• Journal of the korean academy of Pediatric Dentistry
• /
• v.46 no.1
• /
• pp.101-110
• /
• 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
• /
• v.35 no.3
• /
• pp.548-555
• /
• 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
• /
• v.30 no.3
• /
• pp.348-353
• /
• 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
• /
• v.34 no.3
• /
• pp.519-525
• /
• 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
• /
• v.41 no.1
• /
• pp.64-71
• /
• 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
• /
• v.35 no.2
• /
• pp.268-277
• /
• 2008

Authors evaluated 1171 patients at the department of Pediatric Dentistry in Kyoungpook National University Hospital through clinical records and radiographs. And the following features were studied ; age, sex distribution, number of mesiodens per patients, cause of discovery of mesiodens, location, status of eruption, shape and orientation of crown, complication, dental age of adjacent upper incisor tooth at the time of surgical extraction of mesiodens and the relationship between the resolution rate of complication after extraction of mesiodens and the dental age of adjacent upper incisor tooth, length of diastema, the eruption status of lateral incisor and the crowding status of premaxilla. The followings are the results : 1. The cause of discovery of mesiodens were as follows ; delayed eruption of the permanent incisors in 13.8%, midline diastema in 11.6%, radiographs taken for other reasons in 23.4% and for caries treatment in 15.1%. 2. Complication due to the presence of mesiodens did not occur in 36.8%, delayed eruption of adjacent teeth was observed in 16.1%, midline diastema in 34.4%, rotation in 8.8%, displacement in 2.4%, and crowding in 1.0% of all evaluated patients. 3. As for the dental age of adjacent upper incisor tooth at the time of surgical extraction of mesiodens, below 1/3 of total root length were observed in 3.5%, $1/3{\sim}1/2$ of total root length in 19.9%, $1/2{\sim}2/3$ of total root length in 54.7% and over 2/3 in 21.9% of all evaluated patients. 4. Resolution rate of delayed eruption after the extraction of mesiodens was significant higher in the group with the root length below 1/2. Resolution rate of midline diastema was significant higher in the group with diastema width below 3mm and with non-crowding of adjacent upper incisor teeth.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.26 no.2
• /
• pp.275-283
• /
• 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).

• Journal of the korean academy of Pediatric Dentistry
• /
• v.30 no.3
• /
• pp.363-372
• /
• 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
• /
• v.29 no.4
• /
• pp.574-578
• /
• 2002

Mesiodens is developmental tooth anomaly which is commonly found in clinical pediatric dentistry. however, it may cause many partial problem in tooth alignment when congenitally missing teeth was accompanied by mesiodens. The terms, concomitant hypodontia and hyperdontia' and oligo-pleiodontia' have been used to describe the condition in witch developmental absence of teeth and supernumerary teeth are present in the same individual. Only a few case reports of this rare condition which is opposite developmental phenomena exist in the literature. The purpose of this study is survey of congenitally missing teeth in mesiodens case and to compare previous literature of congenitally missing teeth in normal. The subjects were 310 children(247 male and 63 female) at the age from 5 to 12 years visiting the Department of Pediatric Dentistry, Pusan National University Hospital with mesiodens for last 3 years. With their pantomograms we studied congenitally missing teeth except permanent 3rd molar. 1. The preference of congenitally missing teeth in mesiodens cases was revealed to be 17.1%(53 out of 310 in total), and there was a higher prevalence in females(22.2%) than in males(15.8%). 2. The most frequently missing teeth were maxillary lateral incisors(22.7%) and mandibular second premolars(22.7%), followed by maxillary second premolar(17.3%), and mandibular lateral incisors(16.0%). There was no significant differences between maxilla(49.3%) and mandible(50.7%). 3. In number of congenitally missing teeth per person, 69.9% had one missing tooth, 22.7% had two missing teeth and 9.4% had three missing teeth.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.43 no.3
• /
• pp.246-253
• /
• 2016

The optimal time for the removal of supernumerary teeth can be divided into two groups; early removal and late removal. While each group has its own advantages, the effects on maxillary central incisor can be significant. The purpose of this study was to determine the ideal time for the removal of the supernumerary teeth by evaluating 166 patients for three months after surgical removal of supernumerary teeth. Relatively young patients in early Hellman's dental stage with less developed or unerupted maxillary central incisor had less midline deviation. No statistical significance was found in diastema, rotation of the maxillary incisors and their changes during a follow-up period. Removal of supernumerary teeth should be considered as a preventative measure prior to eruption of the maxillary incisors when the midline deviation is observed in panoramic radiographic examination. This study will be useful in determining the optimal time for the removal of supernumerary teeth depending on the location of the maxillary incisors. This study will be informative on deciding the optimal time to remove the supernumerary teeth depending on the various positions of the maxillary central incisor. (this sentence is better to use)