Hypodontia, Hyperdontia and Concomitant Hypohyperdontia Prevalence in the Western Turkish Population

Hypodontia, Hyperdontia and Concomitant Hypohyperdontia Prevalence in the Western Turkish Population | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Hypodontia, Hyperdontia and Concomitant Hypohyperdontia Prevalence in the Western Turkish Population Ersen BİLGİLİ, Akın COŞKUN, Ender AKAN, Burçin AKAN This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7365574/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objectives To describe the dental and sex-related distributions and the prevalence of numerical dental anomalies in the Western Turkish population and compare the results with those in the literature. Materials and Methods A comprehensive investigation was conducted on panoramic X-rays from a total of 10,000 individuals, with 5,088 identified as female and 4,912 as male. The analysis focused on the identification of numerical dental anomalies. To evaluate potential sex-related differences, the Mann‒Whitney U test was performed. Results The prevalence of hypodontia was 3.72%, that of hyperdontia was 0.77%, and that of concomitant hypohyperdontia was 0.04%. The prevalence of hyperdontia and hyperdontic anterior teeth was found to be higher in females than in males. However, no significant differences in the prevalence of hypodontia were observed between the sexes. Conclusion There is an evident necessity to modernize the available data concerning the prevalence of dental numerical anomalies, particularly those classified as hypohyperdontia. The present study has made a significant contribution to the existing body of knowledge in this area. A tendency towards hyperdontia has been observed in males. However, no significant differences in hypodontia or concomitant hypohyperdontia have been identified among the Western Turkish population based on sex. Prevalence values are contingent upon the size and characteristics of the population. The following are dental anomalies hypohyperdontia concomitant hypohyperdontia hypodontia and hyperdontia Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Introduction Numerical dental anomalies encompass anodontia, oligodontia, hypodontia, hyperdontia, and concomitant hypohyperdontia (CHH) 1 . Anodontia is defined as the complete absence of all teeth in both the primary and permanent dentition stages. The absence of six or more teeth is referred to as oligodontia, and the absence of five or fewer teeth is called hypodontia. The absence of third molars is not generally considered a missing tooth in contemporary dental practice 1 – 3 . Consequently, the concept of hypodontia is not contingent upon the total number of teeth present in the oral cavity. An individual possessing 28 teeth, accompanied by congenital absence of third molars yet otherwise complete dentition, does not exhibit a numerical anomaly. Conversely, an individual with 30 teeth, having erupted third molars but lacking, for instance, two second premolars, is categorized as hypodontic 4 . According to the extant literature, the most commonly absent congenital teeth, in order of frequency, are the mandibular second premolars, maxillary lateral incisors, and maxillary second premolars. In contrast, the maxillary central incisors, maxillary and mandibular canines, and first premolars are rarely affected 5 , 6 . The manifestation of hypodontia can occur as an isolated condition affecting a solitary tooth or as an associated condition with specific syndromes. As indicated in the extant literature, there are multiple genes associated with nonsyndromic hypodontia, including the signaling molecule transforming growth factor alpha (TGFA) and the transcription factors Msh homeobox 1 (MSX1) and paired box gene 9 (PAX9) 5 . The presence of mutations in the MSX1 gene has been associated with the absence of second premolars and mandibular central incisors. The Axis inhibition protein 2 (AXIN2) gene has been identified as a causative agent for disruptions in the proliferation and differentiation stages of tooth development, resulting in the absence of mandibular incisors 7 . Hyperdontia, also known as supernumerary teeth, is defined as the presence of additional teeth in the dental arch. However, it is important to note that this condition does not necessarily imply an excess in the total number of teeth. The phenomenon under consideration pertains to the occurrence of an increased number of teeth in a specific area that is normally expected to have a fixed number of teeth. As illustrated in the case of hypodontia, an individual with two congenitally absent third molars who also possesses two supernumerary teeth between the maxillary central incisors, resulting in a total of 32 teeth, would be classified as a hyperdontia case 4 . The most prevalent form of hyperdontia is mesiodens, characterized by the presence of an additional tooth situated between the central incisors. A plethora of supernumerary teeth have been documented, with prevalence varying by type. Among these are extra premolars, lateral incisors, distomolars located distal to the third molars, and paramolars found between molars. Supernumerary teeth are defined as teeth that are present but not functioning. These teeth may remain unerupted and be incidentally detected during a radiographic examination. Alternatively, they may erupt into the oral cavity 1 , 8 , 9 . Hyperdontia is regarded as a developmental anomaly influenced by both genetic and environmental factors; however, its etiology has not been fully elucidated. The condition may manifest with the presence of one or more supernumerary teeth 9 . The presence of multiple supernumerary teeth is frequently observed in conjunction with syndromes such as cleidocranial dysplasia. 9 . Mutations in the Runt related transcription factor 2 (RUNX2) gene are found in patients with syndromic hyperdontia, whereas no specific genetic characteristic has been identified in patients with nonsyndromic hyperdontia 10 . Hyperdontia and hypodontia are considered opposite extremes of numerical anomalies when a healthy individual with the correct number and alignment of teeth is positioned at the center. Therefore, the occurrence of both anomalies in the same individual is quite rare 11 . Camilleri coined the term "concomitant hypodontia" in 1967 to describe the condition of having both missing and extra teeth in the same individual. Nathanail described this condition as "oligopleiodontia," meaning "missing and extra teeth" in Greek. This term was later simplified to "hypohyperdontia" by Gibson 11 – 13 . Gibson classified hypohyperdontia cases based on the position of the teeth: premaxillary (only in the anterior maxilla), maxillary (in both the anterior and posterior maxilla), mandibular (in both the anterior and posterior mandible), and bimaxillary (in different jaws) 11 , 13 . According to the literature, the prevalence of concomitant hypodontia (CHH) is reported to range from 0.002% to 3.1% 1, 11, 14, 15 . However, when the results of prevalence studies are examined in detail and those considering third molar agenesis as hypodontia are excluded, as well as outdated studies with unverifiable data, the prevalence ranges from 0.01% to 0.35% 1, 8, 15, 16 . In light of this information, this study aimed to assess the prevalence and tooth and sex distributions of hypodontia, hyperdontia, and CHH in the Izmir region using 10,000 panoramic films. Another objective was to evaluate similarities and differences between the findings and those of existing studies, as well as the reasons behind these variations. The initial null hypothesis of the study posited that there is no sex difference in numerical dental anomalies, whereas the subsequent null hypothesis suggested that the prevalence of numerical dental anomalies in Western Türkiye did not differ from that observed in other populations. Materials and Methods This study was approved by the Clinical Research Ethics Committee of Health Sciences, İzmir Bozyaka Training and Research Hospital Türkiye, with decision number 2022/35. The present study sought to ascertain the prevalence of numerical dental anomalies within the Western Turkish population. To this end, the expected prevalence (p), confidence interval (Z), and margin of error (d) derived from the findings of preceding prevalence studies were employed to calculate the minimum sample size (n). The formula n = [Z². p. (1 - p)]/d² was utilized for this purpose 17 . The minimum sample size of the present was calculated as “8509” using above mentioned formula. This calculation was based on