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Objective @#To explore the related factors for the unilateral flap and bilateral flap by changing the original operation plan in the extraction of maxillary impacted mesiodens. @*Methods @#81 patients with impacted mesiodens in the middle of the maxillary were retrospectively analyzed. The primary outcome variables were planned surgery (unilateral flap)and unplanned surgery (bilateral flap) . The secondary outcome variables consisted of operation time and postoperative swelling. The predictive variables were as follows:the differential value of the shortest distance from the supernumerary tooth to the labial and palatal bone plates , which was divided into≥1. 5 mm group and < 1. 5 mm group ; the ratio of the distance from the adjacent tooth apex to the nasal floor, compared to the length of the supernumerary teeth , was recorded as≥1 and < 1 . A statistical software SPSS 20 was used to complete the statistical analysis. @*Results @#When the differential value was less than 1. 5 mm , the possibility of unplanned surgery increased , and the probability of planned surgery was 0. 085 times than that of unplanned surgery. With age growing each 1 ⁃year, the probability of planned surgery gradually decreased , HR = 0. 745. The postoperative swelling of the palatal approach was only 0. 374 times than that of the labial approach. With age increasing , the operation time increased gradually , B = 1. 213. The ratio of the distance from the adjacent tooth apex to the nasal floor to the length of the supernumerary teeth did not affect the change of the surgical plan during the operation. @*Conclusion @#The shortest distance difference between the supernumerary teeth and the labial and palatal bone plates can be used as a reference for the selection of surgical approach for the extraction of maxillary impacted mesiodens.
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Objective@# To discuss the correlation between the extraction timing of mesiodens and the orthodontic treatment duration of its eruption-related complications in children to provide a reference for the clinic.@*Methods @#The mesiodentes of 187 children were classified as eruption type (typeⅠ), dental crown impacted type (type Ⅱ), interdental impacted type (type Ⅲ), and dental root impacted type (type Ⅳ). According to the timing of extraction, mesiodentes in typeⅠ, type Ⅲ, and type Ⅳ were divided into Groups A: before the eruption of the adjacent central incisor and B: after the eruption of the adjacent central incisor. Mesiodentes in type Ⅱ were divided into Group A: before the eruption of the contralateral central incisor and B: after the eruption of the contralateral central incisor. Eruption-related complications and orthodontic treatment durations caused by mesiodens were statistically analyzed. @*Results @# There were 106 cases of displacement, 28 cases of failed eruption, 27 cases of tooth rotation, and 26 cases of individual cross-bite among the eruption-related complications caused by mesiodens. The mean orthodontic treatment cycle in Group A of type Ⅰ (7.07 ± 2.45 month), Group A of type Ⅱ (6.57 ± 1.12 month), and Group A of type Ⅲ (6.95 ± 2.52 month) were lower than that in Group B of type Ⅰ (9.67 ± 3.04 month), Group B of type Ⅱ (10.25 ± 1.29 month), and Group B of type Ⅲ (9.33 ± 3.26 month), and the differences were statistically significant (P<0.01). Meanwhile, there was no significant difference in the mean orthodontic treatment duration between Groups A (6.00 ± 0.94 month) and B (6.33 ± 0.80 month) of type Ⅳ (P>0.05).@*Conclusion@# In most cases, the mesiodens are removed before the eruption of the adjacent central incisor, which can reduce the duration of orthodontic treatment for eruption-related complications in children.
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The aim of this study was to evaluate and compare the microstructural properties and mineralization quality of mesiodens with permanent and primary central incisors.Fifteen mesiodens, permanent and primary central incisors were collected. The enamel rod diameter and enamel thickness were observed and measured using field emission scanning electron microscope (FE-SEM). Chemical composition of the enamel was analyzed using energy dispersive X-ray spectrometer (EDS). The measurements were then assessed using the one-way ANOVA and Tukey test.There was no statistically significant difference in the enamel rod diameter between mesiodens and permanent central incisors. However, enamel rods of primary central incisors were smaller than remaining two groups. The thickness of enamel was thick in order of permanent central incisors, mesiodens, primary central incisors. In the composition analysis using EDS, there was no difference in the Ca/P ratio and Ca/C ratio between mesiodens and permanent central incisors, but small in primary central incisors.In conclusion, the microstructural properties of mesiodens were more similar to those of permanent central incisors compared to primary central incisors. Futher, the mineralization quality of mesiodens did not differ significantly from that of permanent central incisors.
