• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.406-411
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• 2004

Inverted Impaction of the permanent maxillary central incisor is rare. The causes of impaction are trauma and periapical inflammation of primary maxillary incisor teeth. Treatment options for a inverted incisor is extraction, surgery and orthodontic traction, transplantation, and spontaneous eruption guidance. Treatment depends on the incisor's root development and the space available for eruption. If root development is immature, prognosis would be good. We reported successful treatment for inverted maxially central incisor of proper eruption and normal root development by correction of a eruption route. But further observation will be required to evaluate the final root development state and amount of at tachment gingiva.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.1
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• pp.162-168
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• 2007

Impaction of the maxillary central incisor may cause social, esthetic, and functional problems in children. There are various means of treatment for the inverted maxillary central incisor, such as extraction, surgical opening followed by orthodontic traction surgical repositioning or intra-alveolar autotransplantation prior to extraction. In this case, we surgically repositioned the inverted maxillary central incisor to normal semi-erupted position in a 5-year-old boy The developmental stage of the inverted tooth was Nolla's 6.5, which indicates formation of less than one third of the root. After surgical reposition, we did follow-up for 21 months, expecting spontaneous growth Unfortunately, poor prognosis was noted further root was not observed. Such failure seems to originate from possible injury on Hertwig's epithelial root sheath by surgical trauma. We performed surgical repositioning to retain the tooth instead of extraction. However, arrest of root development occurred which is one of the critical complications. In order to increase the success rate of the surgical reposition procedure, minimal surgical trauma is required as well as selection of adequate indication and decision of proper time of treatment considering the stage of root development.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.21 no.2
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• pp.393-403
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• 1991

The purpose of this study was to evaluate the incidence and radiographic features of 1,300 cases of supernumerary teeth by means of the analysis of periapical radiograms and/or pantomograms in 69,442 persons visited the Department of Oral Radiology, School of Dentistry, Kyung Hee University during January 1980 to December 1989. This study of supernumerary teeth revealed the following features: 1. The incidence of supernumerary tooth was revealed to be 1.5% in total examined persons, and there was a higher incidence in males (74.0%) than in females (26.0%). 2. The supernumerary teeth were most frequently occurred in the 1 st decade (42.7%), followed by the 2nd decades (20.2%), the 3rd decades (14.1 %), and the 5th decades (7.2%). 3. There was a higher incidence in the maxilla (98.7%) than in the mandible (1.3%), and mesiodens (90.1 %) was the most frequently occurred. The maxillary lateral incisor region (3.1%) was next in order of frequency followed by maxillary distomolar (2.2%), and maxillary paramolar (1.5%). 4. There was a higher incidence of the impaction (82.7%) than that of the eruption (17.3%), and supernumerary tooth in lateral incisor region (87.8%) was the most frequently impacted one. 5. The inverted impaction was occurred in 63.1%, the vertical impaction in 18.1%, and the angulated impaction in 18.8%. In localization, a palatally (lingually) impacted supernumerary tooth was occurred in 85.0%, and middle impacted and buccally (labially) impacted supernumerary tooth showed the same incidence (7.5%). 6. A supplemental tooth was occurred in 3.2%, an accessory tooth in 96.8%, and a supplemental tooth was the most frequently occurred in maxillary lateral incisor and mandibular premolar region. 7. In effects of supernumerary tooth on adjacent tooth, crowding was occurred in 0.4%, diastema in 10.6%, rotation in 5.4%, eruption disturbance in 4.5%, root resorption in 2.5%, and dentigerous cyst in 2.2%.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.21 no.2
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• pp.367-375
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• 1991

