Mesiodens: A case report and literature review

Mesiodens is the most prevalent supernumerary teeth, positioned in the central anterior area, that may cause a series of consequences and whose treatment depends on a series of factors.

Case report: A 7-year-old boy came to the dental clinic of EUC, preoccupied for two teeth that erupted, one behind the other, after the exfoliation of #61. The clinical examination revealed a tooth behind #21, that looked permanent, while #21 was positioned more buccally and higher compared to #11. The radiographic examination revealed that the tooth palatally was a supernumerary tooth, and not a permanent tooth with ectopic eruption. The treatment plan included the extraction of the mesiodens, that was conducted lastly, to ensure patient’s cooperation during restorative treatments, since its position made the extraction a procedure with higher difficulty. The extraction was indeed challenging since apart from performing palatal anesthesia, supplementary anesthesia was also needed. Additionally, the morphology/shape of the mesiodens made securing with forceps difficult, and the mesiodens had the size of a permanent tooth. The patient though was very cooperative during the procedure and healing was excellent during recalls.

Conclusion: Extraction of erupted in the oral cavity mesiodens can be conducted by general dentists for cooperative children as long as radiographic examination is conducted before, to eliminate the possibility of ectopic eruption of the permanent tooth. The dentist must have in mind the challenges which might be confronted during the procedure. While for the management of unerupted mesiodens, several factors should be taken into account, to decide the appropriate time of extraction.