• 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.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.42
• /
• pp.30.1-30.7
• /
• 2020

Background: Dental studies of precocious puberty have focused on examination of jaw and dentition growth. The aim of the study was to analyze the relationship between precocious puberty and maxillary dental developmental abnormalities (DDAs). Methods: This retrospective study was conducted on the Korean patients in whom dental panoramic and hand-wrist radiographs had been taken before they were 15 years of age. The maxillary DDAs were assessed as mesiodens, congenital missing teeth, peg-shape lateral incisors, or impacted teeth. The chronological ages of the control group members were within the normal range of the hand-wrist bone age. Others with a peak luteinizing hormone of ≥ 5 and < 5 IU/L were allocated to central precocious puberty (CPP) and peripheral precocious puberty (PPP), respectively. Results: Of the enrolled 270 patients, 195, 52, and 23 were allocated to the control, CPP, and PPP groups, respectively. The maxillary DDAs were significantly more prevalent in the CPP group than in the other groups. Among those with maxillary DDA, the mesiodens predominated. Age- and sex-adjusted multivariate analysis revealed maxillary DDA (odds ratio, 3.36; 95% CI, 1.60-7.05) and especially mesiodens (odds ratio, 5.52; CI, 2.29-13.28) to be significantly associated with CPP. Conclusions: Maxillary DDAs were significantly more prevalent in the CPP group than in the PPP or control groups. Among the many types of maxillary DDAs, mesiodens was significantly associated with CPP and may be considered a predictor of the development of CPP.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.4
• /
• pp.630-635
• /
• 2004

The etiology of mesiodens is unknown but the most widely accepted theory is the hyperactivity of the dental lamina. Complications of mesiodens are delayed or prevented eruption of maxillary central incisors, displacement or rotation of permanent teeth, crowding of affected region, abnormal diastema or permanent space closure, dilaceration or abnormal root development of permanent teeth, primordial or follicular cyst formation, root resorption of adjacent teeth, eruption into nasal cavity. If mesiodens rotate the maxillary central incisors, space deficiency is not common and relapse is very common. So overcorrection is needed. To prevent the rotational relapse, early treatment, overcorrection, long retention period, properly formed proximal surface, use of coupled force, and surgical techniques have been suggested. The authors present two cases, whose chief complain were severely rotated maxillary incisors by mesiodens, treated by orthodontic and surgical technique and showed good results.

• 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.

• Imaging Science in Dentistry
• /
• v.40 no.2
• /
• pp.69-74
• /
• 2010

Purpose : The research was performed to predict the three dimensional relationship between the impacted mesiodens and the maxillary central incisors and the proximity with the anatomic structures by comparing their panoramic images with the CT images. Materials and Methods : Among the patients visiting Seoul National University Dental Hospital from April 2003 to July 2007, those with mesiodens were selected (154 mesiodens of 120 patients). The numbers, shapes, orientation and positional relationship of mesiodens with maxillary central incisors were investigated in the panoramic images. The proximity with the anatomical structures and complications were investigated in the CT images as well. Results : The sex ratio (M : F) was 2.28 : 1 and the mean number of mesiodens per one patient was 1.28. Conical shape was 84.4% and inverted orientation was 51.9%. There were more cases of anatomical structures encroachment, especially on the nasal floor and nasopalatine duct, when the mesiodens was not superimposed with the central incisor. There were, however, many cases of the nasopalatine duct encroachment when the mesiodens was superimpoised with the apical 1/3 of central incisor (52.6%). Delayed eruption (55.6%), crown rotation (66.7%) and crown resorption (100%) were observed when the mesiodens was superimposed with the crown of the central incisor. Conclusion : It is possible to predict three dimensional relationship between the impacted mesiodens and the maxillary central incisors in the panoramic images, but more details should be confirmed by the CT images when necessary.

• Imaging Science in Dentistry
• /
• v.42 no.4
• /
• pp.255-260
• /
• 2012

Dentigerous cysts are the most common developmental cysts of the jaws, most frequently associated with impacted mandibular third molar teeth. Dentigerous cysts around supernumerary teeth, however, account for 5% of all dentigerous cysts, with most developing around a mesiodens in the anterior maxilla. This report describes two cases of a dentigerous cyst associated with an impacted mesiodens. Both of the patients complained of swelling in the maxillary anterior region. Radiographic examination revealed an impacted mesiodens surrounded by a large corticated radiolucency in both cases. A provisional diagnosis of infected odontogenic cyst was made. The cysts were enucleated with the removal of the mesiodens in the two cases. Histopathological examination confirmed the diagnosis of infected dentigerous cyst associated with an impacted mesiodens in both cases. The patients remained asymptomatic, and no complications were noted.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.24 no.4
• /
• pp.727-733
• /
• 1997

Autotransplantation is a procedure which transplants teeth from the original position to other positions in the same individual. It is classified surgical reposition by intraalveolar autotransplantation and transalveolar autotransplantation. The prognosis for successful autotransplantation is dependent on a number of factors such as root development, surgical technique, patient's age, endodontic treatment, time and type of splinting, preservation of periodontal ligament and storage medium. The most important factor is preservation of periodontal ligament. The cause of the failure of transplantation include damage of the transplant during removal from deep palatal malposition, poor regeneration of the bone around the transplant and chronic periodontal infection. In case I, Impacted maxillary canine for which surgical exposure and orthodontic treatment was impossisle was transplanted. After 2 weeks, It showed periapical radiolucency and external root resorption. So, endodontic treatment was done. One year later, permanent filling was done with gutta percha. In case II, Transpositioned maxillary central incisor was transplanted after extraction of impacted mesiodens. Pulp vitality was maintained during 5 months without other clinical symptons.

• 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 Korean Dental Science
• /
• v.16 no.1
• /
• pp.63-73
• /
• 2023

Purpose: Hyperdontia is a developmental disorder of the oral cavity. Mesiodens refers to the hyperdontia located between the maxillary central incisors. During the surgical procedure, the anesthetic method for pain control should be considered along with factors related to the surgery itself. The purpose of this study was to evaluate the effect of the impacted position of the mesiodens on the selection of sedation method and to suggest incisive foramen as a brief reference. Materials and Methods: This study included 126 patients who were scheduled for extraction of mesiodens. The selection criteria included patients with one palatally impacted inverted mesiodens accessible from the palatal gingival margin, and those with good cooperation potential in order to control for clinical information. Using cone beam computed tomography, vertical, horizontal, and palatal positional factors were measured, and the anesthetic method was determined by two examiners. The patients were grouped into vertical and horizontal groups based on the position of the incisive foramen. Data were statistically analyzed using the Mann-Whitney test, the chi-square test, and logistic regression analysis. Result: All positional factors differed between the outpatient and inpatient anesthetic groups. The vertical minimum distance from the alveolar ridge to the mesiodens (Va) and the minimum distance from the palatal surface to the crown tip of the mesiodens (Tc) were factors affecting the choice of anesthetic method. The distribution of the vertical and horizontal positional groups differed between the outpatient and inpatient anesthetic groups. Conclusion: The incisive foramen can be used as a brief reference to determine the appropriate anesthetic method. Referral for inpatient anesthesia may be a priority if they are in the V₂H₂ group with Va ≥5 mm, and Tc ≥6 mm, and outpatient sedation may be considered if they are in the V₁H₁ group with Va ≤1.5 mm, and Tc ≤2.5 mm.

• 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.