Impacted supernumerary tooth in the horizontal plate of palatine bone: a rare case report

Abstract Background Supernumerary teeth, defined as extra teeth beyond the normal series of dentition, can appear anywhere in the dental arch. They may present as solitary or multiple, unilateral or bilateral, and can be either erupted or impacted. Rarely, supernumerary teeth are found in ectopic lo...

Full description

Saved in:
Bibliographic Details
Main Authors: Manoj Adhikari, Kanistika Jha, Aashish Shah, Sarita KC, Mallika Rayamajhi, Resham Koirala
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Oral Health
Subjects:
Online Access:https://doi.org/10.1186/s12903-024-05316-0
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850254019945037824
author Manoj Adhikari
Kanistika Jha
Aashish Shah
Sarita KC
Mallika Rayamajhi
Resham Koirala
author_facet Manoj Adhikari
Kanistika Jha
Aashish Shah
Sarita KC
Mallika Rayamajhi
Resham Koirala
author_sort Manoj Adhikari
collection DOAJ
description Abstract Background Supernumerary teeth, defined as extra teeth beyond the normal series of dentition, can appear anywhere in the dental arch. They may present as solitary or multiple, unilateral or bilateral, and can be either erupted or impacted. Rarely, supernumerary teeth are found in ectopic locations outside the dental arches, such as the nasal cavity, inferior nasal conchae, maxillary sinus, ethmoid sinus, or skull. To our knowledge, only two cases of supernumerary teeth in the horizontal plate of the palatine bone have been reported globally in the literature. This case represents the third known instance. Case presentation A 10-year-old boy presented to the Oral and Maxillofacial Surgery outpatient department (OPD) with his parents, reporting a bony hard swelling on the palate that had been present for three years. The swelling was asymptomatic, with no associated pain or discomfort. Clinical examination revealed a non-tender, bony hard swelling on the midline of the posterior hard palate, with healthy overlying mucosa. A non-contrast computed tomography (NCCT) scan of the face confirmed the presence of an impacted supernumerary tooth in the middle of the horizontal plate of the palatine bone, with the crown oriented posteriorly and the root anteriorly. Surgical extraction was performed under general anesthesia. A palatal crevicular incision was made from the right second molar to the incisive papilla, and a full-thickness mucoperiosteal flap was raised. The impacted supernumerary tooth was located, the overlying bone was removed, and the tooth was extracted in its entirety. The flap was then closed primarily. Postoperative care included antibiotics, analgesics, and daily dressing for five days. The healing was uneventful, with no complications observed during the one-year follow-up. Conclusion In cases of swelling in the posterior hard palate, an impacted supernumerary tooth should be considered in the differential diagnosis. Although extraction is the preferred treatment, when supernumerary teeth are located near vital structures and are asymptomatic, close observation with periodic radiographic monitoring is a reasonable management option.
format Article
id doaj-art-ece625c4c48c42d293744ee9206ad21d
institution OA Journals
issn 1472-6831
language English
publishDate 2024-12-01
publisher BMC
record_format Article
series BMC Oral Health
spelling doaj-art-ece625c4c48c42d293744ee9206ad21d2025-08-20T01:57:13ZengBMCBMC Oral Health1472-68312024-12-012411610.1186/s12903-024-05316-0Impacted supernumerary tooth in the horizontal plate of palatine bone: a rare case reportManoj Adhikari0Kanistika Jha1Aashish Shah2Sarita KC3Mallika Rayamajhi4Resham Koirala5Nepalese Army Institute of Health Sciences, College of MedicineCollege of Medical SciencesNepalese Army Institute of Health Sciences, College of MedicineNepalese Army Institute of Health Sciences, College of MedicineNepalese Army Institute of Health Sciences, College of MedicineNepalese Army Institute of Health Sciences, College of MedicineAbstract Background Supernumerary teeth, defined as extra teeth beyond the normal series of dentition, can appear anywhere in the dental arch. They may present as solitary or multiple, unilateral or bilateral, and can be either erupted or impacted. Rarely, supernumerary teeth are found in ectopic locations outside the dental arches, such as the nasal cavity, inferior nasal conchae, maxillary sinus, ethmoid sinus, or skull. To our knowledge, only two cases of supernumerary teeth in the horizontal plate of the palatine bone have been reported globally in the literature. This case represents the third known instance. Case presentation A 10-year-old boy presented to the Oral and Maxillofacial Surgery outpatient department (OPD) with his parents, reporting a bony hard swelling on the palate that had been present for three years. The swelling was asymptomatic, with no associated pain or discomfort. Clinical examination revealed a non-tender, bony hard swelling on the midline of the posterior hard palate, with healthy overlying mucosa. A non-contrast computed tomography (NCCT) scan of the face confirmed the presence of an impacted supernumerary tooth in the middle of the horizontal plate of the palatine bone, with the crown oriented posteriorly and the root anteriorly. Surgical extraction was performed under general anesthesia. A palatal crevicular incision was made from the right second molar to the incisive papilla, and a full-thickness mucoperiosteal flap was raised. The impacted supernumerary tooth was located, the overlying bone was removed, and the tooth was extracted in its entirety. The flap was then closed primarily. Postoperative care included antibiotics, analgesics, and daily dressing for five days. The healing was uneventful, with no complications observed during the one-year follow-up. Conclusion In cases of swelling in the posterior hard palate, an impacted supernumerary tooth should be considered in the differential diagnosis. Although extraction is the preferred treatment, when supernumerary teeth are located near vital structures and are asymptomatic, close observation with periodic radiographic monitoring is a reasonable management option.https://doi.org/10.1186/s12903-024-05316-0Tooth, impactedTooth, supernumeraryPalate, hardDentitionTooth abnormalitiesCase report
spellingShingle Manoj Adhikari
Kanistika Jha
Aashish Shah
Sarita KC
Mallika Rayamajhi
Resham Koirala
Impacted supernumerary tooth in the horizontal plate of palatine bone: a rare case report
BMC Oral Health
Tooth, impacted
Tooth, supernumerary
Palate, hard
Dentition
Tooth abnormalities
Case report
title Impacted supernumerary tooth in the horizontal plate of palatine bone: a rare case report
title_full Impacted supernumerary tooth in the horizontal plate of palatine bone: a rare case report
title_fullStr Impacted supernumerary tooth in the horizontal plate of palatine bone: a rare case report
title_full_unstemmed Impacted supernumerary tooth in the horizontal plate of palatine bone: a rare case report
title_short Impacted supernumerary tooth in the horizontal plate of palatine bone: a rare case report
title_sort impacted supernumerary tooth in the horizontal plate of palatine bone a rare case report
topic Tooth, impacted
Tooth, supernumerary
Palate, hard
Dentition
Tooth abnormalities
Case report
url https://doi.org/10.1186/s12903-024-05316-0
work_keys_str_mv AT manojadhikari impactedsupernumerarytoothinthehorizontalplateofpalatineboneararecasereport
AT kanistikajha impactedsupernumerarytoothinthehorizontalplateofpalatineboneararecasereport
AT aashishshah impactedsupernumerarytoothinthehorizontalplateofpalatineboneararecasereport
AT saritakc impactedsupernumerarytoothinthehorizontalplateofpalatineboneararecasereport
AT mallikarayamajhi impactedsupernumerarytoothinthehorizontalplateofpalatineboneararecasereport
AT reshamkoirala impactedsupernumerarytoothinthehorizontalplateofpalatineboneararecasereport