The surgical removal of supernumerary teeth is necessary in some cases, especially before the commencement of any orthodontic or implant treatment procedure. In the mandibular supernumerary premolar, a more conservative approach is required because of the presence of complications associated with conventional surgery due to the close proximity of the said premolar to the alveolar inferior and mental nerves, and the need for bone conservation for implant placement. The endoscopic surgical approach has been used for the removal of the maxillary supernumerary tooth, impacted third molar, and implants. In this case report, we present an endoscopically assisted surgical technique for the removal of an unerupted supernumerary premolar in the mandible associated with a dental implant placement procedure. 1. Introduction A supernumerary tooth is defined as any tooth or odontogenic structure formed from a tooth germ in excess of the usual number in any region of the dental arc [1]. Supernumerary teeth have been found in all areas within the dental arches, as well as outside them, in primary and permanent dentition. They may be of single, multiple, unilateral, or bilateral distribution [2], with a prevalence in permanent teeth of between 0.15% and 3.9% [3]. It is classified morphologically into conical, tubercles, complementary, and odontoma types. Mesiodens is the most common type in terms of location, followed by paramolars in the premolar area [3]. Supernumerary teeth are the result of changes occurring in the process of normal epithelial-mesenchymal interactions of tooth development. However, the etiology of supernumerary teeth is unknown. Some of the most accepted theories suggest the dichotomy of the tooth germ, other overgrowth, or hyperactivity of the dental lamina, where the proliferations of epithelial rests of dental lamina induced by pressure from the rest of the dentition are outbreaks of supplemental supernumerary teeth [2]. The diagnosis is easy when supernumerary teeth are erupted. However, many do not erupt and may remain asymptomatic throughout life. Some cases are responsible for disorders such as delayed tooth eruption, tooth malposition, or associated pathologies such as dentigerous cyst, requiring surgical intervention [2]. The finding of an unerupted supernumerary tooth in a potential site for the placement of implants can make a forecast difficult; prior removal of the supernumerary tooth with removal of the surrounding bone for broad access will be required, generating major defects after removal. The use of support endoscope makes a
References
[1]
W. G. Shafer, M. K. Hine, and B. M. Levy, A Textbook of Oral Pathology, W.B. Saunders, Philadelphia, Pa, USA, 4th edition, 1983.
[2]
R. P. Anthonappa, R. S. M. Omer, and N. M. King, “Characteristics of 283 supernumerary teeth in southern Chinese children,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, vol. 105, no. 6, pp. e48–e54, 2008.
[3]
L. D. Rajab and M. A. M. Hamdan, “Supernumerary teeth: review of the literature and a survey of 152 cases,” International Journal of Paediatric Dentistry, vol. 12, no. 4, pp. 244–254, 2002.
[4]
W. Engelke, W. Schwarzw？ller, A. Behnsen, and H. G. Jacobs, “Subantroscopic laterobasal sinus floor augmentation (SALSA): an up-to-5-year clinical study,” International Journal of Oral and Maxillofacial Implants, vol. 18, no. 1, pp. 135–143, 2003.
[5]
N. Nakamura, T. Mitsuyasu, and M. Ohishi, “Endoscopic removal of a dental implant displaced into the maxillary sinus: technical note,” International Journal of Oral and Maxillofacial Surgery, vol. 33, no. 2, pp. 195–197, 2004.
[6]
A. S. Hasbini, U. Hadi, and J. Ghafari, “Endoscopic removal of an ectopic third molar obstructing the osteomeatal complex,” Ear, Nose and Throat Journal, vol. 80, no. 9, pp. 667–670, 2001.
[7]
A. Sanei-Moghaddam, N. Hyde, and P. Williamson, “Endoscopic removal of a supernumerary tooth from the nasal cavity in an adult,” British Journal of Oral and Maxillofacial Surgery, vol. 47, no. 6, pp. 484–485, 2009.
[8]
M. M. Suarez-Cunqueiro, R. Schoen, A. Schramm, N.-C. Gellrich, and R. Schmelzeisen, “Endoscopic approach to removal of an ectopic mandibullar third molar,” British Journal of Oral and Maxillofacial Surgery, vol. 41, no. 5, pp. 340–342, 2003.
[9]
A. Franco, S. Riscala, M. Kahoudji, and A. Croue, “Endoscopic removal of a mandibular ameloblastic fibro-odontoma,” Revue de Stomatologie et de Chirurgie Maxillo-Faciale, vol. 110, no. 6, pp. 359–361, 2009.
[10]
W. G. H. Engelke, “In situ examination of implant sites with support immersion endoscopy,” International Journal of Oral and Maxillofacial Implants, vol. 17, no. 5, pp. 703–706, 2002.
[11]
V. Beltrán, R. Fuentes, and W. Engelke, “Endoscopic visualization of anatomic structures as a support tool in oral surgery and implantology,” Journal of Oral and Maxillofacial Surgery, vol. 70, no. e1, p. e6, 2012.
[12]
V. Beltrán, M. Cantín, R. F. Fernández, and W. Engelke, “Bilateral presence of mandibular incisive canal. An anatomical structure with clinical relevance,” International Journal of Morphology, vol. 29, no. 2, pp. 543–549, 2011.
[13]
M. Davarpanah and S. Szmukler-Moncler, “Unconventional implant treatment: I. Implant placement in contact with ankylosed root fragments. A series of five case reports: case report,” Clinical Oral Implants Research, vol. 20, no. 8, pp. 851–856, 2009.
[14]
P.-I. Branemark, “Osseointegration and its experimental background,” The Journal of Prosthetic Dentistry, vol. 50, no. 3, pp. 399–410, 1983.
[15]
R. Guarnieri, L. Giardino, R. Crespi, and R. Romagnoli, “Cementum formation around a titanium implant: a case report,” International Journal of Oral and Maxillofacial Implants, vol. 17, no. 5, pp. 729–732, 2002.
[16]
G. Juodzbalys, S. Bojarskas, R. Kubilius, and H.-L. Wang, “Using the support immersion endoscope for socket assessment,” Journal of Periodontology, vol. 79, no. 1, pp. 64–71, 2008.
