• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.1
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• pp.77-82
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• 2011

A long-term follow-up study of a case of impacted teeth associated with a large dentigerous cyst in the left maxilla is presented. The patient was a 30-year-old man who had a large dentigerous cyst in the premaxilla and left posterior maxilla, which impacted the canine and supernumerary tooth. This is one of the most prevalent types of odontogenic cysts associated with an erupted or developing tooth, particularly the mandibular third molars. The other teeth commonly affected in order of frequency are the maxillary canines, maxillary third molars and rarely, the central incisor. Radiographically, the cyst appears as huge ovoid well-demarcated unilocular radiolucency with a sclerotic border and causes ectopic displacement of the inferior border of the maxillary sinus without destruction. Dentigerous cysts may grow unnoticed to such extensive sizes as to occupy a considerable portion of the maxillary sinus. These cysts appear to be associated with a supernumerary tooth in the maxillary anterior incisors region called the mesiodens and impacted canine. The present case report describes the surgical enucleation of a dentigerous cyst involving the permanent maxillary left canine and mesioden. After surgery, left maxillary sinus recovered their normal size and apposition of bone was observed around the apex of the posterior teeth. During the subsequent years, there was no recurrence of the cystic lesion but the inflammation was evoked in the anterior maxilla after 42 months. This complication appeared to have correlated with bony healing in the enucleation site of the cyst. We report the healing status of a huge dentigerous cyst in the maxilla for 5 years with a review of the relevant literature.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.2
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• pp.180-186
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• 2014

One or two mesiodens are mostly common to the clinician. However, three mesiodens is rarely found and can cause complications such as orthodontic problems or interruptions of the adjacent teeth with more than 1 or 2 mesiodens. Many factors cause irregularities in the permanent dentition. Mesiodens, especially in the anterior maxilla, can disturb the eruption of adjacent permanent teeth and cause diastemas, ectopic eruptions, root resorption, or the formation of dentigerous cysts. The early diagnosis of mesiodens is important for preventing such complications, and the timing of intervention should be based on their location and number. Periodic checkups and improved diagnostic devices make it easy to find mesiodens and associated complications. In this case, 3 supernumerary teeth in the maxillary anterior region were affecting the eruption of the adjacent permanent incisors. To minimize complications and preserve the deciduous teeth, the three supernumerary teeth were extracted in 2 steps. Since cone-beam computed tomography was not available, a brace wire was used to measure the depth of the mesiodens.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.4
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• pp.260-267
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• 2013

The aim of this study was to analyze the three dimensional characteristics of the size, shape and location of mesiodens and their effect on permanent teeth arrangement using Cone-beam computed tomography(CBCT). 191 patients under 15 years old who had visited the hospital between June 2006 and December 2012 and taken CBCT were investigated. Among them, 43 patients with diastema were analyzed to investigate the correlation between the amount of diastema and the mesiodens. The results showed that mesiodens were found in males 3.9 times more than females and found most in 7 years old. The mean length of mesiodens was 13 mm and the width was 6.8 mm. The conical shape comprised of 52.9%. Many mesiodens were located in the palatal side rather than the labial side and located vertically near the crown. 63.0% of mesiodens were reversed and the common complications were delayed eruption followed by diastema, and teeth rotation. And the amount of diastema had correlation with size and mesiodistal position of the mesiodens. The current study used 3D analysis to show the size and position of mesiodens and occurrence distribution of complication. Among these, the amount of diastema had shown the correlation with the size and mesiodistal position of mesiodens.

• 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.27 no.4
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• pp.490-493
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• 2000

Mesiodens are supernumerary teeth in the region of the maxillary central incisors, a condition which can lead to disorders of the dentition. Their presence may lead to disorders, such as delay in eruption of permanent teeth, development of dentigerous cysts, resorption of adjacent roots and eruption of a supernumerary tooth into nasal cavity. The optimal time for surgical intervention is controversial. Early diagnosis is important so as to enable good prognosis. Diagnosis primarily depends on x-ray films. Panorama film, occlusal film, periapical film have been used for detection of mesiodens. But, all of them have disadvantages. $SCANORA^{(R)}$ is a multimodal radiology system which utilizes the principles of narrow beam radiology and spiral tomography. Pre-programmed imaging procedure are provided for many dental situations An optional personal computer can be connected into the unit to help design the examination. We report two cases diagnosed by $SCANORA^{(R)}$. When compared with tube shift technique, it is simple and exact method of detecting mesiodens.

• The Journal of the Korean dental association
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• v.22 no.8 s.183
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• pp.699-703
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• 1984

The author surveyed on the maxillary median diastema of 1,522 (male: 805, female:717) 'H' and 'K' primary school children aged from 6 to 13. The results were as follows: 1. The prevalence of the maxillary median diastema was 11.6% in male, 7.5% in female and 9.7% in both sexes. 2. The prevalence of the maxillary median diastema showed the highest rate in 8 years old boys and girls, and it showed decreasing tendency according to increasing ago. 3. The prevalence of mesiodens was 0.4%, and boys had higher rate than girls. 4. Mean value of 'Frenum Distance' was 5.7mm in male, 5.5mm in female and mean value of 'Divergent Degree' was 2.0mm in male, 1.6mm in female.

