Rationale:
Mesiodens are supernumerary teeth located in the pre-maxilla between the two central incisors with a prevalence rate of 0.15–1.9%. An impacted mesiodens may cause delayed eruption of permanent incisors, ectopic eruption, pathological disturbances and malalignment of teeth.
Patient Concerns:
The patient complained of missing upper front teeth associated with pain in the same region for two weeks.
Diagnosis:
Upon clinical and radiographic examination, it was diagnosed as triple impacted mesiodens with impacted permanent maxillary central incisors.
Treatment:
The clinicians in the study approached the issue by surgical removal of the impacted mesiodens and orthodontic treatment for extrusion of the impacted permanent maxillary central incisors.
Outcomes:
The patient was relieved of the pre-operative concerns and followed up regularly for the eruption of permanent maxillary central incisors.
Take-away Lessons:
The authors advocate the importance of timely diagnosis and proper management of such rare pathologies.