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.