A 19-month-old spayed female Burmese had recently been treated for epiphora. During that clinical examination, the referring veterinarian noticed moderate gingivitis and calculus accumulation. On referral to CADS, bilateral supernumerary (SN) maxillary fourth premolar teeth were diagnosed (), with associated stage 3 periodontal disease (PD3). SN 108 and SN 208 were positioned palatal to the normal maxillary fourth premolar teeth. The supernumerary teeth were orientated in the same manner as the normal teeth; that is, the mesiobuccal and distobuccal roots were buccally situated and the mesiopalatal root, palatally situated (). PD3 was also diagnosed at 206, 209, 302, 401 and 402, and tooth resorption (TR) at 309 and 409. Closed extraction of 206, 209, 302, 401 and 402 was performed, without elevating a mucogingival flap, while open extractions were performed on SN 108, SN 208, 309 and 409 (), by elevating a mucogingival flap. The SN 108 and SN 208 surgical sites were not sutured closed and were allowed to heal by second intention.
Case 2. A male, leucoderma, Brazilian patient, aged 9 years and 11 months, presenting Class 3 malocclusion, sought a private clinic for orthodontic treatment, which was planned in two phases (interceptive and corrective), to be completed with orthognathic surgery. Similarly to Case 1, the initial panoramic radiographs revealed no abnormalities in the dentition (Figures and ).\nIn the first phase of the orthodontic treatment, a modified HAAS expander associated with a facial mask was used for 8 months. Two years later, a new expander and facial mask were recommended for further 6 months.\nDuring the planning of the second phase of the treatment, with complete permanent dentition, an orthodontic/surgical approach was deemed necessary after facial growth had been completed. When additional tests were performed, the radiographic follow-up revealed the presence of three supernumerary teeth in the premolar region (Figures and ). Surgical removal of all third molars as well as the 3 supernumerary teeth was performed in a hospital setting under general anesthesia, along with the surgery for the correction of deviated nasal septum ().\nAt 20 years and 5 months, during orthognathic surgery planning, a new radiographic image showed a supplemental supernumerary tooth in the left mandibular premolar region (), which was also surgically removed.