ORTHODONTICS: Surgical management of impacted incisors in associate with supernumerary teeth: A combine case report of spontaneous eruption and orthodontic extrusion

Impaction of maxillary permanent incisors is not a frequent case in dental practice, but its treatment is challenging because of these teeth importance to facial esthetics.

Supernumerary teeth are the main cause of the impaction of upper incisors. 56-60% of pre-maxillary supernumerary teeth cause impaction of permanent incisors.

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The supernumerary teeth (hyperdontia) is a state which can be defined as any teeth or tooth like substance in excess of the usual configuration of the normal number of deciduous or permanent teeth. Although several theories have been submitted to explain their development, the precise etiology of supernumerary teeth is not clearly understood. 

But the common suggestion about etiology of supernumerary teeth is considered to develop as a result of horizontal proliferation or a hyperactivity of the dental lamina.

The frequency of supernumerary tooth in the maxillary incisor region is very common. A study was conducted in Australia demonstrated that supernumerary teeth were most frequently located in maxillary incisor region (64.3%) with mesiodens accounting for 32.4% of such presentation. 

In decreasing order of frequency came supernumeraries in the maxillary third molar region (29.6%), mandibular third molar region (7.0%), mandibular premolar region (7%), maxillary pre-molar region (4.2%) and mandibular incisor region (4.2%).

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