the expected prevalence, which was taken as the average of previous studies (0.0001 + 0.0035)/2 = 0.0018, and the margin of error, which was taken as the half of the expected prevalence. A total of 10,000 panoramic radiographs (4,912 male, 5,088 female) taken between 2009 and 2024 for various reasons at the Izmir Training Dental Hospital Radiology Unit were retrospectively analyzed. The images were evaluated by an oral and maxillofacial radiologist under standard conditions. Third molar agenesis was not classified as hypodontia. The numerical dental anomalies were divided into three primary categories: hypodontia (Figure 1), hyperdontia (Figure 2), and CHH (Figures 3, 4, 5, and 6). Subsequently, an analysis was conducted on the three primary groups, with the parameters of tooth region and sex distribution. The inclusion criteria did not differentiate by age, and the evaluation was limited to permanent dentition. Patients with hypodontia—extracted teeth or hyperdontia—hypoplastic teeth in the same region of normal dentition were excluded from the study (Figure 7). Statistical Analysis The data analysis for the study was conducted using SPSS 21 software (IBM Co., Chicago, USA). Descriptive statistics, frequencies, and cross-tabulations were used for prevalence data. To assess potential sex differences, the Mann‒Whitney U test was performed. The confidence interval was set at 95%. Results A total of 245 patients (116 women and 129 men) were identified with numerical dental anomalies in the 10,000 panoramic films examined. The study's findings indicated a prevalence of numerical dental anomalies of 2.45%. Among the 245 patients with numerical anomalies, 181 exhibited hypodontia in various regions, 60 demonstrated hyperdontia in different regions, and 4 presented with CHH. In 212 patients, a total of 361 hypodontic teeth were observed. Single tooth agenesis was observed in 102 patients, two teeth were missing in 65 patients, three teeth were missing in 11 patients, and four teeth were missing in 8 patients. As indicated by the data, the sample of oligodontic patients included one female subject with 15 missing teeth and one male subject with 19 missing teeth. The most frequently absent teeth were the mandibular second premolar, the maxillary lateral incisor, and the maxillary second premolar, respectively (Fig. 8 ). The investigation revealed no statistically significant differences in hypodontia patients based on sex (Table 1 ).. Table 1 Data associated with hypodontia. Female Male Total p value* Hypomolar − 1 2 0 2 Hypomolar − 4 3/ 12** 0 3/ 12** Hypomolar − 5 0 1/ 5** 1/ 5** Hypomolar Total 14 5 19 0,077 Hypopremolar − 1 33 43 76 Hypopremolar − 2 18/ 36** 13/ 26** 31/ 62** Hypopremolar − 3 2/ 6** 8/ 24** 10/ 30** Hypopremolar − 4 1/ 4** 4/ 16** 5/ 20** Hypopremolar − 5 0 2/ 10** 2/ 10** Hypopremolar − 6 1/ 6** 0 1/ 6** Hypopremolar Total 85 119 204 0,251 HypoAnterior – 1 19 16 35 HypoAnterior – 2 21 /42** 17 /34** 38 /76** HypoAnterior – 3 0 2 /6** 2 /6** HypoAnterior – 4 3 /12** 1 /4** 4 /16** HypoAnterior – 5 1 /5** 0 1 /5** HypoAnterior – 11 0 1 /11** 1 /11** HypoAnterior Total 78 71 149 0,136 Hypodontia − 1 49 53 102 Hypodontia − 2 38/76** 27/54** 65/130** Hypodontia − 3 2/6** 6/18** 11/22** Hypodontia − 4 4/16** 4/16** 8/32** Hypodontia − 5 1/5** 2/10** 3/15** Hypodontia − 7 0 1/7** 1/7** Hypodontia − 8 1/8** 0 1/8** Hypodontia − 9 0 1/9** 1/9** Hypodontia − 15 1/15** 0 1/15** Hypodontia − 19 0 1/19** 1/19** Hypodontia Total 177** 195** 372** 0,157 *p values < 0.05 indicate significance, **Total tooth number in this category A total of 77 supernumerary teeth were identified in 60 patients. Of these, 36 supernumerary anterior teeth were identified in 22 patients, 18 distomolars in 15 patients, 18 supernumerary premolars in 12 patients, and 5 paramolars in 4 patients. A statistically significant difference was observed in the prevalence of anterior and total hyperdontia cases between male and female subjects (see Fig. 9 and Table 2 ). Table 2 Data in association with Hyperdontia. Female Male Total p value* Distomolar − 1 8 4 12 Distomolar − 2 1/ 2** 2/ 4** 3/ 6** Distomolar Total 10 8 18 0,325 Paramolar − 1 0 3 3 Paramolar − 2 1/ 2** 0 1/ 2** Paramolar - Total 2 3 4/5** 0,374 HyperPremolar − 1 4 4 8 HyperPremolar − 2 2/ 4** 1/ 2** 3/ 6** HyperPremolar − 4 0 1/ 4** 1/ 4** HyperPremolar - Ttl 8 10 18 0,854 HyperAnterior − 1 6 16 22 HyperAnterior − 2 0 7 /14** 7 /14** HyperAnterior - Total 6 30 36 0,002* Hyperdontia − 1 17 26 43 Hyperdontia − 2 3/6 9/ 18** 12/ 24** Hyperdontia − 3 1/3 1/ 3** 2/6** Hyperdontia − 5 0 1/ 5** 1/ 5** Hyperdontia - Total 26** 51** 77** 0,043* * p values < 0.05 indicate significance, **Total tooth number in this category A total of four patients were evaluated as CHH. The sample included two female subjects and two male subjects. In all cases, the missing teeth were premolars, specifically mandibular second premolars in three subjects and maxillary first premolars in one subject. In three cases of CHH, the supernumerary tooth was identified as a mesiodens, while in a single case, it was determined to be a paramolar. While the number of missing teeth varied among the CHH patients, each patient had only one supernumerary tooth. According to Gibson's classification system, which categorizes cases of hypo-hyperdontia based on their tooth position, three cases were classified as bimaxillary, while one case was classified as maxillary. The distribution of CHH cases exhibited no significant differences between males and females (Table 3 ). Table 3 Data in association with CHH. Female Male Total p value* HypoHyperdontia − 0 114 127 241 0,915 HypoHyperdontia − 1 2 2 4 * p values < 0.05 indicate significance. Discussion The results of prevalence studies on dental anomalies may be influenced by factors such as sample size and societal differences 9 . In addition to the aforementioned information, while there are extant studies on the prevalence of hypodontia and hyperdontia, the paucity of studies on CHH elucidates the contribution of this study to the extant literature on the subject 1 , 3 , 8 , 15 , 16 , 18 – 20 . In some case reports and prevalence studies on hypodontia in the literature, third molars have been identified as the most frequently absent teeth. Given its high incidence, this condition is regarded as a physiological state that may be considered part of human evolution 21 , 22 . Consequently, the exclusion of third molar agenesis from the study was deemed necessary. Excluding third molars, the most frequently missing teeth identified in the extant literature are maxillary laterals in some studies 3 , 19 , 23 , 24 , whereas other studies rank mandibular second premolars ahead of maxillary laterals 1 , 6 , 25 – 27 . The present study's findings align with existing literature on the subject, as the most prevalent missing teeth are mandibular second premolars, maxillary laterals, and maxillary second premolars. The observed discrepancies in the extant literature are hypothesized to be attributable to societal differences, variations in sample size, and disparities in study content. A study on African populations revealed that maxillary lateral incisors were the most commonly absent teeth, whereas mandibular second premolar agenesis was more prevalent in European populations 23 , 25 , 26 . Furthermore, prevalence studies conducted with orthodontic populations may not accurately reflect societal data. For instance, maxillary lateral incisor agenesis may result in greater esthetic concerns than mandibular second premolar agenesis, potentially increasing the inclination for orthodontic intervention. Consequently, this phenomenon may lead to an elevated incidence of maxillary lateral agenesis.The absence of canines and first molars is considered quite rare in the literature and typically occurs in patients with multiple missing teeth 28 , 29 . Consistent with the extant literature, the present study demonstrated that isolated first molar agenesis and a limited number of canine agenesis cases were classified as oligodontic. As indicated in the extant literature, the prevalence of missing teeth, excluding third molars, has been reported to range from 1.6% to 6.9% 30,31 . In the present study, the prevalence of hypodontia was 3.72%. The majority of studies conducted on diverse populations have indicated a higher prevalence of missing teeth among women compared to men. However, some studies have not observed a statistically significant difference in terms of sex-related variation in tooth loss 1 , 32 . The present study revealed no statistically significant