Impacted Mesiodens Research Articles

Esthetic Rehabilitation in a Patient with Mesiodens

Supernumerary tooth is one that is additional to the normal series and can be found in almost any region of the dental arch. They may be single, multiple, unilateral or bilateral erupted or unerupted and in one or both jaws. Mesiodens is the most common type of supernumerary tooth found in the premaxilla between two central incisors. Presented here is a case of ten year old male child with supplemental mesiodens with talons cusp erupted in the oral cavity causing malocclusion and an another horizontally impacted mesiodens near the nasal floor. Mesiodens was extracted and esthetic reconstruction of the patient was done by bringing left maxillary central incisor to correct position by orthodontic treatment.

Clinical and surgical considerations for impacted mesiodens in young children: An update

Background: Most supernumerary teeth are located in the anterior maxillary region and are classified according to their form and location. Their presence may give rise to a variety of clinical problems. Detection of supernumerary teeth is best achieved by thorough clinical and radiographic examination. Supernumerary teeth may be encountered by the general dental practitioner as a chance finding on a radiograph or as the cause of an impacted central incisor. Design: This article presents an overview of the clinical problems associated with supernumerary teeth and includes a discussion of the classification, diagnosis, and management of this difficult clinical entity. Conclusion: The most common supernumerary tooth, which appears in the maxillary midline, is mesiodens. Their diagnosis and management should form part of a comprehensive treatment plan. Treatment depends on the type and position of the supernumerary tooth and on its effect on adjacent teeth. The article throws a light on various modalities for investigation and treatment of supernumerary teeth, which is important for an early intervention in children to avoid major complications.

Management of an inverted impacted mesiodens, associated with a partially erupted supplemental tooth—a case report

Ectopically impacted supernumerary teeth are common anomalies of the maxillofacial complex. Most of such cases are usually asymptomatic and are diagnosed on routine clinical or radiographic examination. Associated complications include crowding, displacement, root resorption, or delayed eruption of adjacent teeth, diastema, or dentigerous cyst formation. To minimize these complications, early diagnosis, and appropriate management of the supernumerary teeth is essential for a more favorable prognosis in order to prevent aesthetic and occlusal problems. In this article, we discuss a case with two supernumerary teeth, one being an inverted impacted mesiodens, placed high in the palate and the other a partially erupted, rotated mesiodens in maxillary left anterior region associated with delayed eruption of permanent maxillary left central incisor.

Quantitative localization of impacted mesiodens using panoramic and periapical radiographs

PurposeThe purpose of this study was to evaluate a new technique for localizing impacted mesiodens using its horizontal magnification ratio on panoramic radiographs.Materials and MethodsLocation-magnification equation of a panoramic equipment was obtained from horizontal magnification ratio of a metal ball which was located variable positions from the center of image layer at interval of 2 mm. Panoramic radiographs were obtained from a skull phantom with a metal ball which was a substitute for impacted mesiodens and was embedded 10mm(Group 1), 15mm(Group 2), and 20mm(Group 3) posterior to the central incisor. Each group obtained 7 panoramic radiographs at variable positions and one periapical radiograph. Three methods were used to estimate the actual width of the incisors and the balls which were used to calculate the magnification ratio. The methods included using the actual incisor width and the calculated ball width (Method 1), using the actual incisor width and the ball widths measured on periapical radiograph (Method 2), and using the incisor and the ball widths measured on periapical radiograph (Method 3). The location of the metal ball was calculated by using the location-magnification equation.ResultsThe smallest difference between the calculated and the actual distance was 0.1±0.7 mm in Group 1/Method 3. The largest difference was -4.2±1.6 mm in Group 3/Method 2. In all groups, method 3 was the most accurate.ConclusionQuantitative localization of impacted mesiodens is possible by using panoramic radiograph.

Trauma‐induced dentigerous cyst involving an inverted impacted mesiodens: case report

There have been only a small number of studies on the association of dentigerous cysts with supernumerary teeth. The purpose of this article was to report the case of a dentigerous cyst associated with an impacted inverted mesiodens that developed secondary to trauma to its predecessor, a non-vital permanent maxillary central incisor. As a consequence of trauma, the central incisor's root development was prematurely arrested and the open apex lay close to the follicle of the underlying inverted mesiodens. The negligent attitude of both the child and parent in seeking dental treatment was a contributing factor. The case was further complicated by impaction of the adjacent permanent central incisor due to the presence of another unerupted but normally oriented mesiodens. Occlusal and Intraoral periapical radiographs revealed a well-defined radiolucent area surrounding the inverted mesiodens. Microscopic examination revealed a cystic cavity that was lined by 2-3 cell thick non-keratinized stratified squamous epithelium resembling reduced enamel epithelium. Dentigerous cysts associated with impacted permanent teeth are not uncommon but the cysts which are induced by trauma are uncommon. Development of trauma-induced dentigerous cyst around an inverted impacted mesiodens associated with the periapical area of a traumatized, non-vital, immature permanent central incisor is a rare occurrence.

