Multilobed mesiodens: a supernumerary tooth with unusual morphology

Abstract

An 8-year-old boy came with a chief complaint of an abnormally shaped tooth situated in upper front teeth region. On examination a supernumerary tooth with multiple lobes was present palatally to the maxillary right permanent central incisor. The morphology of the tooth crown was found to be unusual due to the presence of five lobes in the crown portion. Because of the supernumerary tooth, the permanent right central incisor was displaced labially. Radiographic examination showed a completely formed supernumerary tooth with dilacerated root. On the basis of clinical and radiographic examination, the supernumerary tooth was diagnosed as multilobed mesiodens. Since patient expressed dissatisfaction with the presence of supernumerary tooth, it was decided to extract this mesiodens followed by orthodontic treatment for alignment of labially placed maxillary right permanent central incisor.

Common dental diseases in children and malocclusion

“…Mesiodens is the most common type of hyperdontia, with the additional tooth developing between the maxillary central incisors. Some problems may be arisen from hyperdontia, including failure of eruption, crowding or abnormal diastema, displacement and/or rotation of adjacent teeth 38 (Fig. 4 ), and so on.…”

Dens invagination and root dilaceration in double multilobed mesiodentes in 14-year-old patient with anorexia nervosa

“…A traumatic injury to primary front teeth is a shared risk factor of all identified abnormalities, but the patient's mother denied that the girl had suffered an injury to primary upper teeth. The hyperactivity of dental lamina may explain the development of multilobed mesiodentes [6], but it does not explain other malformations found in this case.…”

“…It is diagnosed if a root or sometimes a crown shows a severe distortion or bend. The most typical locations are maxillary incisors and mandibular molars; there is also a report on dilaceration in a mesiodens [6]. The aetiology is not clearly understood and, with respect to the anterior teeth, cases of dilacerations are most often explained by a traumatic injury to primary predecessors.…”

“…A supernumerary tooth located in the maxillary midline region is called a mesiodens [20]. The prevalence of mesiodentes ranges between 0.09% and 2.05%, with a higher frequency in people of Asian ethnicity [4,6].…”

“…Less often the crown is complicated with many tubercules (tuberculated, lobular-like) or is molariform. A multilobed mesiodens with 4 or 5 lobes is a rare finding [6,19]. As a rule, the root of a conical mesiodens is normally formed, while other-shaped mesiodentes may have incompletely developed roots [17].…”