Surgical treatment of mesiodens in a pediatric patient. Case Report

Abstract

Introduction: Supernumerary teeth are defined anomaly in dental development that may not be associated with syndrome, presenting increased number of teeth. Depending on its shape, is classified as: Supplemental eumorphic rudimentary dysmorphic: Conical, tubercular and molariform teeth. They are classified according their location: Mesiodens, paramolar and distomolar. Its prevalence 0.3%-3.8%, and its incidence 0.1%-3.8% depending the population studied. occurs more in men with 2:1 ratio. They are diagnosed by means of periapical and panoramic radiographs and computerized axial tomography that allow knowing their location and relationship with anatomical structures. They can cause complications such as retained teeth, ectopic eruption, functional problems, gaps, dental malposition, occlusal problems, rotations. Objective: To present a surgical alternative for the approach and extraction of a mesiodens. Presentation of the case: A 12-year-old male comes the clinic for general check-up. Systemically healthy. Clinically, gyroversion of the dental organ 1.1 is observed. In routine radiographic evaluation, the mesiodens was found in an inverted position with close relation to the floor of the nasal cavity. The surgical procedure was performed under local anesthesia, performing vestibular triangular flap, osteotomy to locate and remove. Vicryl suture was placed with simple stitches and hemostasis with sterile gauze. Postoperative control is performed a week later and the suture was removed, presenting good healing. Conclusions: The role  the pediatric dentist is to make a correct diagnosis for an adequate treatment according to the patient. Surgical treatment is planned according to the location, its relationship with anatomical tissues, age and behavior of the patient.