Maxillary impacted mesiodentes in unusual positions: Two case reports

Area of Science:

• Dentistry
• Oral and Maxillofacial Surgery
• Radiology

Background:

• Mesiodens are the most frequent supernumerary teeth, but unusual presentations like multiple formations or nasal cavity eruption are rare.
• Management strategies for mesiodens, especially in asymptomatic individuals, are not definitively established.

Purpose of the Study:

• To present two exceptional cases of mesiodens with rare anatomical variations.
• To evaluate the efficacy of conservative management and cone-beam computed tomography (CBCT) in diagnosing and monitoring mesiodens.

Main Methods:

• Detailed case reports of two patients with asymptomatic mesiodens: one with multiple palatal formations, the other with nasal cavity eruption.
• Utilized cone-beam computed tomography (CBCT) for precise diagnosis, anatomical assessment, and treatment planning.
• Employed a conservative 'watchful waiting' approach with regular clinical and radiological follow-up for both cases.

Main Results:

• CBCT enabled detailed evaluation of root development and anatomical relationships, aiding in complication exclusion.
• Conservative management was successfully implemented in both asymptomatic patients.
• No adverse outcomes or complications were observed during the follow-up period.

Conclusions:

• Conservative management, including CBCT-based monitoring, is a safe and viable alternative to surgery for selected asymptomatic mesiodens.
• Individualized, patient-centered decision-making is crucial for managing rare mesiodens presentations.
• CBCT is an indispensable tool for the diagnosis and management planning of complex mesiodens cases.