sex difference in the prevalence of hypodontia. Hyperdontia cases are less frequently observed than hypodontia cases in the literature, and their etiology is more complex 8 , 14 . In the present study, 372 cases of hypodontia and 77 cases of hyperdontia were detected among 10,000 patients. As indicated in the extant literature, the most prevalent supernumerary teeth reported in cases of hyperdontia are mesiodens in the maxillary central incisor region. Distomolars, paramolars, premolars, mandibular anterior teeth, and maxillary lateral supernumerary teeth have been reported in different orders in prevalence studies 1 , 3 , 9 , 20 , 27 , 31 , 33 , 34 . The findings of the present study are in alignment with the extant literature on the subject. The prevalence of hyperdontia documented in the extant literature ranges from 0.03% to 3.8%. In this study, the prevalence of hyperdontia was determined to be 77 cases per 10,000 individuals, which corresponds to an overall frequency of 0.77%. In line with the literature, hyperdontia cases are more common in men than in women, with a 2:1 ratio 20 , 26 , 31 , 33 . The extant literature does not provide a precise prevalence of CHH. A review of the extant literature revealed that the prevalence of CHH ranges from 0.002% to 3.1% 1,11,14,15,35 . According to the literature, the value of 0.002% is reported in Stafne's 1932 study. In this study, a sample of 48,550 patients' teeth were evaluated via periapical radiographs, and 441 patients were found to have supernumerary teeth, with a supernumerary tooth prevalence of 0.91%. Stafne's account also includes a case of agenesis of two mandibular second premolars and the presence of a supernumerary tooth in the mandibular anterior region. However, the author does not specify whether he conducted a screening for such cases or if there were no other similar cases. No prevalence data were shared, and at that time, CHH had not yet been defined as a research topic 13 , 36 . The 3.1% result cited in the extant literature was derived from Novak's publication, which reported the incidence of CHH among cases of supernumerary teeth rather than within the whole population. Furthermore, in certain studies, the absence of third molars is classified as hypodontia 37 , 38 . A review of the extant literature reveals a prevalence of 0.35% in 41,648 patients with 145 cases, as reported by Qiu; a prevalence of 0.01% in 10,000 patients with one case, as reported by Kurt; 0.33% in 2,801 patients with seven cases, as reported by Varela; and 0.27% in 1,101 patients with three cases, as reported by Eshgian. The results of the present study indicate that the CHH rate for the Western Turkish population is 4/10,000, or 0.04%. Qiu and colleagues conducted a study with a large sample size in the Chinese population. The case of 21 reported by Wang in a population with supernumerary teeth in Taiwan suggested that CHH may be more prevalent in the Chinese population 16 , 39 . A notable finding emerged from a comparison of the results of this study with those of other prevalence studies. Kurt's study was conducted in the northern region of Türkiye The existence of internal migration, in conjunction with the substantial sample size, facilitates the examination of societal disparities between the two studies 1 . Varela's study, conducted in Spain within an orthodontic population, involved a relatively small sample. This phenomenon may be attributable to racial disparities, population size, and the fact that the study was conducted on patients who were already experiencing dental irregularities 8 . In Eshgian's study in the United States, the three CHH cases encountered in the limited population were racially evaluated, with all cases being of Spanish–Latin descent. CHH cases were not identified among European, African American, or Asian groups 15 . A notable limitation of the study is the absence of categorization of patients into specific age groups, which raises the possibility that the missing teeth may have been extracted or were simply not visible due to positional issues with hyperdontic teeth. In an effort to mitigate the repercussions of this constraint, a review of the treatment records of active patients was conducted for a subset of the potentially extractable hypodontic teeth. In instances where this was not feasible, they were designated as extracted rather than hypodontic. The study's single-observer design ensured standardization in the approach to cases. Conclusion The study's findings revealed no statistically significant differences in the prevalence of hypodontia or CHH between males and females. However, hyperdontia was observed to be more prevalent among male subjects. The initial null hypothesis of the study was found to be partially accepted and partially rejected. The present study revealed a hypodontia prevalence of 3.72%, a hyperdontia prevalence of 0.77%, and a CHH prevalence of 0.04%. These results are consistent with the prevalence ranges reported in the extant literature. Furthermore, the observed variations in the prevalence of numerical dental anomalies suggest that these anomalies are influenced by the characteristics of the respective societies and populations. The second null hypothesis of the study was rejected. A reexamination of the prevalence knowledge of the CHH in the literature is imperative. The data are influenced by factors such as sample size, the general patient population, the presence of orthodontic patients, patients with syndromes, or specific age groups. The implementation of standardized criteria in the introduction or sharing of numerical anomaly prevalence data has a positive effect on the existing literature. Abbreviations CHH Concomitant Hypohyperdontia TGFA Transforming Growth Factor Alpha MSX1 MSH Homebox 1 PAX9 Paired Box Gene 9 AXIN2 Axis Inhibition Protein 2 RUNX2 Runt Related Transcription Factor 2 Declarations Ethics Approval and Consent to Participate This study was approved by the Clinical Research Ethics Committee of Health Sciences, İzmir Bozyaka Training and Research Hospital Türkiye, with decision number 2022/35. Study adhered to declaration of Helsinki. Informed consent to participate forms are obtained from all participants. Consent for Publication Not Applicable Availability of Data and Materials Data and materials are available. Competing Interests The authors have no conflicts of interest to declare that are relevant to the content of this article. Funding No funding was received to assist with the preparation of this manuscript. Authors’ Contribution E.B and A.C designed the study, E.B. performed analysis of the panoramic x-rays E.B. wrote the main manuscript text E.A. prepared figures, tables B.A. performed statistics and language edition All authors reviewed the manuscript. Acknowledgements Not Applicable. References Kurt A, Kara P. Dental Number Anomalies in Children Applying to Recep Tayyip Erdoğan University Faculty of Dentistry: A Retrospective Cross-Sectional Study. Turkiye Klinikleri J Dental Sci. 2022;28(1):72-8 Doi: 10.5336/dentalsci.2021-81197 Ye X, Attaie AB. Genetic basis of nonsyndromic and syndromic tooth agenesis. J Pediatr Genet. 2016;5(4):198–208. Shen, Z., Wei, J., Zhang, J. et al . 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1","display":"","copyAsset":false,"role":"figure","size":160377,"visible":true,"origin":"","legend":"\u003cp\u003ePanoramic radiograph of a hypodontic patient with several missing teeth.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7365574/v1/085e1b4c2b461d1b6974ca2f.png"},{"id":92947764,"identity":"50474f10-7869-459a-b9ea-2dfe6cf26920","added_by":"auto","created_at":"2025-10-07 12:54:22","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":253328,"visible":true,"origin":"","legend":"\u003cp\u003ePanoramic radiograph of a hyperdontic patient with supernumerary teeth (black arrows) in the right and left mandibular \u0026nbsp;and right maxillary quadrants.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7365574/v1/5bc1a7c676953e4b805d7985.png"},{"id":92947677,"identity":"1b3c9f13-4489-4a65-a813-38f3ec9852a5","added_by":"auto","created_at":"2025-10-07 12:54:16","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":313855,"visible":true,"origin":"","legend":"\u003cp\u003eA\u003cstrong\u003e \u003c/strong\u003eCHH case in the present study with mesiodens (blue arrow) and tooth number 35 missing (orange arrow).