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Esmalte Dentário , Incisivo , MineradoresRESUMO
Se presenta el caso de un paciente de sexo femenino, de 8 años 9 meses de edad, que acude al Centro Odontológico de la Universidad Científica del Sur por ausencia de un incisivo central, madre refiere como antecedente trauma en la dentición decidua. Fue evaluada clínicamente y se le solicitaron radiografías panorámica y cefalométrica, las cuales evidenciaron la presencia de un mesiodens el cual ocasionaba la impactación del incisivo central superior. Dadas las condiciones de la pieza se optó por un tratamiento quirúrgico en dos pasos acompañado de tracción ortodóntica progresiva, seguido de la técnica 4x2.
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Dentro de las anomalías dentarias, los dientes supernumerarios son anomalías de número, es decir, hay un aumento de piezas dentarias. Estos dientes pueden presentarse en la línea media (mesiodens), siendo el más común de los dientes; le siguen los premolares, y los molares, por último lugar. Los dientes supernumerarios (mesiodens) tienen una morfología variada, pueden ser dismórficos o cónicos, eumórficos o suplementarios. Su diagnóstico se realiza mediante un estudio radiológico y el plan de tratamiento sugerido es la exodoncia, aunque depende de cada caso en particular. (1) El propósito de este artículo es presentar dos casos clínicos de dientes supernumerarios ubicados en la línea media, de pacientes de 7 y 8 años de edad; uno de los casos presenta un supernumerario con forma conoide, y, el otro, eumórfico que alteraron la oclusión de dichos pacientes; tratados interdisciplinariamente en la Clínica de la Especialidad de Odontopediatría, con los Servicios de Cirugía Máxilo-Facial y de Ortodoncia y Ortopedia Funcional de la Facultad de Odontología de la Universidad Nacional del Nordeste durante 2015-2016 (AU)
Within the dental anomalies, the supernumerary teeth are number anomalies, that is to say that there is an increase of dental pieces. These teeth can appear in the midline (mesiodens), being the most common of the teeth; the premolars follow, and the molars last. The supernumerary teeth (mesiodens) have a varied morphology, they can be dysmorphic or conical, eumorphic or supplementary. The diagnosis is made through a radiological study and the suggested treatment plan is the extraction, although it depends on each particular case.(1) The purpose of this article is to present two clinical cases of supernumerary teeth located in the midline, of patients of 7 and 8 years of age, in which one of the cases presents a supernumerary with conoid and the other eumorphic that altered the occlusion of these patients; which were treated inter-disciplinary in the Clinic of the Specialty of Pediatric Dentistry, with the service of Maxillo-Facial Surgery and the Service of Orthodontics and Functional Orthopedics of the Faculty of Dentistry of the National University of the Northeast during the year 2015- 2016 (AU)
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Humanos , Masculino , Feminino , Criança , Assistência Odontológica para Crianças , Dentição Mista , Equipe de Assistência ao Paciente , Anormalidades Dentárias , Dente Supranumerário , Oclusão Dentária , Diagnóstico por Imagem , Aparelhos Ortodônticos Funcionais , Extração DentáriaRESUMO
Fundamento El mesiodens es un diente supernumerario que con mayor frecuencia se evidencia en la clínica y su diagnóstico se dan casualmente cuando se observan diastemas, giroverciones, o ausencia de incisivos permanentes, las radiografías rutinarias complementaran las posibles sospechas, muchas veces estos dientes se encuentran retenidos y en posiciones anómalas que impiden su erupción en boca, ocasionando complicaciones estéticas y funcionales en la dentición permanente. Objetivo Demostrar que el diagnóstico, y tratamiento a tiempo que realicen los odontopediatras es importante para obtener resultados favorables en la dentición permanente. Caso Clínico Paciente de 9 años de sexo masculino, clínicamente se observa en etapa de dentición mixta, diastema en la línea media y mesioversión de la P.D 1.1, se palpa un ligero abultamiento entre los dos incisivos centrales, se recurre a exámenes auxiliares de diagnóstico como radiografía periapical, en el cual se observó la presencia de un diente supernumerario con forma cónica en posición invertida entre los incisivos centrales (mesiodens),el cual obstaculiza la posible alineación de los dientes si se planifica un tratamiento de ortodoncia. El tratamiento realizado fue multidisciplinario con la extracción quirúrgica del supernumerario y tratamiento de ortodoncia con la técnica dos por cuatro maxilar superior e inferior, obteniendo con ello la mejora del frente estético y funcionabilidad oclusal, el cual se evidenció en el seguimiento de caso.
