The Journal of Anatomy

 A Pathogenetic Model For The Origins And Locations Of Idiopathic Supernumerary Teeth

Correspondence to Author:  Mark Lubinsky M.D. (orcid.org/0000-0002-6788-6876) 

DOI: 10.52338/tjoa.2025.4848

Abstract:

The origins and localizations of idiopathic supernumerary teeth are much debated. However, idiopathic supernumeraries can be explained by a combination of localized anterior premaxillary factors and a general dental lamina effect that may also involve normal teeth. Midface Sonic hedgehog (SHH) signaling induces mesiodentes and tuberculate incisors, potentiated by midline developmental weaknesses and genetic variants. SHH can affect morphology, with complex tuberculates from longer primary dentition exposures, but simpler secondary mesiodentes with crown inversions and palatal placements that reflect gradients. Such local factors are minimized with multiple supernumeraries (5 or more), showing other effects more clearly. Here, laminal layer growth differences cause inductive morphogen “sinks” through buckling at stress points, which is greatest at mid-lamina and least at the ends, and increasing with length. Dental lamina sectional differences in these parameters explain more mandibular than maxillary multiples, relatively few incisors, premolars as commonest in the lower jaw, and molars in the upper. Terminal laminal buckling with supplemental teeth at the end of incisor and molar series is unexpected, but teeth develop as groups, and a correctly oriented supernumerary may develop normally and displace a series, while end position vulnerabilities cause distortions of an otherwise normal tooth.

Keywords: Buckling; dental lamina; premaxilla; Sonic hedgehog; supernumerary teeth.

Citation:

Mark Lubinsky. A Pathogenetic Model For The Origins And Locations Of Idiopathic Supernumerary Teeth. The Journal of Anatomy 2025.

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