Abstract：
OBJECTIVE: The study aims to provide a comprehensive case analysis from a single center, with the objective of clarifying the optimal timing and recommending a preferred treatment strategy customized to the specific presentation of each type of supernumerary tooth (SNT) identified in our research.
METHODS: A retrospective study was conducted on patients who presented with SNT and were treated through an interdisciplinary at the clinic.
RESULTS: 55 patients with 81 SNT of the permanent dentition were analyzed. They included 30 males and 25 females. The dentition status of the patients was as follows: 31 patients with mixed dentition, 0 patients with deciduous dentition, and 24 patients with permanent dentition. The diagnosis of SNT diagnosis was primarily made by general or pediatric dentists and/or orthodontists. Patients were then referred to maxillofacial surgeons for treatment decision. The timing of treatment was mainly determined by the oral surgeon, based on the recommendations of the other specialists involved. Cases involving mal-eruption or malalignment of permanent teeth required both surgical and orthodontic treatment. Patients over 9 years old were treated either under local anesthesia or sedation, while those under 9 years old were treated under deep sedation or general anesthesia A comprehensive investigation of cases involved the utilization of cone beam computerized tomography (CBCT) at the SNT site to facilitate treatment planning. There was a significant correlation between younger age and the preference for treatment under sedation or general anesthesia (p=0.01, t-test). Similarly, a strong association was found between younger age and the need for additional orthodontic treatment (p=0.016, t-test). Cases of surgical removal of SNT at a young age typically did not require orthodontic traction of the permanent tooth, in contrast to cases of late surgical intervention (patients over 11 years old), which often did necessitate such traction. There was a strong tendency for treating supernumerary teeth (SNT) in the maxilla. The proximity of SNTs to vital anatomical landmarks significantly influenced treatment decisions. Patients with SNTs near the mental foramen or the inferior dental canal in the premolar area were exclusively placed under follow-up care (p=0.002, Pearson\'s chi-square test). However, in the maxilla, the proximity of SNTs to vital structures such as the floor of the nose and the incisive nerve did not affect the treatment approach, and those supernumerary teeth were mostly removed.
CONCLUSIONS: A team approach for managing supernumerary teeth (SNT) is recommended. The timing of treatment should carefully consider the advantages and disadvantages of early versus late intervention. Early surgical treatment in cases where eruption is disturbed might result in spontaneous eruption, eliminating the need for orthodontic traction of the permanent teeth.
METHODS: A retrospective study was conducted on patients who presented with SNT and were treated through an interdisciplinary at the clinic.
RESULTS: 55 patients with 81 SNT of the permanent dentition were analyzed. They included 30 males and 25 females. The dentition status of the patients was as follows: 31 patients with mixed dentition, 0 patients with deciduous dentition, and 24 patients with permanent dentition. The diagnosis of SNT diagnosis was primarily made by general or pediatric dentists and/or orthodontists. Patients were then referred to maxillofacial surgeons for treatment decision. The timing of treatment was mainly determined by the oral surgeon, based on the recommendations of the other specialists involved. Cases involving mal-eruption or malalignment of permanent teeth required both surgical and orthodontic treatment. Patients over 9 years old were treated either under local anesthesia or sedation, while those under 9 years old were treated under deep sedation or general anesthesia A comprehensive investigation of cases involved the utilization of cone beam computerized tomography (CBCT) at the SNT site to facilitate treatment planning. There was a significant correlation between younger age and the preference for treatment under sedation or general anesthesia (p=0.01, t-test). Similarly, a strong association was found between younger age and the need for additional orthodontic treatment (p=0.016, t-test). Cases of surgical removal of SNT at a young age typically did not require orthodontic traction of the permanent tooth, in contrast to cases of late surgical intervention (patients over 11 years old), which often did necessitate such traction. There was a strong tendency for treating supernumerary teeth (SNT) in the maxilla. The proximity of SNTs to vital anatomical landmarks significantly influenced treatment decisions. Patients with SNTs near the mental foramen or the inferior dental canal in the premolar area were exclusively placed under follow-up care (p=0.002, Pearson\'s chi-square test). However, in the maxilla, the proximity of SNTs to vital structures such as the floor of the nose and the incisive nerve did not affect the treatment approach, and those supernumerary teeth were mostly removed.
