Cone-beam CT-based age-specific risk prediction model for maxillary anterior supernumerary teeth

Maxillary supernumerary teeth (ST) frequently induce complications (e.g., dental irregularities, bone destruction), but precise risk stratification remains challenging. This retrospective study analysed cone-beam computed tomography (CBCT) data from 217 patients, stratified into childhood (6-12 years) and adulthood (≥ 19 years). Morphological assessment showed that 77.1% of ST were conical, with a significantly higher proportion in females (88.3% vs. 73.4% in males). Age-stratified risk modelling revealed that root curvature was strongly associated with adult bone destruction (adjusted odds ratio [OR] = 3.5), while ST number drove childhood dental anomalies (adjusted OR = 4.2). The adult bone destruction model achieved an area under the curve (AUC) of 0.80 (outperforming non-stratified models), whereas the childhood dental anomaly model had modest performance (AUC = 0.69). These findings support age-specific clinical strategies: early extraction for high-risk children and prioritised surgical intervention for adults with ≥ 2 ST plus root curvature, thereby enhancing precision and reducing unnecessary treatments.