Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2022; 10(27): 9886-9896
Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9886
Application of digital positioning guide plates for the surgical extraction of multiple impacted supernumerary teeth: A case report and review of literature
Zhi Wang, Shu-Yi Zhao, Wu-Shu He, Fan Yu, Shao-Jie Shi, Xue-Ling Xia, Xin-Xiao Luo, Yu-Hong Xiao
Zhi Wang, Shu-Yi Zhao, Wu-Shu He, Fan Yu, Shao-Jie Shi, Xue-Ling Xia, Xin-Xiao Luo, Yu-Hong Xiao, Department of Oral and Maxillofacial Surgery, 920th Hospital of Joint Logistics Support Force, PLA, Teaching Hospital of Kunming Medical University, Kunming 650032, Yunnan Province, China
Author contributions: Wang Z, Xiao YH and He WS performed the surgery and contributed to manuscript drafting; Yu F and Shi SJ reviewed the literature and designed the research study; Zhao SY, Luo XX and Xia XL analyzed and interpreted the imaging findings; Wang Z, Yu F and Xiao YH were responsible for the revision of the manuscript for important intellectual content; all authors read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81970972; Applied Basic Research Projects of the 920th Hospital of Joint Logistics Support Force, No. 2020YGB06.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Hong Xiao, MD, Chief Physician, Department of Oral and Maxillofacial Surgery, 920th Hospital of Joint Logistics Support Force, PLA, Teaching Hospital of Kunming Medical University, No. 212 Da Guan Road, Xishan District, Kunming 650032, Yunnan Province, China. xiaoyuhong56@126.com
Received: May 5, 2022
Peer-review started: May 5, 2022
First decision: June 16, 2022
Revised: June 25, 2022
Accepted: August 15, 2022
Article in press: August 15, 2022
Published online: September 26, 2022
Abstract
BACKGROUND

An extra tooth in the normal tooth sequence in any region of the dental arch is regarded as a supernumerary tooth (SNT). Due to the large variation in location and morphology, the extraction of impacted SNTs is an extensive and complex procedure with high risks of several complications. This report presents a rare case of seven impacted SNTs in the bilateral upper and lower arch that were successfully extracted with the use of digital positioning guide plates.

CASE SUMMARY

In January 2022, a 21-year-old male was referred to our department with a chief complaint of pain in relation to tooth #36. Clinical examination showed a deep carious lesion with pulpal involvement in tooth #36 and lingual swelling of the bilateral mandibular posterior area. Radiographic examination revealed seven deeply impacted SNTs in the bilateral posterior area and bilateral impacted mandibular third molars. Based on these findings, the patient was diagnosed with bilateral, multiple impacted SNTs and tooth #36 chronic pulpitis. A root canal treatment and an all-ceramic crown restoration for tooth #36 were performed. An individualized digital positioning guide plate was designed by computer-aided design/computer-aided manufacturing technology and cone-beam computed tomography for extraction of the impacted SNTs. During the operation, the digital positioning guide plate allowed rapid positioning and exposure of the SNTs while avoiding adjacent important anatomical structures. At 3-month follow-up, regeneration of bone and soft tissues was visible.

CONCLUSION

The application of digital positioning guide plates is useful for the individualized and minimalized extraction of impacted supernumerary teeth.

Keywords: Supernumerary teeth, Computer aided design/computer aided manufacturing, Digital, Surgical guide, Minimal invasion, Case report

Core Tip: We present a rare case of seven impacted supernumerary teeth (SNTs) in the bilateral maxilla and mandible extracted with the aid of digital positioning guide plates manufactured by computer-aided design/computer-aided manufacturing technology. The use of these convenient and practical digital positioning guide plates for SNT extraction can provide accurate positioning, reduce the surgical complexity, decrease the operation time and minimize the invasiveness of the procedure. The surgery can be performed under local anesthesia, broadening the application prospects of digital positioning guide plates in other outpatient programs.