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Multiple supernumerary teeth without any associated syndromes are not common. A mesiodens is a supernumerary tooth located in the palatal midline between the two maxillary central incisors. Mesiodens may give rise to a variety of complications, such as impaction, delayed eruption and ectopic eruption of adjacent teeth.
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En este artículo se describen los supernumerarios, las diversas teorías sobre su etiología, su frecuencia y lasalteraciones que pueden producir. Además, se dan pautas para su tratamiento. Los supernumerarios son anomalías del desarrollo que se encuentran con poca frecuencia, del 0,30 por ciento al 3,80 por ciento de la población, pero en pacientes con labio ypaladar fisurado pueden llegar al 28 por ciento. Se los puede definir como dientes adicionales a la serie dental normal. Se los encuentra raramente en ladentición primaria, en esta la distribución por sexo es similar; mientras que en la dentición permanente el sexo masculino prevalece en una proporción de 2 a 1. El mesiodens es el que se encuentra con mayor frecuencia. Constituye, según Shafer y Cols, más del50 por ciento de todos los supernumerarios...
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Humanos , Masculino , Feminino , Criança , Dente Impactado/diagnóstico , Dente Impactado/terapia , Dente Supranumerário/diagnóstico , Dente Supranumerário/etiologia , Dente Supranumerário/terapia , Distribuição por Idade e Sexo , Dente Pré-Molar , Dente Canino , Dentição Permanente , Dente Supranumerário/epidemiologia , Extração Dentária/normas , Incisivo , Dente Molar , Dente DecíduoRESUMO
Supernumerary teeth or hyperdontia are those that are additional to the normal complement of teeth. Mesiodens is an extra tooth most commonly seen in the premaxillary region, while talon cusp is a well demarcated additional cusp extending form cingulum or cemento- enamel junction to the incisal edge. It is usually present on labial or palatal surface of primary and permanent anterior teeth. Occurrence of talon cusp on a mesiodens is an uncommon phenomenon. This paper presents a rare case of facial and palatal talon cusp on a mesiodens in association with hyperdontia, reported in a 12-year old girl.
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Introduction: Mesiodens is a common supernumerary tooth occurring in anterior region of maxilla. Its occurrence is more in permanent dentition than the primary dentition. Presence of mesiodens is associated with various complications, cystic changes being less common complication of mesiodens itself. Objective: The aim of the present article is to report an atypical mesiodens with cystic changes causing complication in adjacent structures. Case report: Hereby we report a case of dentigerous cyst associated with atypical mesiodens which was impacted, inverted and had dilaceration in the crown. Surgical removal of cystic lesion along with the mesiodens was carried out. Conclusion: Supernumerary tooth associated with dentigerous cyst may result in considerable bone destruction along with other complications. Dentist should be aware of complications associated with supernumerary structures.
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Mesiodens are relatively common and can cause a variety of complications. The clinician should recognize signs and problems suggesting the presence of supernumerary teeth or mesiodens, particularly aberrations in the eruptive pattern, and perform the relevant investigations. On diagnosis, each case should be managed appropriately in order to minimize complications to the developing dentition. Mesiodens is most commonly occurring supernumerary tooth located in anterior maxilla usually seen between upper two central incisors placed labially or palatally and may be erupted or impacted. The present paper describes the surgical management of palatally placed impacted mesiodens in 15-year-old female.