The clinical and radiographic features of 1,171 mesiodenses were studied with periapical radiograms and/or pantomograms in 942 persons visited the Department of Oral Radiology, School of Dentistry, Kyung Hee University during January 1980 to December 1989. The obrained results were as follows; 1. The incidence of mesiodens was higher in males (75.4%) than in females (24.6%). 2. In number of mesiodenses per individual, a single mesiodens was found to be 75.9%, 2-mesiodenses to be 23.8%, and 3-mesiodenses to be 0.2%. 3. In mesiodenses according to erupted and impacted status, the erupted mesiodens was found to be 16.5%, the impacted mesiodens in the interdental alveolar bone to be 66.6%, and in the region below root apex to be 16.9%. 4. In impacted mesiodenses according to direction of tooth crown, the inverted impaction was found to be 68.8%, the vertical impaction to be 15.1%, and the angulated impaction to be 16.1%. Among the impacted mesiodenses, a palatally located impaction was 87.5%, a middle 4.9%, and a labially 7.6%. 5. In mesiodenses according to shape of the tooth crown, a incisor-like type was found to be 1.6%, a canine-like type to be 6.8%, a conical type to be 79.2%, and a tuberculated type to e 12.4%. 6. In effect of mesiodens on adjacent tooth, non-specific influences were found to be 73.4%, crowding to be 0.3%, diastema to be 11.8%, rotation to be 5.7%, delayed eruption to be 3.8%, root resorption to be 2.6%, and dentigerous cyst to be 2.4%.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.4
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• pp.644-651
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• 1999

It is a relatively common clinical experience to see an unerupted maxillary central incisor. This phenomenon is apparent at the dental age of almost eight years and over. Among the possible cause for failure of eruption, ectopic development of the tooth germ is mentioned. This is not fully understood but trauma or periapical imflammation of primary predecessors is accepted. The case with no history of trauma may be impacted by the periapical imflammation of primary predecessors. For bringing into the tooth eruption and the continued normal root developement by the Hertwig's epithelial root sheath, there are early considered of surgical invention and orthodontic traction with removable appliance. We reported successful treatment for inverted maxillary central incisor with proper eruption and normal root developement by forced eruption using removable appliance. But further observation will be required to evaluate the final root developement state and amount of keratinized attachment gingiva.

• 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.

• Imaging Science in Dentistry
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• v.40 no.3
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• pp.109-114
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• 2010

Purpose : This study was performed to analyze the position, pattern of impacted mesiodens, and their relationship to the adjacent teeth using Dental cone-beam CT. Materials and Methods : Sixty-two dental cone-beam CT images with 81 impacted mesiodenses were selected from about 2,298 cone-beam CT images at Chonnam National University Dental Hospital from June 2006 to March 2009. The position, pattern, shape of impacted mesiodenses and their complications were analyzed in cone-beam CT including 3D images. Results : The sex ratio (M : F) was 2.9 : 1. Most of the mesiodenses (87.7%) were located at palatal side to the incisors. 79% of the mesiodenses were conical in shape. 60.5% of the mesiodenses were inverted, 21% normal erupting direction, and 18.5% transverse direction. The complications due to the presence of mesiodenses were none in 43.5%, diastema in 19.4%, tooth displacement in 17.7%, delayed eruption or impaction in 12.9%, tooth rotation in 4.8%, and dentigerous cyst in 1.7%. Conclusions : Dental cone-beam CT images with 3D provided 3-dimensional perception of mesiodens to the neighboring teeth. This results would be helpful for management of the impacted mesiodens.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.1
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• pp.90-96
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• 2012

Supernumerary tooth occurs most frequently at premaxilla area. Followed by mandibular premolar area, mandibular fourth molar area, maxillary paramolar area. Mesiodens are mainly impacted in the palatal area and surgical approach is made at palatal side. The time of surgery remains controversial. In case of inverted or horizontal impacted supernumerary tooth, intraosseous tooth movement and vertical growth of premaxilla makes surgical extraction more difficult. And also the more quantity of removed bone is, the higher degree of difficulty is. Inverted mesiodens of these cases were impacted superior to apex level of adjacent permanent incisor. Although CT examination revealed exact location of impacted tooth, surgical procedure including ostectomy may take a long time more than expected. So, before surgical extraction, it's need to be considered several factors such as necessity of CT taking, degree of difficulty, direction of surgical approach, necessity of general anesthesia etc.