A Retrospective Cone-Beam Computed Tomography Study of Impacted Supernumerary Teeth and Maxillary Anterior Alveolar Bone

Impacted supernumerary teeth frequently occur in the maxillary anterior region and may alter the supporting alveolar bone around adjacent incisors. This retrospective imaging study evaluated alveolar bone morphology and cone-beam computed tomography (CBCT) gray values in 31 patients with one unilateral impacted supernumerary tooth adjacent to a maxillary central incisor. The central incisor on the affected side was paired with the contralateral incisor as an internal control. Width at the cervical one-third, middle one-third, and apical levels, alveolar bone height, four regional areas, and corresponding gray values were measured. Case sides had greater middle one-third width (p = 0.002), apical width (p = 0.001), alveolar bone height (p = 0.021), and palatal apical area (Area 3; p = 0.014). No statistically significant paired differences were detected for cervical width, the other regional areas, or regional gray values; these negative findings do not establish equivalence. Exploratory comparisons among high (n = 9), middle (n = 2), and low (n = 20) sagittal-position groups identified overall differences in Areas 1 and 2 (p = 0.028 and p = 0.025, respectively), although the very small middle-position group limits inference. These findings indicate localized morphological associations with impacted supernumerary teeth but do not support a detectable difference in regional CBCT gray values. Larger, prospectively standardized studies are needed to validate the subgroup findings.