Management of a maxillary central incisor impacted by a supernumerary tooth

Supernumerary teeth in the maxillary midline are common and can present both esthetic and pathologic problems that can be extremely difficult to solve. Early detection of the mesiodens is most important if such complications are to be avoided. This case required both surgical and orthodontic treatment to bring an unerupted, impacted maxillary central incisor into position. Using a combination of conservative surgical treatment and careful orthodontic management, the tooth was brought into good position in the dental arch and injury to root structure and surrounding oral tissues was avoided.