• The Journal of the Korean dental association
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• v.19 no.12 s.151
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• pp.1039-1044
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• 1981

The author surveyed on maxillary median diastema of 1440 (male: 740, female:700) 'Y' primary school children aged from 6 to 12 and obtained the following results. 1. The prevalence of maxillary median diastema was 16.08% in male, 14.00% in female and 15.07% in both sexes. 2. The prevalence of maxillary median distema showed the highest rate in 8 years old children (male: 29.55%, female: 34.83%) and it showed decreasing tendency according to increasing age. 3. The prevalence of mesiodens was 0.79% and boys had higher rate than girls. 4. Mean value of 'Divergent degree' was 20.6mm in male, 20.5mm in female and mean value of 'Frenum distance' was 4.08mm in male, 41.1mm in female.

• The Journal of the Korean dental association
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• v.16 no.1 s.104
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• pp.37-42
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• 1978

A study on the impacted teeth of the anterior segment was carried out. The data for this study were compiled form 1739 outpatients of the Department of Orthodontics, College of Dentistry, Seoul National University. The following conclusions were obtained; 1. The frequency of the impacted teeth of the anterior segment was 2.8% and the frequency of male was 4.0%, that of female was 2.1%., respectively. 2. The order of occurrence of the impacted teeth in the anterior segment was maxillary canine mesiodens, maxillary central incisor, maxillary lateral incisor, mandibular canine. 3. The etiologic factors of the impaction were the space deficiency for eruption, cleft palate, the prolonged retention of deciduous teeth, dentigerous cyst. 4. The favorable results of treatment and prognosis were obtained from the impacted teeth of the normal shape after surgical exposure and adhered the plastic attachment and inducted them into the dental arch.

• The Journal of the Korean dental association
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• v.21 no.10 s.173
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• pp.829-833
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• 1983

The author surveyed on the maxillary median diastema of 1,686(male; 850, female; 836) 'H' and 'K' primary school children aged from 6 to 13. The results were as follows : 1. The prevalence of the maxillay median diastema was 12.6% in male, 7.9% in female and 10.3% in both sexes. 2. The prevalence of the maxillary median diastema showed the highest rate in 9 years old boys and 8 years old girls, and it showed decreasing tendency according to increasing age. 3. The prevalence of mesiodens was 0.6% and boys had higher rate than girls. 4. Mean value of 'Frenum Distance' was 5.8mm in male, 5.7mm in female and mean value of 'Divergent Degree' was 2.0mm in male, 1.6mm in female.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.1
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• pp.46-53
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• 2001

The prevalence of supernumerary teeth is between $1{\sim}3%$. Of these, $90{\sim}98%$ occur in the maxilla with particular predilection for the premaxilla, preceded by mandibular third premolars, mandibular forth molars and maxillary paramolars. The most common ones occur in the maxillary anterior region, they may occur singly between the central incisors(mesiodens), or they may be double(mesiodentes). Maxillary anterior supernumeraries may erupt into the oral cavity or remain unerupted. It is found that approximately 25% are erupted, while the rest are unerupted. They are usually a small tooth with a cone-shaped crown and a short root. They may cause delayed eruption, median diastema, bodily displacement or rotation of the adjacent permanent teeth. Occasionally they may lead to the developement of dentigerous cyst or primordial cyst, or eruption into nasal cavity. In this study, 109 supernumeraries surgically extracted from premaxilla in 84 patients are analysed. The results are as follows : 1. Sex distribution of male and female is 2.2 : 1. 2. Almost cases are in pediatric age from 5 to 12 years old (87%). 3. Problems with supernumeraries are tooth malpositon, diastema, delayed eruption, eruption to nasal cavity and cyst formation. 4. Of 109 supernumeraries, 16(15%) are erupted into oral cavity, 92(84%) are impacted, and 1(1%) is erupted into nasal cavity. 5. Of 84 patients, 59(70%) have one supernumeray while 25(30%) have two supernumeraries. 6. Of 109 supernumeraries, 96(88%) are found within the region of the central incisors. 7. Of 109 supernumeraries, 94(86%) are vertically impacted, 11(10%) are horizontally impacted, 3(3%) are labiopalatally impacted and 1(1%) is impacted in nasal cavity. 8. Of 84 patients, we used palatal flap in 67(80%), labial flap in 6(7%), both flaps in 4(5%) and no flap in 7(8%). And incisive nerve was cut in 33(49%) of 67 palatal flaps. 9. Extration with ostectomy was done in 72 supernumeraries(66%), without ostectomy in 37 teeth(34%). 10. Extraction with tooth sectioning was done in 21 supernumeraries(19%), without tooth sectioning was done in 88 teeth(81%). 11. We used local anesthesia in 70 patients(83%) and general anesthesia in 14 ones(17%).