\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-7365574/v1/cffe2cc647f0795e54c4f112.png"},{"id":92947824,"identity":"e9cf10c8-86b3-49c7-9f48-8823083efd02","added_by":"auto","created_at":"2025-10-07 12:54:24","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":262874,"visible":true,"origin":"","legend":"\u003cp\u003eAnother CHH case in the present study with a mesiodens (blue arrow) and tooth number 35 missing (orange arrow).\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-7365574/v1/659fbbf0e000557c2374f15c.png"},{"id":92947893,"identity":"7a519eeb-52c2-49e2-9490-ea341525c05f","added_by":"auto","created_at":"2025-10-07 12:54:30","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":148245,"visible":true,"origin":"","legend":"\u003cp\u003eThird CHH case in the present study with a mesiodens (blue arrow) and tooth number 35 missing (orange arrow).\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-7365574/v1/cd57d4fc2421c422ece2ee02.png"},{"id":92947657,"identity":"bfb751d0-c043-440c-899d-55bca01292e0","added_by":"auto","created_at":"2025-10-07 12:54:13","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":175861,"visible":true,"origin":"","legend":"\u003cp\u003eFourth CHH case in the present study with a paramolar (blue arrow) and missing premolars (orange arrow).\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-7365574/v1/0af12e2fc5fe0d5a2ddc86ef.png"},{"id":92947979,"identity":"30c72ea6-1dce-4dec-a7ad-f4256b24c1c6","added_by":"auto","created_at":"2025-10-07 12:54:34","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":173236,"visible":true,"origin":"","legend":"\u003cp\u003eCase without any numerical dental anomaly mimicking CHH. Tooth number 22 with localized microdontia (Peg Lateral) mimicking a mesiodens (green arrow) and attrited23 mimicking 22 (Watch the cingulum formation and opposite tooth (33) also with attrition).\u003c/p\u003e","description":"","filename":"7.png","url":"https://assets-eu.researchsquare.com/files/rs-7365574/v1/e0921a67df0360c39bb4e25d.png"},{"id":92947715,"identity":"158cc16b-7641-4410-bc78-6613a13dbeba","added_by":"auto","created_at":"2025-10-07 12:54:20","extension":"png","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":45110,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of hypodontia frequency amongteeth.\u003c/p\u003e","description":"","filename":"8.png","url":"https://assets-eu.researchsquare.com/files/rs-7365574/v1/900aeab782967aaf6e401603.png"},{"id":92947990,"identity":"15a215fb-9cea-40a7-b252-4dab93f2ab20","added_by":"auto","created_at":"2025-10-07 12:54:35","extension":"png","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":70495,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of hyperdontia amongteeth.\u003c/p\u003e","description":"","filename":"9.png","url":"https://assets-eu.researchsquare.com/files/rs-7365574/v1/e28eee2064bb486726ba1513.png"},{"id":94012945,"identity":"211143b1-350a-4939-ba23-56fa91bbf1a8","added_by":"auto","created_at":"2025-10-21 10:26:55","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2657068,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7365574/v1/accb1a9a-6c0f-41a3-b97d-746d77f79412.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Hypodontia, Hyperdontia and Concomitant Hypohyperdontia Prevalence in the Western Turkish Population","fulltext":[{"header":"Introduction","content":"\u003cp\u003eNumerical dental anomalies encompass anodontia, oligodontia, hypodontia, hyperdontia, and concomitant hypohyperdontia (CHH)\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Anodontia is defined as the complete absence of all teeth in both the primary and permanent dentition stages. The absence of six or more teeth is referred to as oligodontia, and the absence of five or fewer teeth is called hypodontia. The absence of third molars is not generally considered a missing tooth in contemporary dental practice\u003csup\u003e\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. Consequently, the concept of hypodontia is not contingent upon the total number of teeth present in the oral cavity. An individual possessing 28 teeth, accompanied by congenital absence of third molars yet otherwise complete dentition, does not exhibit a numerical anomaly. Conversely, an individual with 30 teeth, having erupted third molars but lacking, for instance, two second premolars, is categorized as hypodontic\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. According to the extant literature, the most commonly absent congenital teeth, in order of frequency, are the mandibular second premolars, maxillary lateral incisors, and maxillary second premolars. In contrast, the maxillary central incisors, maxillary and mandibular canines, and first premolars are rarely affected\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe manifestation of hypodontia can occur as an isolated condition affecting a solitary tooth or as an associated condition with specific syndromes. As indicated in the extant literature, there are multiple genes associated with nonsyndromic hypodontia, including the signaling molecule transforming growth factor alpha (TGFA) and the transcription factors Msh homeobox 1 (MSX1) and paired box gene 9 (PAX9)\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. The presence of mutations in the MSX1 gene has been associated with the absence of second premolars and mandibular central incisors. The Axis inhibition protein 2 (AXIN2) gene has been identified as a causative agent for disruptions in the proliferation and differentiation stages of tooth development, resulting in the absence of mandibular incisors\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eHyperdontia, also known as supernumerary teeth, is defined as the presence of additional teeth in the dental arch. However, it is important to note that this condition does not necessarily imply an excess in the total number of teeth. The phenomenon under consideration pertains to the occurrence of an increased number of teeth in a specific area that is normally expected to have a fixed number of teeth. As illustrated in the case of hypodontia, an individual with two congenitally absent third molars who also possesses two supernumerary teeth between the maxillary central incisors, resulting in a total of 32 teeth, would be classified as a hyperdontia case\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe most prevalent form of hyperdontia is mesiodens, characterized by the presence of an additional tooth situated between the central incisors. A plethora of supernumerary teeth have been documented, with prevalence varying by type. Among these are extra premolars, lateral incisors, distomolars located distal to the third molars, and paramolars found between molars. Supernumerary teeth are defined as teeth that are present but not functioning. These teeth may remain unerupted and be incidentally detected during a radiographic examination. Alternatively, they may erupt into the oral cavity\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eHyperdontia is regarded as a developmental anomaly influenced by both genetic and environmental factors; however, its etiology has not been fully elucidated. The condition may manifest with the presence of one or more supernumerary teeth \u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. The presence of multiple supernumerary teeth is frequently observed in conjunction with syndromes such as cleidocranial dysplasia.\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eMutations in the Runt related transcription factor 2 (RUNX2) gene are found in patients with syndromic hyperdontia, whereas no specific genetic characteristic has been identified in patients with nonsyndromic hyperdontia \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eHyperdontia and hypodontia are considered opposite extremes of numerical anomalies when a healthy individual with the correct number and alignment of teeth is positioned at the center. Therefore, the occurrence of both anomalies in the same individual is quite rare\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. Camilleri coined the term \"concomitant hypodontia\" in 1967 to describe the condition of having both missing and extra teeth in the same individual. Nathanail described this condition as \"oligopleiodontia,\" meaning \"missing and extra teeth\" in Greek. This term was later simplified to \"hypohyperdontia\" by Gibson\u003csup\u003e\u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Gibson classified hypohyperdontia cases based on the position of the teeth: premaxillary (only in the anterior maxilla), maxillary (in both the anterior and posterior maxilla), mandibular (in both the anterior and posterior mandible), and bimaxillary (in different jaws)\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eAccording to the literature, the prevalence of concomitant hypodontia (CHH) is reported to range from 0.002% to 3.1% \u003csup\u003e1, 11, 14, 15\u003c/sup\u003e. However, when the results of prevalence studies are examined in detail and those considering third molar agenesis as hypodontia are excluded, as well as outdated studies with unverifiable data, the prevalence ranges from 0.01% to 0.35% \u003csup\u003e1, 8, 15, 16\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eIn light of this information, this study aimed to assess the prevalence and tooth and sex distributions of hypodontia, hyperdontia, and CHH in the Izmir region using 10,000 panoramic films. Another objective was to evaluate similarities and differences between the findings and those of existing studies, as well as the reasons behind these variations.