Mesiodens

Background: A mesiodens, is the most frequent supernumerary tooth present in the maxillary central incisor region. This study is conducted to know the radiographic characteristics and management of mesiodens in children visiting hospital.

Methods: A cross-sectional retrospective data collection was done from hospital dental records of children who visited the institution from December 2015-December 2016. Radiographic characteristic of mesiodens including the number, shape, position, direction of crown and complication caused by mesiodens were recorded. Data were analyzed using IBM SPSS v.20.0.

Results:  Out of 1871 dental records, it was found that 40 children had 53 mesiodens, with male female ratio of 3:1 and most of them were discovered at 8 years. Majority of mesiodens, 54.7% were erupted, conical, palatally placed with 77.3% vertically directed crown.Complications associated with it were crowding followed by diastema and delayed eruption. Among 40 children, one had three mesiodens, eleven had two mesiodens and rest had one each. Radiographically fully formed tooth was seen in 29 mesiodens. Immature apex was seen in 38 central incisors associated with mesiodens. Management undertaken was simple/surgical extraction and only few cases were kept for periodic observation.

Conclusions: Periodic radiographs act as an important tool for clinicians in detecting and managing mesiodens.

Keywords:  Children; complications; extraction; Kathmandu; mesiodens; radiograph.

Objectives: Mesiodens are the most common supernumerary teeth, occurring in 0.15% to 2.2% of the population.
The aim of the present study was to analyze the frequency and radiological features of mesiodens in the pediatric
population.
Material and methods: The study was based on the radiographic evaluation of 4133 pediatric patients of the age
range of 4-15 years, attending the Department of Oral Medicine and Radiology during the time period between
September 2008 to December 2012. In addition to the presence of a supernumerary tooth between the 2 central
incisors, data regarding the number, position, shape and associated complications were also recorded.
Results: The prevalence of mesiodens in the present study was 1.4%. The prevalence was estimated using a 95%
confidence interval. The ratio of boys to girls was 1.8:1 and majority of cases (89.7%) had 1 mesiodens. Most of
the mesiodens (59.6%) were aligned in a vertical position. 39 mesiodens (62.9%) were impacted, while 14 (22.6%)
were partially erupted and only 9 (14.5%) were completely erupted into occlusion. The main complication associated
with the mesiodens was midline diastema (28.6%) and 16 patients were asymptomatic.
Conclusion: Mesiodens can result in spacing in the arch, delayed or ectopic eruption of the permanent incisors,
further altering the occlusion and esthetics of the patient or may remain asymptomatic. It is therefore important for
the practitioners to diagnose a mesiodens early in development to allow for optimal treatment plan.