Radiographic evaluation of orodental anomalies in a Thai population: prevalence, supernumerary teeth characteristics, and associated factors

Background: Orodental anomalies encompass a range of dental conditions affecting tooth number, morphology, and eruption patterns. Among these, supernumerary teeth (hyperdontia) are of particular clinical significance due to their potential to disrupt occlusion, eruption, and alignment. This study aimed to (i) determine the prevalence of orodental anomalies, (ii) characterize the radiographic features of supernumerary teeth, and (iii) assess the associations of supernumerary teeth with other dental anomalies in a Thai population using panoramic radiographs. Methods: A retrospective review of 2,925 panoramic radiographs (PRs) was conducted to identify and classify orodental anomalies, both developmental and acquired, with emphasis on supernumerary teeth. Data was analyzed using descriptive statistics, chi-square tests, and logistic regression models. Inter- and intra-observer agreement was evaluated using Fleiss’ Kappa coefficient. Results: Orodental anomalies were observed in 56.0% of individuals. The most common anomaly was tooth impaction (37.4%), followed by periapical radiolucency (13.5%) and hypodontia (5.1%). Supernumerary teeth were identified in 1.2% of cases, most frequently as single (76.7%), unerupted (70%), and supplemental-type teeth (76.7%), predominantly located in the mandibular parapremolar region (50%). Significant bivariate associations were found between supernumerary teeth and both microdontia (p = 0.001) and tooth impaction (p < 0.002). However, these associations were not statistically significant in multivariable analyses after adjusting for gender. Conclusion: The study identified a range of orodental anomalies in the Thai population using panoramic radiographs, with tooth impaction being the highest prevalent orodental anomaly. The study also focused on characterizing the supernumerary teeth, which were significantly associated with other anomalies such as impaction and microdontia in bivariate analysis, though this association was not confirmed by logistic regression. Despite this, the observed co-occurrence highlights the need for thorough radiographic evaluation in cases presenting with eruption disturbances or tooth size anomalies. These findings underscore the importance of incorporating anomaly screening in routine dental radiography and warrant multicenter investigations for broader generalizability.