\u003c/p\u003e\u003cp\u003eThe initial null hypothesis of the study posited that there is no sex difference in numerical dental anomalies, whereas the subsequent null hypothesis suggested that the prevalence of numerical dental anomalies in Western T\u0026uuml;rkiye did not differ from that observed in other populations.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eThis study was approved by the Clinical Research Ethics Committee of Health Sciences, İzmir Bozyaka Training and Research Hospital T\u0026uuml;rkiye, with decision number 2022/35.\u003c/p\u003e\n\u003cp\u003eThe present study sought to ascertain the prevalence of numerical dental anomalies within the Western Turkish population. To this end, the expected prevalence (p), confidence interval (Z), and margin of error (d) derived from the findings of preceding prevalence studies were employed to calculate the minimum sample size (n). The formula n = [Z\u0026sup2;. p. (1 - p)]/d\u0026sup2; was utilized for this purpose\u003csup\u003e17\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eThe minimum sample size of the present was calculated as \u0026ldquo;8509\u0026rdquo; using above mentioned formula. This calculation was based on the expected prevalence, which was taken as the average of previous studies (0.0001 + 0.0035)/2 = 0.0018, and the margin of error, which was taken as the half of the expected prevalence.\u003c/p\u003e\n\u003cp\u003eA total of 10,000 panoramic radiographs (4,912 male, 5,088 female) taken between 2009 and 2024 for various reasons at the Izmir Training Dental Hospital Radiology Unit were retrospectively analyzed. The images were evaluated by an oral and maxillofacial radiologist under standard conditions.\u003c/p\u003e\n\u003cp\u003eThird molar agenesis was not classified as hypodontia. The numerical dental anomalies were divided into three primary categories: hypodontia (Figure 1), hyperdontia (Figure 2), and CHH (Figures 3, 4, 5, and 6). Subsequently, an analysis was conducted on the three primary groups, with the parameters of tooth region and sex distribution.\u003c/p\u003e\n\u003cp\u003eThe inclusion criteria did not differentiate by age, and the evaluation was limited to permanent dentition. Patients with hypodontia\u0026mdash;extracted teeth or hyperdontia\u0026mdash;hypoplastic teeth in the same region of normal dentition were excluded from the study (Figure 7).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAnalysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data analysis for the study was conducted using SPSS 21 software (IBM Co., Chicago, USA). Descriptive statistics, frequencies, and cross-tabulations were used for prevalence data. To assess potential sex differences, the Mann‒Whitney U test was performed. The confidence interval was set at 95%.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 245 patients (116 women and 129 men) were identified with numerical dental anomalies in the 10,000 panoramic films examined. The study's findings indicated a prevalence of numerical dental anomalies of 2.45%.\u003c/p\u003e\u003cp\u003eAmong the 245 patients with numerical anomalies, 181 exhibited hypodontia in various regions, 60 demonstrated hyperdontia in different regions, and 4 presented with CHH.\u003c/p\u003e\u003cp\u003eIn 212 patients, a total of 361 hypodontic teeth were observed. Single tooth agenesis was observed in 102 patients, two teeth were missing in 65 patients, three teeth were missing in 11 patients, and four teeth were missing in 8 patients. As indicated by the data, the sample of oligodontic patients included one female subject with 15 missing teeth and one male subject with 19 missing teeth. The most frequently absent teeth were the mandibular second premolar, the maxillary lateral incisor, and the maxillary second premolar, respectively (Fig.\u0026nbsp;\u003cspan refid=\"Fig8\" class=\"InternalRef\"\u003e8\u003c/span\u003e). The investigation revealed no statistically significant differences in hypodontia patients based on sex (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)..\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eData associated with hypodontia.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep value*\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypomolar \u0026minus;\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypomolar \u0026minus;\u0026thinsp;4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3/\u003cem\u003e12**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3/\u003cem\u003e12**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypomolar \u0026minus;\u0026thinsp;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1/\u003cem\u003e5**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1/\u003cem\u003e5**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypomolar Total\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003e0,077\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypopremolar \u0026minus;\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypopremolar \u0026minus;\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18/\u003cem\u003e36**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13/\u003cem\u003e26**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31/\u003cem\u003e62**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypopremolar \u0026minus;\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2/\u003cem\u003e6**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8/\u003cem\u003e24**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10/\u003cem\u003e30**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypopremolar \u0026minus;\u0026thinsp;4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1/\u003cem\u003e4**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4/\u003cem\u003e16**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5/\u003cem\u003e20**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypopremolar \u0026minus;\u0026thinsp;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2/\u003cem\u003e10**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2/\u003cem\u003e10**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypopremolar \u0026minus;\u0026thinsp;6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1/\u003cem\u003e6**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1/\u003cem\u003e6**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypopremolar Total\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e119\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e204\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0,251\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypoAnterior \u0026ndash; 1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypoAnterior \u0026ndash; 2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21\u003cem\u003e/42**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17\u003cem\u003e/34**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e38\u003cem\u003e/76**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypoAnterior \u0026ndash; 3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2\u003cem\u003e/6**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003cem\u003e/6**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypoAnterior \u0026ndash; 4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u003cem\u003e/12**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003cem\u003e/4**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u003cem\u003e/16**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypoAnterior \u0026ndash; 5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003cem\u003e/5**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003cem\u003e/5**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypoAnterior \u0026ndash; 11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003cem\u003e/11**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003cem\u003e/11**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypoAnterior Total\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e149\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0,136\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypodontia \u0026minus;\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e102\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypodontia \u0026minus;\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38/76**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27/54**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e65/130**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypodontia \u0026minus;\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2/6**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6/18**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11/22**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypodontia \u0026minus;\u0026thinsp;4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4/16**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4/16**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8/32**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypodontia \u0026minus;\u0026thinsp;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1/5**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2/10**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3/15**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypodontia \u0026minus;\u0026thinsp;7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1/7**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1/7**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypodontia \u0026minus;\u0026thinsp;8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1/8**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1/8**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypodontia \u0026minus;\u0026thinsp;9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1/9**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1/9**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypodontia \u0026minus;\u0026thinsp;15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1/15**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1/15**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypodontia \u0026minus;\u0026thinsp;19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1/19**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1/19**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypodontia Total\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003e177**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003e195**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003e372**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0,157\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e*p values\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicate significance, **Total tooth number in this category\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eA total of 77 supernumerary teeth were identified in 60 patients. Of these, 36 supernumerary anterior teeth were identified in 22 patients, 18 distomolars in 15 patients, 18 supernumerary premolars in 12 patients, and 5 paramolars in 4 patients. A statistically significant difference was observed in the prevalence of anterior and total hyperdontia cases between male and female subjects (see Fig.\u0026nbsp;\u003cspan refid=\"Fig9\" class=\"InternalRef\"\u003e9\u003c/span\u003e and Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eData in association with Hyperdontia.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep value*\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDistomolar \u0026minus;\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDistomolar \u0026minus;\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1/\u003cem\u003e2**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2/\u003cem\u003e4**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3/\u003cem\u003e6**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDistomolar Total\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0,325\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParamolar \u0026minus;\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParamolar \u0026minus;\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1/\u003cem\u003e2**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1/\u003cem\u003e2**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParamolar - Total\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4/5**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0,374\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperPremolar \u0026minus;\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperPremolar \u0026minus;\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2/\u003cem\u003e4**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1/\u003cem\u003e2**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3/\u003cem\u003e6**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperPremolar \u0026minus;\u0026thinsp;4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1/\u003cem\u003e4**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1/\u003cem\u003e4**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperPremolar - Ttl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0,854\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperAnterior \u0026minus;\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperAnterior \u0026minus;\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7\u003cem\u003e/14**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7\u003cem\u003e/14**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperAnterior - Total\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003e0,002*\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperdontia \u0026minus;\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperdontia \u0026minus;\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3/6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e9/\u003cem\u003e18**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12/\u003cem\u003e24**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperdontia \u0026minus;\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1/3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1/\u003cem\u003e3**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2/6**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperdontia \u0026minus;\u0026thinsp;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1/\u003cem\u003e5**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1/\u003cem\u003e5**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperdontia - Total\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003e26**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003e51**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003e77**\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003e0,043*\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e* p values\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicate significance, **Total tooth number in this category\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eA total of four patients were evaluated as CHH. The sample included two female subjects and two male subjects. In all cases, the missing teeth were premolars, specifically mandibular second premolars in three subjects and maxillary first premolars in one subject. In three cases of CHH, the supernumerary tooth was identified as a mesiodens, while in a single case, it was determined to be a paramolar. While the number of missing teeth varied among the CHH patients, each patient had only one supernumerary tooth.\u003c/p\u003e\u003cp\u003eAccording to Gibson's classification system, which categorizes cases of hypo-hyperdontia based on their tooth position, three cases were classified as bimaxillary, while one case was classified as maxillary. The distribution of CHH cases exhibited no significant differences between males and females (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eData in association with CHH.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep value*\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypoHyperdontia \u0026minus;\u0026thinsp;0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e114\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e127\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e241\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0,915\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypoHyperdontia \u0026minus;\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e* p values\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicate significance.