mesiodens
A mesiodens (plural: mesiodentes) is the most common supernumerary tooth and is located in the palatal midline between the two maxillary central incisors.
Epidemiology
It is rare with an estimated prevalence of ~1% (range 0.09 to 2.2%) . There is an increased male predilection with a M F ratio of ~2.5:1.
There is some geographical variation in prevalence ranging from 0.4% in Caucasians, 1.4% in Finnish and 2.2% in Hispanics.
Pathology
- occur as single (85% of cases), multiple, unilateral or bilateral
- more commonly seen in permanent dentition than primary dentition
Etiology
- possible causes include
- restricted increase in the activity of the dental lamina (hyperactivity theory)
- splitting of the tooth bud into two equal or unequal sections (dichotomy theory)
Genetics
An x-linked inheritance documented.
Associations
- it is often an isolated finding
- may be part of a syndrome:
Radiographic features
- classified into eumorphic (similar to a normal-sized central incisor) and dysmorphic
- three common dysmorphic shapes
- conical or peg shaped (most common ~70%)
- tuberculate (more than one cusp or tubercle)
- supplemental (duplication of a normal tooth)
- 55% grow in the downward position (35% are inverted and 7% are horizontal)
- most remain impacted but 25% will erupt (usually eumorphic or conical shape)
Treatment and prognosis
- immediate extraction if there is a complication
- early extraction before root formation of the permanent incisors
- late extraction after root formation of the permanent incisors
Complications
- impaction or delayed eruption of adjacent incisors
- widening of the gap between the incisors (diastema)
- axial rotation or inclination of erupted permant incisors
- abnormal curving of teeth (dilaceration)
- resorption of adjacent teeth
- development of dentigerous cysts (5%)
- eruption into the nasal cavity
Siehe auch:
Assoziationen und Differentialdiagnosen zu mesiodens:
