A 13-year-old patient with no relevant past medical history was referred for dental examination.
At 10 years he had to go for not exfoliating the second left temporal molar.
An orthopantomography showed agenesis of the left lower second premolar and a mesiodens in the upper arch.
Regular monitoring was recommended.
At the time of diagnosis, temporary molar persistence was observed.
The previous sector is erupted correctly.
Mesiodens has not caused any abnormality in the position of the upper limbs.
The orthopantomography shows mesiodens included in a slight compression apex, with the cusp located between the central and lateral roots of the left upper roots, at the level of 1/3.
At the age of 16, the patient presented caries in the temporal molar.
We requested a new X-ray to assess whether the molar can be obturated, control the supernumerary and assess the cords.
In the orthopantomography we observed mesiodens in the midline, slightly more verticalized, but without significant changes in its position compared to previous radiographs.
We decided to continue conducting periodic supernumerary controls and referred him to maxillofacial surgery for extraction of the lower cords due to lack of space for eruption.
We recommend temporary molar obturation.