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe results of prevalence studies on dental anomalies may be influenced by factors such as sample size and societal differences\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. In addition to the aforementioned information, while there are extant studies on the prevalence of hypodontia and hyperdontia, the paucity of studies on CHH elucidates the contribution of this study to the extant literature on the subject\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e,\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eIn some case reports and prevalence studies on hypodontia in the literature, third molars have been identified as the most frequently absent teeth. Given its high incidence, this condition is regarded as a physiological state that may be considered part of human evolution\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. Consequently, the exclusion of third molar agenesis from the study was deemed necessary.\u003c/p\u003e\u003cp\u003eExcluding third molars, the most frequently missing teeth identified in the extant literature are maxillary laterals in some studies\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e, whereas other studies rank mandibular second premolars ahead of maxillary laterals \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan additionalcitationids=\"CR26\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. The present study's findings align with existing literature on the subject, as the most prevalent missing teeth are mandibular second premolars, maxillary laterals, and maxillary second premolars. The observed discrepancies in the extant literature are hypothesized to be attributable to societal differences, variations in sample size, and disparities in study content.\u003c/p\u003e\u003cp\u003eA study on African populations revealed that maxillary lateral incisors were the most commonly absent teeth, whereas mandibular second premolar agenesis was more prevalent in European populations \u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. Furthermore, prevalence studies conducted with orthodontic populations may not accurately reflect societal data. For instance, maxillary lateral incisor agenesis may result in greater esthetic concerns than mandibular second premolar agenesis, potentially increasing the inclination for orthodontic intervention. Consequently, this phenomenon may lead to an elevated incidence of maxillary lateral agenesis.The absence of canines and first molars is considered quite rare in the literature and typically occurs in patients with multiple missing teeth\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e. Consistent with the extant literature, the present study demonstrated that isolated first molar agenesis and a limited number of canine agenesis cases were classified as oligodontic.\u003c/p\u003e\u003cp\u003eAs indicated in the extant literature, the prevalence of missing teeth, excluding third molars, has been reported to range from 1.6% to 6.9%\u003csup\u003e30,31\u003c/sup\u003e. In the present study, the prevalence of hypodontia was 3.72%. The majority of studies conducted on diverse populations have indicated a higher prevalence of missing teeth among women compared to men. However, some studies have not observed a statistically significant difference in terms of sex-related variation in tooth loss\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e. The present study revealed no statistically significant sex difference in the prevalence of hypodontia.\u003c/p\u003e\u003cp\u003eHyperdontia cases are less frequently observed than hypodontia cases in the literature, and their etiology is more complex \u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. In the present study, 372 cases of hypodontia and 77 cases of hyperdontia were detected among 10,000 patients.\u003c/p\u003e\u003cp\u003eAs indicated in the extant literature, the most prevalent supernumerary teeth reported in cases of hyperdontia are mesiodens in the maxillary central incisor region. Distomolars, paramolars, premolars, mandibular anterior teeth, and maxillary lateral supernumerary teeth have been reported in different orders in prevalence studies \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e. The findings of the present study are in alignment with the extant literature on the subject. The prevalence of hyperdontia documented in the extant literature ranges from 0.03% to 3.8%. In this study, the prevalence of hyperdontia was determined to be 77 cases per 10,000 individuals, which corresponds to an overall frequency of 0.77%.\u003c/p\u003e\u003cp\u003eIn line with the literature, hyperdontia cases are more common in men than in women, with a 2:1 ratio \u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e,\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e,\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe extant literature does not provide a precise prevalence of CHH. A review of the extant literature revealed that the prevalence of CHH ranges from 0.002% to 3.1% \u003csup\u003e1,11,14,15,35\u003c/sup\u003e. According to the literature, the value of 0.002% is reported in Stafne's 1932 study. In this study, a sample of 48,550 patients' teeth were evaluated via periapical radiographs, and 441 patients were found to have supernumerary teeth, with a supernumerary tooth prevalence of 0.91%. Stafne's account also includes a case of agenesis of two mandibular second premolars and the presence of a supernumerary tooth in the mandibular anterior region. However, the author does not specify whether he conducted a screening for such cases or if there were no other similar cases. No prevalence data were shared, and at that time, CHH had not yet been defined as a research topic\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe 3.1% result cited in the extant literature was derived from Novak's publication, which reported the incidence of CHH among cases of supernumerary teeth rather than within the whole population. Furthermore, in certain studies, the absence of third molars is classified as hypodontia\u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eA review of the extant literature reveals a prevalence of 0.35% in 41,648 patients with 145 cases, as reported by Qiu; a prevalence of 0.01% in 10,000 patients with one case, as reported by Kurt; 0.33% in 2,801 patients with seven cases, as reported by Varela; and 0.27% in 1,101 patients with three cases, as reported by Eshgian. The results of the present study indicate that the CHH rate for the Western Turkish population is 4/10,000, or 0.04%.\u003c/p\u003e\u003cp\u003eQiu and colleagues conducted a study with a large sample size in the Chinese population. The case of 21 reported by Wang in a population with supernumerary teeth in Taiwan suggested that CHH may be more prevalent in the Chinese population\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e,\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eA notable finding emerged from a comparison of the results of this study with those of other prevalence studies. Kurt's study was conducted in the northern region of T\u0026uuml;rkiye The existence of internal migration, in conjunction with the substantial sample size, facilitates the examination of societal disparities between the two studies\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eVarela's study, conducted in Spain within an orthodontic population, involved a relatively small sample. This phenomenon may be attributable to racial disparities, population size, and the fact that the study was conducted on patients who were already experiencing dental irregularities\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eIn Eshgian's study in the United States, the three CHH cases encountered in the limited population were racially evaluated, with all cases being of Spanish\u0026ndash;Latin descent. CHH cases were not identified among European, African American, or Asian groups\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eA notable limitation of the study is the absence of categorization of patients into specific age groups, which raises the possibility that the missing teeth may have been extracted or were simply not visible due to positional issues with hyperdontic teeth. In an effort to mitigate the repercussions of this constraint, a review of the treatment records of active patients was conducted for a subset of the potentially extractable hypodontic teeth. In instances where this was not feasible, they were designated as extracted rather than hypodontic. The study's single-observer design ensured standardization in the approach to cases.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study's findings revealed no statistically significant differences in the prevalence of hypodontia or CHH between males and females. However, hyperdontia was observed to be more prevalent among male subjects. The initial null hypothesis of the study was found to be partially accepted and partially rejected.\u003c/p\u003e\u003cp\u003eThe present study revealed a hypodontia prevalence of 3.72%, a hyperdontia prevalence of 0.77%, and a CHH prevalence of 0.04%. These results are consistent with the prevalence ranges reported in the extant literature. Furthermore, the observed variations in the prevalence of numerical dental anomalies suggest that these anomalies are influenced by the characteristics of the respective societies and populations. The second null hypothesis of the study was rejected.\u003c/p\u003e\u003cp\u003eA reexamination of the prevalence knowledge of the CHH in the literature is imperative. The data are influenced by factors such as sample size, the general patient population, the presence of orthodontic patients, patients with syndromes, or specific age groups. The implementation of standardized criteria in the introduction or sharing of numerical anomaly prevalence data has a positive effect on the existing literature.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCHH\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eConcomitant Hypohyperdontia\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eTGFA\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eTransforming Growth Factor Alpha\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMSX1\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMSH Homebox 1\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePAX9\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ePaired Box Gene 9\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eAXIN2\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eAxis Inhibition Protein 2\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eRUNX2\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eRunt Related Transcription Factor 2\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThis study was approved by the Clinical Research Ethics Committee of Health Sciences, İzmir Bozyaka Training and Research Hospital Türkiye, with decision number 2022/35. Study adhered to declaration of Helsinki. Informed consent to participate forms are obtained from all participants.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eAvailability of Data and Materials\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eData and materials are available.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe authors have no conflicts of interest to declare that are relevant to the content of this article.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eNo funding was received to assist with the preparation of this manuscript.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eAuthors’ Contribution\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eE.B and A.C designed the study,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eE.B. performed analysis of the panoramic x-rays\u003c/p\u003e\n\u003cp\u003eE.B. wrote the main manuscript text\u003c/p\u003e\n\u003cp\u003eE.A. prepared figures, tables\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eB.A. performed statistics and language edition\u003c/p\u003e\n\u003cp\u003eAll authors reviewed the manuscript.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eNot Applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKurt A, Kara P. Dental Number Anomalies in Children Applying to Recep Tayyip Erdoğan University Faculty of Dentistry: A Retrospective Cross-Sectional Study. Turkiye Klinikleri J Dental Sci. 2022;28(1):72-8 Doi: 10.5336/dentalsci.2021-81197\u003c/li\u003e\n\u003cli\u003eYe X, Attaie AB. Genetic basis of nonsyndromic and syndromic tooth agenesis. J Pediatr Genet. 2016;5(4):198\u0026ndash;208.\u003c/li\u003e\n\u003cli\u003eShen, Z., Wei, J., Zhang, J. et al\u003cem\u003e.\u003c/em\u003e The prevalence of dental agenesis, supernumerary teeth and odontoma in a Chinese pediatric population: an epidemiological study. \u003cem\u003eBMC Oral Health\u003c/em\u003e 25, 458 (2025). https://doi.org/10.1186/s12903-025-05819-4. PMID: 40158139; PMCID: PMC11955147.\u003c/li\u003e\n\u003cli\u003eBrinkmann JC, Mart\u0026iacute;nez-Rodr\u0026iacute;guez N, Mart\u0026iacute;n-Ares M, Sanz-Alonso J, Marino JS, Su\u0026aacute;rez Garc\u0026iacute;a MJ, Dorado CB, Mart\u0026iacute;nez-Gonz\u0026aacute;lez JM. 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DOI: 10.4103/2231-0762.159952\u003c/li\u003e\n\u003cli\u003eVarela M, Arrieta P, Ventureira C (2009) Nonsyndromic concomitant hypodontia and supernumerary teeth in an orthodontic population. Eur J Orthod 31, 632-637. DOI:10.1093/ejo/cjp046\u003c/li\u003e\n\u003cli\u003eArandi NZ. Hyperdontia: Exploring the Developmental Abnormality. Journal of Pre-Clinical and Clinical Research 2020, Vol 14, No 4, 178-183 doi: 10.26444/jpccr/130372\u003c/li\u003e\n\u003cli\u003eMa D, Wang X, Guo J, Zhang J, Cai T. Medicine (2018) 97:32(e11328) http://dx.doi.org/10.1097/MD.0000000000011328\u003c/li\u003e\n\u003cli\u003eAnthonappa RP, Lee CK, Yiu CK, King NM. Hypohyperdontia: literature review and report of seven cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Nov;106(5):e24-30. doi: 10.1016/j.tripleo.2008.07.012. Epub 2008 Sep 20. PMID: 18805710.\u003c/li\u003e\n\u003cli\u003eCamilleri GE. Concomitant hypodontia and hyperodontia. Case report. 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PMID: 30895096; PMCID: PMC6388844.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"The following are dental anomalies, hypohyperdontia, concomitant hypohyperdontia, hypodontia, and hyperdontia","lastPublishedDoi":"10.21203/rs.3.rs-7365574/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7365574/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eObjectives\u003c/b\u003e\u003c/p\u003e\u003cp\u003eTo describe the dental and sex-related distributions and the prevalence of numerical dental anomalies in the Western Turkish population and compare the results with those in the literature.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMaterials and Methods\u003c/b\u003e\u003c/p\u003e\u003cp\u003eA comprehensive investigation was conducted on panoramic X-rays from a total of 10,000 individuals, with 5,088 identified as female and 4,912 as male. The analysis focused on the identification of numerical dental anomalies. To evaluate potential sex-related differences, the Mann‒Whitney U test was performed.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe prevalence of hypodontia was 3.72%, that of hyperdontia was 0.77%, and that of concomitant hypohyperdontia was 0.04%. The prevalence of hyperdontia and hyperdontic anterior teeth was found to be higher in females than in males. However, no significant differences in the prevalence of hypodontia were observed between the sexes.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThere is an evident necessity to modernize the available data concerning the prevalence of dental numerical anomalies, particularly those classified as hypohyperdontia. The present study has made a significant contribution to the existing body of knowledge in this area. A tendency towards hyperdontia has been observed in males. However, no significant differences in hypodontia or concomitant hypohyperdontia have been identified among the Western Turkish population based on sex. Prevalence values are contingent upon the size and characteristics of the population.\u003c/p\u003e","manuscriptTitle":"Hypodontia, Hyperdontia and Concomitant Hypohyperdontia Prevalence in the Western Turkish Population","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-07 12:30:32","doi":"10.21203/rs.3.rs-7365574/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"491f82a0-ebc1-41f5-bea2-d4f7bb12157f","owner":[],"postedDate":"October 7th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-21T10:17:03+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-07 12:30:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7365574","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7365574","identity":"rs-7365574","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}