY 3
A 24 year old apparently healthy Army candidate visited our department with a history of food lodgement in the upper right posterior quadrant. On intraoral examination, the entire soft tissues appeared to be normal. The hard tissue examination revealed the presence of an extra tooth on the buccal side of 18, which was called as a perimolar tooth (supernumerary tooth) (Table/Fig 7).

Deep probing between the supernumerary tooth and 18 revealed a catch and carious lesion, with a supernumerary tooth. As the tooth was placed on the buccal side, he underwent occlusal radiography(Table/Fig 8), but the findings were not very contributory. Then, the patient underwent the extraction of this symptomatic supernumerary tooth. (Table/Fig 8)




Discussion

Several researchers have also proposed that multiple supernumerary teeth are the part of a post permanent dentition (23), (24).

The exact mode of inheritance has not been established. However, a familial tendency has been noted (12), (25). It has been stated that the development of supernumerary teeth may cause various pathologies. Approximately 75% of the supernumerary teeth are impacted and asymptomatic and most of these teeth are diagnosed coincidentally during radiographical examination (6). In a survey on 2,000 schoolchildren, Brook (26) found that supernumerary teeth were present in 0.8% of the primary dentition and in 2.1% of the permanent dentition. The occurrence may be single or multiple, unilateral or bilateral, erupted or impacted and in one or both the jaws. Supernumerary teeth are classified according to the morphology and location as conical, tuberculate, supplemental and odontome (26).

Conical teeth are small peg shaped teeth which are most commonly found in the permanent dentition. The tuberculate type possesses more than one cusp or tubercle. It is frequently described as barrel- shaped and may be invaginated. The supplemental supernumerary teeth refer to a duplication of the teeth in the normal series and are found at the end of the tooth series. The most common supplemental tooth is the permanent maxillary lateral incisor but supplemental premolars and molars can also occur. Odontome has been listed as the fourth category of the supernumerary teeth by Howard. Supernumerary teeth are infrequent developmental alterations that may manifest in any zone of the dental arches and may involve any tooth; they may be associated to syndromes or can also be found in non-syndromic populations (27).

According to the consulted literature sources, the frequency of supernumerary teeth has been found to vary according to the population which is studied, ie. between 0.1-3.8% (28)(29)(30) and this has been found to reach up to 28% in patients with cleft palate and harelip (31).

According to Salcido-Garcia et al (27), the appearance of supernumerary teeth is more frequent in the first three decades of life than in the older age groups. However, in studies on adult populations, the frequencies have been found to be lower (between 0.4% and 1%) with an increased location in the maxilla, though they can also occur in the posterior sectors of the arch (32)(33)(34)(35).

The principal location of the supernumerary teeth is the premaxillary zone (mesiodens) in children and the distomolar in adults.Most authors consider the most common mechanical accident to be the reason for delayed eruption of the adjacent teeth (15), (36).

Conclusion

Early diagnosis is important in order to minimize the risk of complications resulting from supernumerary teeth. If they have caused delay or non-eruption of the permanent teeth, displacement of the permanent teeth and root resorption of the adjacent teeth due to pressure and cystic formations, then extraction is recommended.

However, the extraction of asymptomatic supernumerary teeth that does not affect the dentition may not always be necessary but these teeth should be followed through periodic examinations. The one and two patients in this study were kept under Observation, whereas the third patient presented with supernumerary tooth (decayed) underwent extraction of the same.

Key Message

A supernumerary tooth (or hyperodontia) is defined as an increase in the number of teeth in a given individual.

References

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Prinosch RE. Anterior supernumerary theeth assessment and surgical intervention in children. Pediatr Dent 1981;3:202-15.
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Dehdashti M, Gugny P. A propos des polyodonties, proposition d´une approche therapeutique. Rev Orthop Dento Faciale 1990;24:465-71.
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Koch H, Schwartz O, Klausen B. Indications for surgical removal supernumerary teeth in the premaxila. Int J Oral Maxillofac Surg 1986;15:272- 81.
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