• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.1
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• pp.64-71
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• 2014

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.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.3
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• pp.548-555
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• 2008

Dentigerous cyst is the most common type of odontogenic cyst followed by radicular cyst. Most of dentigerous cysts originate from the permanent dentition and a few of them are associated with mesiodens. The complications of a dentigerous cyst associated with mesiodens are eruption abnomalies of adjacent teeth, root resorption, displacement, rotation, diastema and the secondary infection of the cyst due to adjacent teeth. The treatment of a dentigerous cyst of a maxillary mesiodens is to enucleate a cyst with a mesiodens. Otherwise, when it is close to adjacent teeth, a cyst is to reduce the through marsupialization after removing a mesiodens. There are numerous studies on dentigerous cysts and mesiodentes alone; however, the studies on the association of the two are rare. These are case reports about patients with mixed dentition whose dentigerous cyst of a maxillary mesiodens had been removed. After removal, the patients have been regularly checked up and shown satisfactory progress.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.3
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• pp.149-158
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• 2013

The purpose of this study was to evaluate the shape and impacted pattern of mesiodens and associated complications using three dimensional images produced by dental CBCT. This study was based on the CBCT (CB Mercury, Hitachi, Tokyo, Japan) radiographic view of 280 pediatric patients who visited the Department of Pediatric Dentistry at the Chosun University Dental Hospital with the chief complain of mesiodens during between 2007 and 2012. Impacted mesiodens occurs more frequently in boys than in girls, the ratio being approximately 3.3:1 and most cases were observed between 6 and 8 years of age. The number of mesiodens per patient was 1.38. Majority of the mesiodens were conical (79.5%) in shape and inverted (48.6%) in direction. The mesio-distal position of mesiodens were the most common in middle sector (81.8%), vertical level were the most common near cervical (60.3%), and labio-palatal position were the most common at palatal side of the dental arch (73.8%). 47.5% of mesiodens had complications and common complications associated with mesiodens were displaced tooth and delayed eruptions. The shape, vertical level, and labio-palatal position of mesiodens had correlations with complications. CBCT appears to be an excellent diagnostic tool, providing three dimensional information and accurate images, for diagnosis of impacted mesiodens.

• 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.34 no.4
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• pp.646-650
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• 2007

The purpose of this study was to evaluate the prevalence of mesiodens at pediatric dental clinic in Anyang, Kyeong Gi-Do. From retrospective reviews of all patients who visited Kizwell pediatric dental clinic from 2003.4-2006.4, 241 patients (289 mesiodens) who were shown to have mesiodentes were examed by a periapical radiograph and a panoramic radiograph. The incidence of mesiodens was 3.42% and the ratio of male/female (184/57) was 3.2:1. The number of supernumerary teeth was one in 193 cases (80%), two in 48 cases (20%). The mesiodens was placed at left side more frequently and the most common shape was conical type (208, 78%). Of 289 mesiodens, the direction of the crown of the mesiodens was inverted in 156 (54%), in a normal direction in 104 (36%), in a horizontal direction with regard to the tooth axis in 29 (10%). Early diagnosis of the mesiodens allow the most appropriate treatment, often reducing the extent of surgery, orthodontic treatment and possible complications.

• 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.

• 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.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.363-372
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• 2003

Supernumerary teeth are found frequently in the dental office causing many dental complications. They are one of the many dental abnormalities that may occur during tooth development. Inversely impacted supernumerary teeth in the midpalatal area are especially important clinically because they occur with high frequency and many complications. Though many previous clinical and radiographical studies exist, the sample numbers were small and the evaluation of shape, location, and effects to its surrounding tissue may not be accurate due to the solitary use of intraoral radiographs or panoramic radiographs. Among the patients who visited department of pediatric dentistry, yonsei dental hospital, from July, 1998 to June, 2002, those with inversely impacted supernumerary teeth took computerized tomography for a more accurate diagnosis. Their dental chart, panoramic radiograph and computerized tomography were evaluated for this study. The number, form, convexity, location, distance, and complications of inversely impacted supernumerary teeth in the midpalatal area were recorded. This study show that when the supernumerary teeth is tuberculated with a curved root and is in close proximity to the adjacent teeth, it causes complications such as eruption disturbance, rotation, displacement of adjacent teeth, and diastema. Such factors must be considered in making decisions for diagnosis and treatment.

• 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).