A 6-year-old male patient with no relevant past medical history came for a review to the dental office.
The intraoral examination revealed exfoliation of the upper four quadrants without erupting any of the definitive ones.
In fixation, a tumefaction was observed in the vestibular cortical bone corresponding to the crowns of the upper central incisors, but these were located very apart from the midline.
An orthopantomography was requested to assess the position and state of eruption of upper teeth.
The X-ray showed the presence of two mesiodens in the midline.
The right side was in a more apical position and was larger than the left.
Both were in a vertical position and had a conoid shape.
They caused a large interincisal diastema and prevented the correct eruption of the upper central sites.
The mother was informed about the need to extract supernumerary teeth for the correct dental eruption of the anterior sector, and the patient was referred to the maxillofacial surgery service for surgical extraction.
Before surgery, the patient developed a 1/3 eruption of the left superior crown and the left mesiodens cusp.
The maxillofacial surgery service decides to perform the intervention in two phases: first performs the surgical extraction of the left mesiodens and perform the right one when it has a lower position.
The patient will need periodic controls to control the dental eruption and assess the need for a posterior orthodontic treatment to close the interincisal diastema and also allow upper eruption of the laterals.
