• Imaging Science in Dentistry
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• v.40 no.2
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• pp.69-74
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• 2010

Purpose : The research was performed to predict the three dimensional relationship between the impacted mesiodens and the maxillary central incisors and the proximity with the anatomic structures by comparing their panoramic images with the CT images. Materials and Methods : Among the patients visiting Seoul National University Dental Hospital from April 2003 to July 2007, those with mesiodens were selected (154 mesiodens of 120 patients). The numbers, shapes, orientation and positional relationship of mesiodens with maxillary central incisors were investigated in the panoramic images. The proximity with the anatomical structures and complications were investigated in the CT images as well. Results : The sex ratio (M : F) was 2.28 : 1 and the mean number of mesiodens per one patient was 1.28. Conical shape was 84.4% and inverted orientation was 51.9%. There were more cases of anatomical structures encroachment, especially on the nasal floor and nasopalatine duct, when the mesiodens was not superimposed with the central incisor. There were, however, many cases of the nasopalatine duct encroachment when the mesiodens was superimpoised with the apical 1/3 of central incisor (52.6%). Delayed eruption (55.6%), crown rotation (66.7%) and crown resorption (100%) were observed when the mesiodens was superimposed with the crown of the central incisor. Conclusion : It is possible to predict three dimensional relationship between the impacted mesiodens and the maxillary central incisors in the panoramic images, but more details should be confirmed by the CT images when necessary.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.3
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• pp.519-525
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• 2007

Supernumerary tooth is developed from overgrowth of dental laminar and is mainly observed in the maxillary anterior area, named 'mesiodens. Mesiodens cause many problems such as malposition of permanent anterior tooth, diastema, formation of cyst, and eruption to oral or nasal cavity. Extraction, therefore, is generally recommended choice of treatment. This case report describes that the patient is a 9 years and 8 months old boy, whose unilateral maxillary incisor was missing due to trauma, and he had a mesiodens. We practiced autotransplantation of the mesiodens to the missing maxillary central incisor area and then restored with prosthetics, substantially kept out alveolar bony resorption and provided esthetic appearance. Mesiodens was too small to be used as an abutment because its length is totally 14mm, so that poor prognosis was anticipated due to bad crown/root ratio. However, we observed clinically acceptable result during the observation period of 8 months after operation.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.2
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• pp.180-186
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• 2014

One or two mesiodens are mostly common to the clinician. However, three mesiodens is rarely found and can cause complications such as orthodontic problems or interruptions of the adjacent teeth with more than 1 or 2 mesiodens. Many factors cause irregularities in the permanent dentition. Mesiodens, especially in the anterior maxilla, can disturb the eruption of adjacent permanent teeth and cause diastemas, ectopic eruptions, root resorption, or the formation of dentigerous cysts. The early diagnosis of mesiodens is important for preventing such complications, and the timing of intervention should be based on their location and number. Periodic checkups and improved diagnostic devices make it easy to find mesiodens and associated complications. In this case, 3 supernumerary teeth in the maxillary anterior region were affecting the eruption of the adjacent permanent incisors. To minimize complications and preserve the deciduous teeth, the three supernumerary teeth were extracted in 2 steps. Since cone-beam computed tomography was not available, a brace wire was used to measure the depth of the mesiodens.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.4
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• pp.190-193
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• 2015

Objectives: A mesiodens appears most commonly as a supernumerary tooth impacted in the anterior maxilla. The purpose of this study is analyze mesiodens clinically. Materials and Methods: Gender, crown form, direction of impaction, relation to permanent incisors, and chief complaints of patients with extracted mesiodens were analyzed. Results: Patients were analyzed for motivation to visit the hospital; 85.4% of the patients were referred from other hospitals. Mesiodens was more common in males than in females (3.7:1), and 70.1% of patients had only one mesiodens, while 29.6% had two mesiodenses. Of the mesiodenses, 61.4% were of the aconical form, and the most common direction was upward (62.4%), followed by the normal position (26.0%) and the horizontal position (11.6%). The mesiodenses caused orthodontic problems with the permanent incisors in 46.3% of cases. Mesiodens associated with dentigerous cyst was rarely observed in our patient group. Conclusion: Mesiodens is more common in males than in females and often affects the permanent incisors. Thus, careful clinical and radiological evaluations of mesiodenses are important.

• Imaging Science in Dentistry
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• v.52 no.1
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• pp.67-74
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• 2022

Purpose: To focus on the effects of the presence of mesiodens on adjacent teeth and to investigate the timing of its safe removal. Materials and Methods: Cone-beam computed tomography examinations, obtained at Okayama University Hospital over a three-year period, were inspected. Data were recorded including the number of mesiodens; associated abnormalities; and the relationship with neighboring structures. Depending on multiple factors, the risk of developing complications due to early extraction of a mesiodens was divided into three categories: high, medium, and low risk. Results: A total of 5,958 cone-beam computed tomography exams were obtained, 460 patients aged 3-85 years were diagnosed with a total of 568 mesiodens, 382 (67.3%) of which were discovered in young patients (age <10 years), and 333 (87.2%) of these were associated with abnormalities. Regarding the risk categories, 11 (1.9%) were considered to be in the high-risk, five (0.9%) in the medium-risk and 552 (97.2%) in the low-risk categories. Moreover, eight out of 11 high-risk mesiodens were extracted and no post-operative complications have been seen. Conclusion: As the results showed that no postoperative complications were seen in all the extracted cases of high-risk mesiodens, this indicates the possibility of safe extraction at an early age which could reduce related future complications.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.1
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• pp.77-94
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• 2021

