A labially positioned mesiodens and its repositioning as a missing central incisor

Area of Science:

• Pediatric Dentistry
• Orthodontics
• Oral Surgery

Background:

• Hyperdontia involves an excess number of teeth, frequently impacting the anterior maxillary region as a mesiodens.
• Early diagnosis by pediatric dentists is crucial, as these supernumerary teeth are often impacted and detected radiographically.
• Traditional treatment involves early extraction, which can be complex, especially with associated dental anomalies.

Observation:

• An unerupted, labially placed mesiodens was diagnosed in conjunction with a dilacerated and impacted permanent tooth.
• The patient presented with a missing left central incisor, causing aesthetic concerns.
• Conventional palatal extraction was deemed unsuitable for this specific labial presentation.

Findings:

• A multidisciplinary approach successfully treated the unerupted mesiodens.
• Surgical exposure via a labial approach allowed for orthodontic guidance of the mesiodens into the central incisor position.
• The malformed permanent incisor was extracted, and the guided mesiodens was restored with composites for function and aesthetics.

Implications:

• This case highlights the potential to conserve and utilize a mesiodens as an alternative to extraction and prosthetic replacement.
• Deviating from traditional early extraction can offer favorable aesthetic and functional outcomes in select hyperdontia cases.
• A multidisciplinary approach is vital for managing complex presentations of hyperdontia with associated dental anomalies.