CONCLUSIONS: A team approach for managing supernumerary teeth (SNT) is recommended. The timing of treatment should carefully consider the advantages and disadvantages of early versus late intervention. Early surgical treatment in cases where eruption is disturbed might result in spontaneous eruption, eliminating the need for orthodontic traction of the permanent teeth.
摘要：
目的：该研究旨在提供来自单个中心的全面案例分析，目的是阐明最佳时机，并推荐针对我们研究中确定的每种类型的多余牙齿（SNT）的特定表现而定制的首选治疗策略。
方法：对患有SNT并通过临床跨学科治疗的患者进行了回顾性研究。
结果：分析了55例具有81个永久性牙列SNT的患者。其中包括30名男性和25名女性。患者的牙列状态如下：31例混合性牙列，0例乳牙牙列，和24名恒牙患者。SNT诊断的诊断主要由普通或儿科牙医和/或正畸医生做出。然后将患者转诊给颌面外科医生以进行治疗决定。治疗时机主要由口腔外科医生决定,根据其他相关专家的建议。涉及恒牙萌出或排列不良的病例需要手术和正畸治疗。9岁以上的患者在局部麻醉或镇静下治疗，而9岁以下的患者在深度镇静或全身麻醉下接受治疗。对病例的全面调查涉及在SNT部位使用锥形束计算机断层扫描（CBCT）以促进治疗计划。年龄较小与镇静或全身麻醉下治疗的偏好之间存在显着相关性（p=0.01，t检验）。同样，发现年龄较小和需要额外的正畸治疗之间有很强的相关性(p=0.016,t检验).年轻时手术切除SNT的病例通常不需要恒牙的正畸牵引，与晚期手术干预（11岁以上的患者）相比，这往往需要这样的牵引力。治疗上颌骨多余牙齿（SNT）的趋势很强。SNT与重要解剖标志的接近程度显着影响了治疗决策。前磨牙区精神孔或下牙管附近的SNT患者仅接受随访护理（p=0.002，Pearson卡方检验）。然而,在上颌骨,SNT接近重要结构，如鼻底和切口神经不影响治疗方法，那些多余的牙齿大部分被切除了。
结论：建议采用团队方法管理多余牙齿（SNT）。治疗时机应仔细考虑早期干预与晚期干预的利弊。在喷发受到干扰的情况下，早期手术治疗可能会导致自发喷发，消除了恒牙正畸牵引的需要。
方法：对患有SNT并通过临床跨学科治疗的患者进行了回顾性研究。
结果：分析了55例具有81个永久性牙列SNT的患者。其中包括30名男性和25名女性。患者的牙列状态如下：31例混合性牙列，0例乳牙牙列，和24名恒牙患者。SNT诊断的诊断主要由普通或儿科牙医和/或正畸医生做出。然后将患者转诊给颌面外科医生以进行治疗决定。治疗时机主要由口腔外科医生决定,根据其他相关专家的建议。涉及恒牙萌出或排列不良的病例需要手术和正畸治疗。9岁以上的患者在局部麻醉或镇静下治疗，而9岁以下的患者在深度镇静或全身麻醉下接受治疗。对病例的全面调查涉及在SNT部位使用锥形束计算机断层扫描（CBCT）以促进治疗计划。年龄较小与镇静或全身麻醉下治疗的偏好之间存在显着相关性（p=0.01，t检验）。同样，发现年龄较小和需要额外的正畸治疗之间有很强的相关性(p=0.016,t检验).年轻时手术切除SNT的病例通常不需要恒牙的正畸牵引，与晚期手术干预（11岁以上的患者）相比，这往往需要这样的牵引力。治疗上颌骨多余牙齿（SNT）的趋势很强。SNT与重要解剖标志的接近程度显着影响了治疗决策。前磨牙区精神孔或下牙管附近的SNT患者仅接受随访护理（p=0.002，Pearson卡方检验）。然而,在上颌骨,SNT接近重要结构，如鼻底和切口神经不影响治疗方法，那些多余的牙齿大部分被切除了。
结论：建议采用团队方法管理多余牙齿（SNT）。治疗时机应仔细考虑早期干预与晚期干预的利弊。在喷发受到干扰的情况下，早期手术治疗可能会导致自发喷发，消除了恒牙正畸牵引的需要。
