Spontaneous Orthodontic Movement To Normal Occlusion After Extraction Of A Supernumerary Tooth

Case report

Spontaneous orthodontic movement to normal occlusion after extraction of a supernumerary tooth.

Introduction

A supernumerary tooth (polydontia) is ‘a tooth that is additional to the normal series and can be found in almost any region or the dental arch’. When clinical problems arise (e.g. malocclusion, periodontal disease, overgrowths, etc.) a treatment plan should be implemented.^1,2

Case description

A 6-year old Arabian gelding showed problems during ridden exercise. Clinically, a firm, sensitive, swelling was present at the level of the right cheek adjacent to 106. Oral, radiographic and computed tomographic examinations revealed a supernumerary tooth in the right maxillary arcade (106bis). One tooth with a normal morphology, at the level of 106 was displaced towards buccal whereas the second tooth (106bis) on the palatal side was placed horizontally and had an amorphous appearance. This latter tooth was extracted.

Results

Four months after surgery the external swelling was strongly reduced by repositioning of the 106. The extraction site was covered with healthy gingiva. Oral and repeated CT examination revealed that the tooth on the buccal side was repositioned nearly to its normal position due to tipping of the crown (Fig. 1). The horse showed no clinical symptoms and returned to its normal work. Follow-up was available until 1,5 year after surgery and the horse was still performing without any complaints.

Conclusion

With current possible treatment options for different dental diseases, the goal should be to preserve teeth and obtain normal molar occlusion when possible. In this case, six months after extraction of the tooth, the tooth showed a spontaneous dental drift towards the hard palate, hence its normal position. This supports the assumption that, as in humans, each force executed on the crown of a tooth by mastication and forces of muscle tonicity produce a pressure-tension reaction in the periodontal ligament which results in a spatial arrangement of the dentition. ³

References

1. Dixon PM, Easley J, Ekmann A. Supernumerary Teeth in the Horse. Clinical Techniques in Equine Practice 2005;155-161.
2. Quinn GC, Tremaine WH, Lane JG. Supernumerary cheek teeth (n = 24): clinical features,diagnosis, treatment and outcome in 15 horses. Equine Vet J 2005;37:505-509.
3. Weinstein S. Minimal forces in tooth movement. Am J Orthod 1967;53: 881-903.