Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9886
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
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.
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.
The application of digital positioning guide plates is useful for the individualized and minimalized extraction of impacted supernumerary teeth.
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.