Maxillary supernumerary teeth (ST) frequently induce complications (e.g., dental irregularities, bone destruction), but precise risk stratification remains challenging. This retrospective study analysed cone-beam computed tomography (CBCT) data from 217 patients, stratified into childhood (6–12 years) and adulthood (≥ 19 years). Morphological assessment showed that 77.1% of ST were conical, with a significantly higher proportion in females (88.3% vs. 73.4% in males). Age-stratified risk modelling revealed that root curvature was strongly associated with adult bone destruction (adjusted odds ratio OR = 3.5), while ST number drove childhood dental anomalies (adjusted OR = 4.2). The adult bone destruction model achieved an area under the curve (AUC) of 0.80 (outperforming non-stratified models), whereas the childhood dental anomaly model had modest performance (AUC = 0.69). These findings support age-specific clinical strategies: early extraction for high-risk children and prioritised surgical intervention for adults with ≥ 2 ST plus root curvature, thereby enhancing precision and reducing unnecessary treatments.
Li et al. (Sat,) studied this question.