Hyperdontia is a developmental anomaly of teeth characterized by an excess in tooth number.
The clinical importance of supernumerary teeth is defined by the fact that they rarely erupt into function, but they often impact and determine impaction of teeth of the normal series.
We present the case of a patient with five impacted teeth (18, 28, 38, 47, 48) and an impacted supernumerary tooth (distomolar 49). Supernumerary teeth rarely erupt into the function, thus frequently determining impaction of the teeth of the normal series. During observation, the patient reported localized pains and a slight homolateral submandibular lymphadenopathy, without functional limitations or fever. Anamnesis excluded stomatological pathologies and genetic alterations. Avulsion of teeth 47, 48 and 49 was performed under local anesthesia, after assessing X-ray OrthoPanTomography and Denta-Scan of the inferior maxillary arch: a mucoperiosteal flap was prepared and corticotomy and avulsion of impacted teeth were performed. Follow-up visits on days 1-7-14-21 did not show complications. Furthermore, the patient did not report any reduction in or alteration to sensory skills in the hemiface corresponding to the treated area, even though the extent of the surgical area and the proximity to the mandibular channel would have been capable of causing neuropraxia.

Although we agree on the common hypotheses about identification of the causes of dental impaction, we consider the surgical therapy recommended even for clinically asymptomatic patients.

Key Words
Supernumerary teeth, Impacted teeth, Multiple impactions

Pic. 1 : Preoperatory X-ray O.P.T.

Pic. 2 : Preoperatory C.T. detail.

Pic. 3: First impacted tooth before elevation of mucoperiosteal flap and corticotomy.

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