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Adolescente , Feminino , Humanos , Maxila , Palato/cirurgia , Anormalidades Dentárias/epidemiologia , Anormalidades Dentárias/cirurgia , Dente Impactado/epidemiologia , Dente Impactado/cirurgia , Dente Supranumerário/epidemiologia , Dente Supranumerário/cirurgiaRESUMO
Background: Mesiodens are supernumerary teeth present in the anterior maxillary region that may erupt or remain embedded in the jawbone. The incidence of mesiodens is rare, surgical removal of supernumerary teeth with correction of anterior teeth by orthodontic treatment is performed. Case Report: This case report represents a very rare incidence of multiple mesiodens in a male patient. Extraction of two mesiodens was indicated, as these impacted supernumerary teeth may cause complications during orthodontic treatment. The third tooth was not operated on the fact that it needs to be extracted by additional extraoral approach involving risk factors. The current case report delineates the fruitful administration of the un-erupted supernumerary teeth situated high in the mid-palatal area not associated with any syndrome. Blends of operating and surgical strategies were utilized to enhance the results with hard and soft tissue conservation, maintenance and support. In the surgical phase, surgical removal of the supernumerary teeth, bone grafting was done using the hydroxyapatite. Radiographic evidence of complete healing was observed following up visit. Conclusion: Timely diagnosis and suitable management can decrease the potential complications due to the presence of supernumerary teeth. Dental clinicians should be aware of related clinical signs and must look for unexpected findings during the routine clinical as well radiological examinations.
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BACKGROUND: Pediatric dentists face challenges when young patients require a mesiodens extraction. General anesthesia may be a burden to the child as well as the parent due to dental fears and costs. The aim of this study was to evaluate oral and intravenous sedation in the outpatient setting as a safe and effective means of managing patients who require a mesiodens extraction. METHODS: Records were reviewed retrospectively to find patients who underwent a mesiodens removal procedure from January 2013 to September 2014 in the Department of Pediatric Dentistry at Ajou University Hospital (Suwon, Gyeonggi-do, Republic of Korea). A total of 81 patients (62 male and 19 female) between 4 and 11 years of age (mean [± SD] 81.6 ± 14.1 months) were studied, with a mean weight of 22.9 ± 3.3 kg (16 kg to 30 kg). Vital signs, sedation drug dosage, and sedation time were studied. RESULTS: Mean doses of 63.7 ± 2.5 mg/kg chloral hydrate and 1.36 ± 0.22 mg/kg hydroxyzine were used for oral sedation. Nitrous oxide/oxygen was administrated for 40.0 ± 2.1 min. The mean dose of midazolam administered intravenously was 0.14 ± 0.06 mg/kg (2.38 ± 0.97 times). In all cases, the mesiodens was removed successfully. CONCLUSIONS: Intravenous sedation combined with oral sedation and nitrous oxide/oxygen inhalation can be an alternative to general anesthesia when administrated and monitored properly.
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Criança , Humanos , Masculino , Anestesia Geral , Hidrato de Cloral , Sedação Profunda , Ansiedade ao Tratamento Odontológico , Odontólogos , Hidroxizina , Inalação , Midazolam , Pacientes Ambulatoriais , Pais , Odontopediatria , Estudos Retrospectivos , Sinais VitaisRESUMO
Mesiodens are considered as one of the most common supernumerary teeth. The main objective of the study was to determine the prevalence rate of mesiodens in the school going children between the age group of 6-14 years The study shows a prevalence rate of 0.7% with sex ratio of 2:1 favouring males.
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Humanos , Masculino , Feminino , Criança , Adolescente , Dente Supranumerário , CriançaRESUMO
La hiperdoncia simple no sindrómica es el aumento del número de dientes en una única serie dentaria y que no está asociado a síndromes. La localización es única en los maxilares, sin acompañarse de otros dientes supernumerarios en otras zonas, ni formando parte de síndromes complejos. Se presentó el caso de un paciente que fue atendido en interconsulta de Cirugía Maxilofacial y Ortodoncia. Se describieron las características clínicas de la enfermedad y el tratamiento quirúrgico realizado, que consistió en un método quirúrgico-ortodóncico. Los dientes supernumerarios en al zona de incisivos es una enfermedad rara, existen pocos casos descritos en la literatura nacional y extranjera. Con la técnica quirúrgica utilizada para la exodoncia de los dientes supernumerarios y la reubicación ortodóncica del diente permanente retenido, se obtuvieron resultados estéticos satisfactorios.
