Importance of the surgical extraction of impacted, supernumerary teeth and mesiodens at the national school hospital of Honduras

Abstract

Supernumerary teeth are developmental dental anomalies characterized by the presence of additional teeth beyond the normal number, occurring in either the primary or permanent dentition, and are more frequent in the maxilla. Their origin is multifactorial and includes genetic factors, hyperactivity of the dental lamina, and embryonic alterations. These dental pieces can vary in number, shape (conical, tuberculate, or molariform), and location. The mesiodens, located between the upper central incisors, is the most common type and generally appears in male patients, with a conical shape and without spontaneous eruption. The presence of supernumerary teeth can cause complications such as crowding, interference with tooth eruption, displacement, cyst formation, and aesthetic or functional alterations. Therefore, early diagnosis through radiographs or tomography (CBCT) is essential to plan appropriate treatment. Surgical extraction is the most common treatment, especially in specialized institutions such as the Hospital Escuela of Honduras.In the presented case, the surgical removal of an impacted mesiodens between the upper incisors, inclined toward the right side, as well as a second supernumerary tooth located in the palate over the midline suture, is documented. Both teeth were in ectopic positions with functional implications. The intervention was performed under general anesthesia in the Oral Surgery Service of the Hospital Escuela, following established protocols that included radiographic studies, intraoral scanning, and interdisciplinary preoperative planning. This comprehensive approach ensures better clinical outcomes in complex cases of dental anomalies.