An evaluation of mesiodentes: A retrospective study with cone-beam computed tomography

Abstract

Background: The mesiodens, located in the palatal midline between the two maxillary central incisors, is the most common type of supernumerary tooth. The aim of this study was to evaluate the distribution of mesiodentes according to shape, position, and complications using cone-beam computed tomography (CBCT) images. Methods: This study was carried out retrospectively on the CBCT images of cases. The following data were recorded: age, gender, number, shape (conical, incisor, tuberculate, round), size (less than 8 mm, 8-16 mm, and over 16 mm), direction (vertical, semi-vertical, horizontal, inverted), position (impacted or erupted) of the mesiodens, any pathologies or complications (delayed eruption of adjacent tooth, root resorption, cystic formation, diastema, displacement of adjacent tooth) and relation with neighboring anatomical structures (nasal cavity, nasopalatine canal). Results: The age distribution of the patients ranged from 7 to 61 years; mean 16.8±14.2 years. In total, 65 mesiodens were seen in 50 patients. The results showed that; mesiodentes were observed in the form of an incisor tooth (38.5%) mostly, followed conical shape (33.8%). A majority of the mesiodentes were in vertical direction (38.5%) and impacted (92.3%) in the CBCT images. Thirty-six patients (72%) had one mesiodens, 13 patients (26%) had two, and one patient (2%) had three mesiodentes. The most common complication was delayed eruption (29.2%). No complications were found in 49.2% of the cases. Sixteen cases (24.1%) were associated with the nasal cavity, while 43 cases (66.1%) were associated with the nasopalatine canal. Conclusion: Radiographic examination, especially with CBCT images, is important for an exact diagnosis, evaluation, and management of mesiodens.