Investigation of Transmigrated and Impacted Maxillary and Mandibular Canine Teeth in an Orthodontic Patient Population

The objectives of the present study were to determine the frequency and gender difference of transmigrated and impacted canines and to evaluate the characteristics and treatment protocols in a Turkish orthodontic patient population. We designed a retrospective study composed of pretreatment and post-treatment dental casts, intraoral photographs, and full mouth periapical and panoramic radiographs of 2,215 patients (1,275 females and 940 males). Observations were made regarding impacted mandibular and maxillary canines, retained deciduous canines, patient gender and age, side and number of transmigrated canines and associated pathologic features, and treatment of the impacted canines and transmigrated canines. The Pearson chi(2) test and Fisher's exact test were used to determine the potential differences in the distribution of canine impaction and transmigration when stratified by gender. The frequency of patients with impacted and transmigrated canines was 5.1% and 0.3%, respectively. None of the patients with a transmigrated mandibular canine had any pathologic changes; however, the maxillary transmigrated canine was associated with impacted mesiodens. All transmigrated canines were unilateral and impacted. Four canines migrated from the left to right, and 2 migrated from right to left. Of 6 patients, 2 had retained primary canines and 4 had exfoliated primary canines. Three of the transmigrated mandibular canines were type 1 and 2 were type 2. In the treatment protocol, 4 impacted mandibular canines and 78 maxillary canines were surgically exposed for orthodontic treatment, 4 of 6 transmigrated canines were surgically removed, and 2 were observed periodically. If the diagnosis of canine impaction and transmigration in patients is made earlier, it is possible that the tooth might have been in a better position for orthodontic eruption into the arch. Careful patient selection and preparation are therefore essential, as is cooperation between the orthodontist and oral surgeon.

Mesiodens with an Unususal Morphology - A Case Report

ABSTRACT Supernumerary tooth is one that is additional to the normal series and can be found in almost any region of the dental arch. They may be single, multiple, unilateral or bilateral erupted or unerupted and in one or both jaws. Mesiodens is the most common type of supernumerary tooth found in the premaxilla between two central incisors. Presented here is a case of ten year old male child with supplemental mesiodens with talons cusp erupted in the oral cavity causing malocclusion and another horizontally impacted mesiodens near the nasal floor.

The consequences of an untimely diagnosed mesiodens: Case report

Supernumerary teeth may have all characteristics of normal teeth (dens supernumeratus) or, more frequently, appear as rudimentary remains of the tooth bud (dens accessories). Such teeth may cause various complications and the most frequent are orthodontic anomalies and follicular cysts. Among all supernumerary teeth, the most frequent is mesiodens. It may be of different shape, but most often is conical. Untimely diagnosed and treated mesiodens may, in older age, result in complications and compromise prosthodontic rehabilitation. The aim of this study was to present a case where untimely treatment (diagnostics and extraction) of a mesiodens resulted in the formation of a follicular cyst and a partial resorption of the root of an adjacent tooth (central incisor), which had to be extracted. The patient sought a prosthodontic treatment. However, a hazelnut-size tumor was found in the upper anterior region. Clinical and X-ray examination implied the presence of a follicular cyst around a supernumerary tooth, which was situated between upper central incisors. Cystical sac was removed in a usual manner along with the extraction of the impacted mesiodens. Unfortunately, the upper central left incisor had to be extracted as well due to a progressed root resorption.

Root resorption associated with an impacted mesiodens: a surgical and endodontic approach to treatment

This article describes a case of root resorption of a maxillary non-vital immature incisor associated with an impacted and angulated mesiodens. The impacted tooth was surgically removed and the compromised incisor was subsequently endodontically treated. Over a period of 27 months the tooth was medicated with repeated applications of calcium hydroxide. Radiographically after 18 months, an incomplete hard tissue barrier was observed with full apical closure at the conclusion of 27 months of treatment. Once the patient was comfortable after surgical removal of the mesiodens, the tooth was asymptomatic and remained so for the duration of the treatment and after definitive restorative work had been completed.

PENATALAKSANAAN MESIODENS PADA ANAK DENGAN KELAINAN JANTUNG KONGENITAL DEFEK SEPTUM VENTRIKEL (Laporan Kasus)

Mesiodens is supernumerary teeth which is commonly found and located in midline premaxilla. The supernumerary teeth may cause clinical disorders, such as delayed eruption and malposition of permanent teeth, therefore early diagnosis and intervention is very important. Ventricular Septal Defect (VSD) is a congenital heart disease which frequently occurred in children. Dental treatment in children with heart diseases should be done carefully since there is higher risk of developing on bacterial endocarditis. Dentist should know the contraindication of dental treatment that needs prophylactic antibiotics as suggested by American Heart Association. A 6 years 8 months boy who suffered from VSD came to Pediatric Dental Clinic at Faculty of Dentistry University of Indonesia. In the examination we found impacted mesiodens with inverted position which has conical shape at regio 51. The possible etiology of mesiodens in this patient is x-linked dominant with incomplete penetration. After consultation with Pediatric Cardiologist and Oral Surgeon, the odontectomy was conduted with prophylactic cephadroxyl. There was no signs of bacterial endocarditis after the odontectomy.

下顎正中過剰埋伏歯の１例

The incidence of supernumerary teeth in the maxillary anterior region is high. We frequently encounter maxillary impacted mesiodens that causes diastema. However, the incidence of supernumerary teeth in the mandibular anterior region is low, and mandibular impacted mesiodens is very rare. Here we describe our experience with such a case. A 9-year-old girl was referred to our department on June 11, 1997 for extraction of a mandibular anterior impacted supernumerary tooth. She had previously consulted a dental clinic for mandibular diastema. A radiographic examination showed an impacted supernumerary tooth between the mandibular central incisors. The direction of eruption was normal. A sagittal tomographic image showed that it was located on the labial side. The surrounding gingiva was normal. We extracted the tooth with the patient under local anesthesia. The extracted tooth measured approximately 9 mm by 3 mm. It was a conical tooth, resembling a central incisor. The patient is doing well.

A dentonasal deformity

A case of an impacted mesiodens that produced a marked nasal deformity and a deviated nasal septum is discussed.