Extraction or Not
A 11-year-old boy has been our patient for 6 years. The initial panoramic X-ray appears to be normal (Fig.1). The panormaic film taken 6 months ago shows a possible mesiodens (Fig.2 green dashed line, vs. pink one for the right upper central incisor). A PA taken today confirms the diagnosis (Fig.3). It appears that the supernumerary tooth has penetrated the nasal floor (Fig.1-3: red dashed line). The patient is asymptomatic. There is no diasetema between the upper central incisors (Fig.4). