Indications for surgical removal of supernumerary teeth in the premaxilla

Usually supernumerary teeth in the maxilla are removed surgically, often due to retention of the permanent teeth in the region, but in certain cases the supernumerary teeth do not cause alterations in the eruption, position or integrity of the permanent dentition. This study was performed in order to review the indications for such surgical removal. The patient records of 208 patients with supernumerary teeth during the period of 1970-81 were reviewed retrospectively. Of these patients, 52 non-operated were furthermore examined clinically and radiographically in 1982; mean observation time 7.3 years (1-22 years). Results showed that none of the 52 non-operated patients had any symptoms or pathologic conditions related to the supernumerary teeth. In 37%, progressive resorption of the supernumerary teeth was seen, and in 24% the pericoronary space was markedly reduced compared to the first examination. The position and morphology was found to have influence on the prevalence of retention of the permanent incisors (p less than 0.0001). Widening of the pericoronary space during the observation period of the non-operated patients was not seen in any of the cases. Of the total of 262 teeth, 2 well-defined pericoronary cyst (pericoronary space greater than or equal to 5 mm) were found. From the present study, it is concluded that supernumerary teeth in the premaxilla may cause pathological conditions. However, each case must be considered individually concerning surgical treatment, and if no retention of permanent teeth or pathological conditions are present, observation with regularly radiographic controls is advisable. Enlarged pericoronary space (1-3 mm) does not alone seem to indicate surgical treatment.