Nonsyndromic simply hyperdontia is an increasing number of teeth in a single dental series and it is not associated with syndromes. The location is unique in the jaws, not accompanied by other supernumerary teeth in other areas, or as part of complex syndromes. A patient who was treated at Maxillofacial Surgery and Orthodontics consultation was presented. The clinical features of the disease and surgical treatment, which consisted of a surgical-orthodontic method, were described. Supernumerary teeth in the incisor area is a rare disease, there are few cases reported in the national and international literature. Satisfactory cosmetic results were obtained with the surgical technique used for extraction of supernumerary teeth and orthodontic retained permanent tooth.
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Los dientes supernumerarios son anomalías en el desarrollo dental que pueden estar o no asociadas a algún síndrome; su prevalencia oscila entre 0.3 y 3.8% y su incidencia entre 0.1 y 3.8% de acuerdo a la población de estudio. Estos dientes pueden presentarse en la línea media (mesiodens) en un 48.6%, siendo el más común de los dientes; le siguen los premolares con un 26.4%, los laterales con 11.1% y los molares en un 9.7%. Su diagnóstico se realiza mediante un estudio radiológico (radiografía panorámica). Los dientes supernumerarios tienen una morfología variada, pueden ser dismórficos o cónicos, eumórficos o suplementarios; son una duplicación de los dientes de la serie normal y molariforme que suelen presentar una forma molar irregular. Los dientes supernumerarios suplementarios se encuentran en la dentición caduca, no poseen ninguna variedad anatómica; los dientes supernumerarios rudimentarios se presentan en la dentición permanente y tienen variedad anatómica. Después del diagnóstico radiológico de los dientes supernumerarios se procede a realizar el tratamiento quirúrgico. El objetivo de este artículo es reportar un caso clínico de dos dientes supernumerarios, en una paciente de 9 años de edad que no presenta ningún síndrome, en este artículo se discute su relevancia e implicaciones en la práctica clínica.
Supernumerary teeth are anomalies of dental development. They may or may not be associated to different syndromes. Prevalence of this condition varies from 0.3% to 3.8% and incidence can be placed from 0.1% to 3.8 %, according to the studied population group. In 48.6% of all cases, supernumerary teeth can be present at the midline (mesiodens), which is the most common occurrence, followed by premolars, in 26.4% of all cases, laterals in 11.1% and molars in 9.7%. Diagnosis is emitted after x-ray studies (panoramic x-ray). Supernumerary teeth present different morphologies, they can be dysmorphic or conical, eumorphic or supplementary. They are a duplication of normal and molar shaped series of teeth which present irregular molar shape. Supplementary SN teeth are found in primary dentition and do not possess any anatomical variety. Rudimentary SN teeth are found in permanent dentition and possess anatomical variety. After supernumerary teeth x-ray diagnosis, surgical treatment is undertaken. The aim of the present article is to report the clinical case of two supernumerary teeth present in a non-syndromic 9 year old patient. Relevance and implications in clinical practice are discussed in the present article.
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Paediatric dentistry in the current scenario is not only about teeth and gums that are visible in child's mouth, but also those structures that are hidden, difficult to identify, and often remain undiagnosed. Dentists can come across various anomalies pertaining to the crown structure during clinical practice. Supernumerary tooth is one such anomaly that is additional to the normal series and can be found in almost any region of the dental arch. They may be single, multiple, unilateral or bilateral erupted or un-erupted and in one or both jaws. Mesiodens is the most common type of supernumerary tooth found in the premaxilla between two central incisors. Here is a review of literature relating to mesiodens presented along with two case reports to illustrate some possible presentations, diagnostic features, and treatment options.
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La erupción ectópica de los incisivos centrales superiores es poco frecuente de encontrar. El tratamiento es controversial y consiste en la extracción de la pieza dentaria o su ubicación en el arco. La modalidad de tratamiento actual, en lugar de la extracción, ha utilizado la generación del espacio requerido, la exposición quirúrgica de la corona y el posicionamiento ortodóncico de la pieza dentaria. El objetivo del presente trabajo es mostrar el caso clínico de un paciente de sexo masculino en su etapa prepuberal, con 11,9 años de edad. El mismo presentaba un incisivo central superior permanente ectópico retenido en posición horizontal con anomalía de forma coronaria y dilaceración radicular. Este incisivo fue ubicado exitosamente en el arco dentario mediante la liberación quirúrgica y la posterior tracción ortodóncica. Si bien con el paso del tiempo puede llegar a perderse la pieza dentaria, el tratamiento es considerado exitoso ya que conservamos hueso y mantenemos la estética natural de la pieza dentaria en una etapa crucial de la vida. Además, en este tipo de casos es fundamental la interrelación cirugía-ortodoncia.
