# Bilateral Non-Syndromic Supplemental Mandibular Incisors: Report on a Rare Clinical Case

## TL;DR

This paper reports a rare case of a child with extra lower front teeth and how their removal helped align the other teeth naturally.

## Contribution

The novelty lies in documenting a rare clinical case of bilateral supplemental mandibular incisors and their successful orthodontic management.

## Key findings

- Extraction of supplemental mandibular incisors led to spontaneous alignment of remaining incisors.
- Timely removal of such teeth can prevent complications like crowding and delayed eruption.
- Rapid maxillary expansion helped coordinate the dental arches in this pediatric case.

## Abstract

Background: Supplemental teeth are a rare subtype of supernumerary elements that closely resemble the morphology of normal dentition. Their occurrence in the mandibular anterior region is extremely uncommon. Aim: To describe the clinical features, diagnosis, and phased orthodontic management of a rare case involving bilateral supplemental mandibular incisors in a pediatric patient. Case report: A 7-year-old female patient presented with early mixed dentition and significant lower anterior crowding due to the presence of two fully erupted supplemental mandibular incisors. Treatment phase I included extraction of the malpositioned supplemental teeth and rapid maxillary expansion to transversally coordinate the arches. By the end of phase I, spontaneous alignment of the remaining lower incisors was observed. Discussion: The presence of two supplemental mandibular incisors is extremely rare in Caucasian populations. Supernumerary teeth can cause crowding, impaction, or delayed eruption of adjacent permanent teeth. Timely extraction can prevent such complications and often allows spontaneous alignment. Conclusions: The prompt removal of supplemental mandibular incisors, when they have just erupted, might lead to the alignment of the other incisors, considering that they spontaneously occupy the extractive spaces often without the aid of fixed appliances first line.