The Effect of Early Removal of Mesiodens for the Correction of Central Incisor Rotation

Abstract

Mesiodens is defined as a supernumerary tooth in the premaxillary region. It can cause several clinical manifestations in normal eruption and position of adjacent teeth, such as displacement and impaction. Although the mesiodens accompanied by a clinical complication is indicated for removal, the optimal time of mesiodens removal is still controversial. Some authors suggest immediate intervention defining the removal of mesiodens as soon as possible after the first detection. On the other hand, others recommend delayed intervention which denotes the removal of mesiodens after complete root development of adjacent teeth. This case report is presented with three cases of spontaneous correction and proper alignment of rotated maxillary central incisors by extraction of mesiodens when the crowns of rotated incisors were completely formed while the roots of them were at an early developmental stage.

Radiographic characteristics of mesiodens in a non‐syndromic pediatric population in the Black Sea region

“…30 Complications that negatively affect the vitality of permanent teeth, such as a dentigerous cyst, root resorption in permanent teeth, or infection (infections present intraorally), require immediate intervention. 27 There are several limitations to the present study. Because the shapes were examined in two dimensions on panoramic film, clear information could not be obtained about the shape of the teeth in the horizontal position.…”

“…3 Early and late responses have both advantages and disadvantages. 20,27,28 The 20 Due to the risk of displacement of a permanent tooth in a surgical procedure, it is generally not suggested to remove a supernumerary tooth in the primary dentition through surgery. 20 A single mesiodens positioned on the buccal, palatal, or arch that has erupted in the mouth should be extracted when diagnosed.…”

“…Therefore, mesiodens should be extracted before the complete development of the gingival fiber system to ensure that the rotation recovers rapidly, or to ensure that relapse is minimized after orthodontic treatment . Complications that negatively affect the vitality of permanent teeth, such as a dentigerous cyst, root resorption in permanent teeth, or infection (infections present intraorally), require immediate intervention . There are several limitations to the present study.…”

“…In general, an early extraction is defined as an extraction performed before the age of 6 years, whereas a late extraction is defined as an extraction between 8 and 10 years, when the root development of adjacent teeth is complete . The negative impacts of an immediate response include possible injury to the adjacent teeth due to devitalization and/or root malformation, a young child's incapacity to accept the surgical process in a psychological aspect, and conducting an avoidable procedure in case complications do not occur in the future .…”

“…Early and late responses have both advantages and disadvantages . The negative impacts of an immediate response include possible injury to the adjacent teeth due to devitalization and/or root malformation, a young child's incapacity to accept the surgical process in a psychological aspect, and conducting an avoidable procedure in case complications do not occur in the future . However, if the response is delayed until the eruption of the lateral incisors, this could aggravate the risk of a lack of eruption of the central incisors, a loss of anterior arch space or midline shift, further extensive surgery, and an orthodontic procedure for recovery…”