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Humanos , Masculino , Criança , Dens in Dente , Erupção Ectópica de Dente/cirurgia , Erupção Ectópica de Dente/terapia , Incisivo/anormalidades , Erupção Ectópica de Dente/diagnóstico , Erupção Ectópica de Dente , Aparelhos Ortodônticos , Radiografia PanorâmicaRESUMO
Dilaceración es un término utilizado para describir la distorsión que ocurre en la raíz durante el desarrollo dentario, el cual se manifiesta alterando la normal relación axial entre la corona y la raíz dentaria. La dilaceración radicular es una angulación o curvatura de la raíz dentaria. Esta alteración es frecuentemente observada en dientes permanentes como consecuencia de un traumatismo de su correspondiente temporario, con una incidencia de 3 %. En la literatura hay solamente cinco casos de dilaceración que involucran a incisivos temporarios. El propósito de este artículo fue hacer una revisión y presentar un caso clínico que fue un hallazgo radiográfico
Dilaceration is a term used to describe the distortion that occurs in the root during tooth development, which manifests itself by altering the normal axial relationship between the crown and the dental root. The root is dilaceration, angulation or curvature of the tooth root. This alteration is frequently observed in permanent teeth as a result of trauma to the corresponding temporary, with an incidence of 3%. In the literature there are only five cases involving dilaceration temporary incisors. The purpose of this article was to review and present a clinical case was a radiographic finding
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Humanos , Masculino , Pré-Escolar , Anormalidades Dentárias/terapia , Dente Decíduo/anormalidades , Raiz Dentária/anormalidades , Raiz Dentária/crescimento & desenvolvimento , OdontopediatriaRESUMO
The aim of this study was to investigate the prevalence of supernumerary teeth in a Brazilian pediatric population. One examiner evaluated the presence of supernumerary teeth in panoramic radiographs of 1719 subjects (762 male and 957 female), with ages ranging from 4 to 14.5 years (mean 8.4 years old), from the archive of the Preventive Orthodontic Course of the Rehabilitation Hospital of Bauru, São Paulo. Supernumerary teeth were present in thirty subjects (1.7 percent, 16 males and 14 females). Difference between sexes was not statistically significant. Twenty-nine supernumerary teeth (96.7 percent) were located in the maxilla, and only 1 (3.3 percent) located in mandible. Seventeen supernumerary teeth (56.7 percent) located in maxilla were mesiodens. The early diagnosis of supernumerary teeth is essential to prevent malocclusion and malposition of permanent teeth demonstrating the importance of panoramic radiographs in their detection.
El objetivo de este estudio fue investigar la prevalencia de dientes supernumerarios en una población pediátrica de Brasil. Un examinador evaluó la presencia de dientes supernumerarios en radiografías panorámicas de 1719 sujetos (762 hombres y 957 mujeres), con edades comprendidas entre 4 y 14,5 años (media 8,4 años de edad), del archivo del Curso de Ortodoncia Preventiva del Hospital de Rehabilitación de Bauru, São Paulo. Los dientes supernumerarios se presentaron en treinta sujetos (1,7 por ciento, 16 hombres y 14 mujeres). La diferencia entre sexos no fue estadísticamente significativa. Veintinueve dientes supernumerarios (96,7 por ciento) se ubicaron en el maxilar, y sólo 1 (3,3 por ciento) se ubicó en la mandíbula. Diecisiete dientes supernumerarios (56,7 por ciento) ubicados en el maxilar eran mesiodens. El diagnóstico precoz de los dientes supernumerarios es esencial para prevenir la maloclusión y malposición de los dientes permanentes, lo que demuestra la importancia de la radiografía panorámica en su detección.