Abstract
BACKGROUND: Hypohyperdontia, a rare numeric dental anomaly combining tooth agenesis and supernumerary teeth (ST), impacts aesthetics and function. Limited epidemiological data exist in Chinese populations. This study investigates its prevalence and distribution. METHODS: This retrospective study analyzed 10,112 panoramic radiographs(PRs)(August 2021 ~ December 2023) to assess hypohyperdontia prevalence, distribution and associated characteristics, including patient demographics, dentition type, ST (number, morphology, location, orientation), and tooth agenesis patterns (number, location). The hypohyperdontia patients were stratified into pre- and post-eruption groups based on permanent anterior/supernumerary tooth eruption status. All data were presented as counts(n) and percentage (%), and statistically analysed using logistic regression and Chi-square test. RESULTS: Prevalence was 0.66% (67/10112; M: F 42:25) without gender difference (OR = 1.28, 95% CI: 0.78-2.11, p = 0.329). Most cases were diagnosed in the mixed dentition (mean age: 6.97 years), with 85.07% (57/67) affecting both jaws. The anteroposterior type (58.21%, 39/67) predominated over anterior type (41.79%, 28/67). Eruption-wise, 10 and 57 cases were pre- and post-eruption, respectively. ST were predominantly single (73.13%, 49/67), conical (56/85), and vertically/inverted-oriented (38/85 and 34/85, respectively), with premaxillary predilection (p = 0.001). Single-tooth agenesis was most common (38/67 cases; total missing teeth = 115). Mandibular agenesis was more frequent (p = 0.001), primarily affecting second premolars (64/115), followed by lateral incisors (26/115), without side preference (p = 0.641). CONCLUSIONS: Hypohyperdontia prevalence is 0.66%, within the global range (0.002% to 3.1%) with no gender bias. Typically diagnosed in mixed dentition, most cases are bimaxillary involvement. Isolated posterior involvement is rare. ST and agenesis patterns mirror isolated anomalies. Early panoramic screening in suspected cases facilitates timely multidisciplinary management to prevent functional and aesthetic complications.