case_images: PMC4770477_01
case_images: (a) Occlusal view showing abnormal supernumerary teeth in the anterior superior region and tilting of the palatal raphe; (b) Occlusal radiograph of the maxilla; (c) Panoramic radiograph demonstrating the presence of supernumerary teeth in the anterior superior region and palatal raphe; (d) The threedimensional reconstruction showing the presence of abnormal and supernumerary teeth (in maxilla and palate); (e) Axial section; (f and g) Abnormal supernumerary teeth (n = 4) and deciduous tooth removed.
case_images: DRJ-13-85-g001.jpg
case_images: PMC4770477_01_DRJ-13-85-g001.jpg
case_images: F1
case_images: Clinically, dental elements 53, 12, 51, 21, 22, and 63, including two supernumerary teeth erupted into the palate [Figure 1a], were observed in the region. There was no images compatible with expansive lesion [Figure 1b and c]. CBCT images identified of the impacted tooth (11), which was horizontally positioned, in addition to other four supernumerary teeth presenting developmental anomaly [Figure 1d and e].
case_images: PMC4770477_02
case_images: (a) Occlusal view showing teeth 53 and 63 as well as residual root of tooth 52 in the anterior superior region; (b) Occlusal radiograph of the maxilla; (c) Panoramic radiograph demonstrating the presence of supernumerary teeth in the anterior superior region and palatal raphe; (d) The threedimensional reconstruction for evaluation of impacted teeth 12, 11, 21, 22, and 23; hyperdense image compatible with amorphous dental structure positioned in the region of the alveolar ridge of the right anterior maxilla; (e) Sagittal section; (f) Abnormal supernumerary teeth (n = 3) removed.
case_images: DRJ-13-85-g002.jpg
case_images: PMC4770477_02_DRJ-13-85-g002.jpg
case_images: F2
case_images: Clinically, only teeth 53 and 63 were present in the region, in addition to a residual root of tooth 52 [Figure 2a]. Impacted teeth (12, 11, 21, and 22) with suggestive images of supernumerary teeth in the maxilla anterior region were identified in both panoramic and occlusal radiographs, but these complementary exams provided no detail necessary for planning a surgical removal [Figure 2b and c]. CBCT images showed that teeth 12, 11, 21, 22, and 23 were impacted and had an unfavorable eruption axis [Figure 2d and e]. Absence of root resorption and cystic lesions in permanent teeth in the region [Figure 2f].