The purpose of this study was to investigate the three-dimensional characteristics of mesiodens using Cone-beam Computed Tomography(CBCT) and analyze the factors affecting complications and anesthetic methods of extraction. This study evaluated 602 mesiodens of 452 patients who underwent extraction of mesiodens at the department of Pediatric Dentistry in Seoul National University Dental Hospital between 2017 and 2019. The ratio of mesiodens patients over total patient per year was gradually increased over the past 20 years. Mesiodens with labio-palatally horizontal direction while root directing labial were the most common among the mesiodens with horizontal direction. Mesiodens were the most common at the cervical side of the adjacent teeth(37.0%) and mesiodens located in the near-palatal side were observed about 3.83 times higher than the far-palatal side. Most of the mesiodens(82.1%) were in contact with adjacent permanent teeth on all three sides of the CBCT and 46.2% of mesiodens had curved roots. The patient's age, vertical position, presence of complications, and proximity showed a significant difference in the selection of general anesthesia among anesthetic methods. The direction and vertical position of mesiodens had a significant effect on complications. These results provide a better understanding of mesiodens for establishing an accurate diagnosis and treatment plan.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.348-353
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• 2003

Early detection and prudent management of mesiodens or supernumerary tooth should be considered essential in reducing disturbance in the eruption and position of the adjacent permanent incisor. While it is true that the presence of diastema may be regarded as normal at the early mixed dentition stage, the early detection and removal of the mesiodens is a prerequisite to facilitate spontaneous alignment or subsequent approximation of the permanent central incisors. In many cases, diastema due to mesiodens can be physiologically corrected spontaneously after the extraction of mesiodens. The best choice of treatment of diastema may be observation. Orthodontic intervention is required only spontaneous closing of diastema does not occur within observation period. In orthodontic intervention, careful treatment plan should be established. Clinician gives considerations to angulation of central and lateral incisor, proximity of lateral incisor, developmental stage and position of canine, pattern and extent of anterior crowding. Orthodontic movement should be done slowly with light force. In addition, periodic radiographic observation are needed to monitor the root development and root resorption. Case 1, 2 and 3 showed physiologic closures after the extraction of mesiodens. In these cases, acceptable alignment of central and lateral incisors was obtained. In case 4, orthodontic correction for diastema was performed successfully after the extraction of mesiodens. After the orthodontic closure of the diastema, it was decided that a retainer was not needed, because the dentition was under a dynamic stage in exchanging teeth and also developing arches.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.2
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• pp.275-283
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• 1999

Authors evaluated 152 patients at the department of Pediatric Dentistry in Seoul National University Hospital through clinical records and radiographs. And the following features were studied ; age, sex distribution, number of mesiodens per patients, location, status of eruption, shape and orientation of crown, and complication. From the above results, the relationship between features of mesiodens and complications were evaluated using chi-square analysis. 1. Complications due to the presence of mesiodens did not occur in 31.6%, delayed eruption of adjacent teeth was observed in 33.6%, midline diastema in 22.4%, rotation in 8.6%, displacement in 3.3%, and crowding in 0.7% of all evaluated patients. 2. As compared with the above 8.5 year group, in the under 8.5 year group, the frequency of complications was significantly higher(P<0.05). As compared with those positioned lingually, in mesiodens labially or within the arch the frequency of complications was significantly higher(P<0.01). Also, the frequency of complications was significantly higher when the mesiodens was tuberculate in form(P<0.05). 3. Of the 104 patients with complications, the frequency of delayed eruption was significant higher in the under 8.5 year group, and in above 8.5 year group, the frequency of malocclusion was significantly higher(P<0.05). When mesiodens were located in the midline region, the frequency of malocclusion was significant higher, while in case with laterally positioned mesiodens the frequency of delayed eruption was significantly higher(P<0.01).

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.1
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• pp.101-110
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• 2019

The aim of this study was to evaluate and compare the microstructural properties and mineralization quality of mesiodens with permanent and primary central incisors. Fifteen mesiodens, permanent and primary central incisors were collected. The enamel rod diameter and enamel thickness were observed and measured using field emission scanning electron microscope (FE-SEM). Chemical composition of the enamel was analyzed using energy dispersive X-ray spectrometer (EDS). The measurements were then assessed using the one-way ANOVA and Tukey test. There was no statistically significant difference in the enamel rod diameter between mesiodens and permanent central incisors. However, enamel rods of primary central incisors were smaller than remaining two groups. The thickness of enamel was thick in order of permanent central incisors, mesiodens, primary central incisors. In the composition analysis using EDS, there was no difference in the Ca/P ratio and Ca/C ratio between mesiodens and permanent central incisors, but small in primary central incisors. In conclusion, the microstructural properties of mesiodens were more similar to those of permanent central incisors compared to primary central incisors. Futher, the mineralization quality of mesiodens did not differ significantly from that of permanent central incisors.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.256-259
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• 2010

Impacted supernumerary anterior teeth (mesiodens) usually are removed surgically with drug sedation and local anesthesia. After extraction of mesiodens, the wound are sutured and removable resin plate is then applied. In this operation, the postoperative bleeding and infection is likely to occur owing to postoperative accumulation of hematoma & seroma, psychologic stress and other contaminated factors (resin plate, poor oral hygiene, etc). So, the authors established the immediate rubber & iodoform gauze drainage into the sutured wound of mesiodens extraction for the prevention of postoperative bleeding and infection. The removable resin splint are not used because of the poor oral hygiene and economic factor. The results were more favorable without the postoperative blood oozing & wound infection in the dentistry (OMFS) of Wonju Christian Hospital.