Report of the Case
In December 2019, a 9 year-old Iranian boy was referred to our
department (Oral and Maxillofacial Surgery Department of school of
Dentistry, xxxxxxxx University of Medical Sciences) with a chief
complaint of two bilateral deeply impacted mesiodens. The patient had
first presented to the Department of Pediatric Dentistry at School of
Dentistry of xxxxxxx University of Medical Sciences for a routine dental
checkup. The patient’s past medical history was unremarkable and there
was no familial history in terms of mesiodens or other forms of
supernumerary teeth. Intraoral examination showed normal dentition, and
no abnormalities were found in occlusion or tooth alignment. A panoramic
radiograph was obtained, which showed two bilateral deeply impacted
mesiodens in an inverted position (Figure 1). A cone-beam computed
tomography (CBCT) was requested to further assess the details regarding
the exact position of mesiodens relative to the nasal floor and the
adjacent permanent teeth. Sagittal CBCT scans showed deeply inverted
position of both mesiodens and their proximity to the roots of the
adjacent permanent incisors. The crowns of the two mesiodens had been
covered with a very thin layer of the nasal floor. Both mesiodens were
located in the anterior region of the nasal floor and close to the
anterior nasal spine (ANS) and the piriform aperture (Figure 2). The
distance between the crowns of the two mesiodens that were located
bilaterally at both sides of the nasal septum and ANS is an important
variable that determines the required amount of nasal floor dissection.
Written informed consent was obtained from the patient and his parents
prior to the surgical procedure. Also, the patient and his parents
consented to the publication of this report.