Supplemental Mandibular Mesiodens: A Diagnostic Challenge

Abstract

A 34-year-old man reported to the Department of Oral Medicine and Radiology, Educare Institute of Dental Sciences, Malappuram, Kerala, India, with chief complaints of bad breath and mobile lower front teeth, which were there since 2 years.The family and medical histories were non-contributory. There were no signs of any identified syndrome.On intra-oral examination, he was found to have severe calculus, generalized cervical abrasion and generalized periodontitis, with mobility with respect to lower incisors. A careful examination revealed five incisors in the mandibular anterior region. All five incisors were separate, with well formed morphologies [Table/ Fig-1, 2] show five mandibular incisors which are well formed and separate -frontal and occlusal views respectively.To distinguish between them, the following steps were adopted. During examination, the median area was defined positionally by the inferior labial frenum and radiographically by the genial tubercle; it appeared that the supernumerary tooth was more towards the right side from the midline. Upon carefully examining all 5 incisors clinically and radiographically, a conclusion was drawn that the distal most incisors on either side of midline were normal lateral incisors, as their crown measurements were greater than those of the remaining 3 incisors. Distinguishing the supernumerary tooth among the 3 incisors was quite challenging, as crown measurements of all the 3 were found to be roughly the same. Since the second incisor from left showed a marked rotation and thereby caused crowding, with the presence of labial frenum just in front of the incisor, it was concluded that the tooth positioned centrally was the supernumerary one. A final diagnosis of mandibular mesiodens of supplemental type and chronic generalized periodontitis was made. aBstRaCtDevelopmental anomalies affecting the number of teeth are occasionally encountered clinically. The incidence of super numerary teeth is approximately 1-3%. Among these are the maxillary anterior teeth, the maxillary molars, and the maxillo-mandubular premolars, in terms of descending order of occur rence. Supernumeraries occur rarely in the mandibular anterior teeth region. They may be either supplemental or rudimentary. We are reporting case of a supplemental type of supernumerary tooth in the mandibular anterior region and steps which were followed to distinguish supernumerary tooth from the normal series.

The prevalence of developmental anomalies among school children in Southern district of Andhra Pradesh, India

“…[ 33 ] A few cases of mandibular mesiodens were reported from India. [ 34 35 ] The present study did not document the occlusal challenges with supernumerary teeth.…”

Orthodontic management of a non-syndromic patient with concomitant bimaxillary hypohyperdontia: a case report

“…17 Hypohyperdontia can be divided into mandibular, maxillary with premaxillary subtype, and bimaxillary hypohyperdontia. 20 There are several clinical presentations of concomitant hypohyperdontia. However, while a wide range of treatment approaches have been proposed, 21 little information is available regarding the clinical and functional assessment of these factors in orthodontic patients.…”

Mandibular Mesiodens: A Case Report of Rare Clinical Entity

“…The tooth had grade 2 mobility and had to be extracted. 9 Marya et al described a case of congenital absence of mandibular permanent central incisors and the presence of a midline supernumerary tooth. When compared to the lateral incisors, the tooth displayed an unusual morphological pattern.…”