Orthodontic-Surgical Management of Triple Impacted Mesiodens and Maxillary Incisors - A Case Report.

Rationale: Mesiodens are supernumerary teeth located in the pre-maxilla between the two central incisors with a prevalence rate of 0.15-1.9%. An impacted mesiodens may cause delayed eruption of permanent incisors, ectopic eruption, pathological disturbances and malalignment of teeth.

Patient Concerns: The patient complained of missing upper front teeth associated with pain in the same region for two weeks.

Diagnosis: Upon clinical and radiographic examination, it was diagnosed as triple impacted mesiodens with impacted permanent maxillary central incisors.

Treatment: The clinicians in the study approached the issue by surgical removal of the impacted mesiodens and orthodontic treatment for extrusion of the impacted permanent maxillary central incisors.

Outcomes: The patient was relieved of the pre-operative concerns and followed up regularly for the eruption of permanent maxillary central incisors.

Take-away Lessons: The authors advocate the importance of timely diagnosis and proper management of such rare pathologies.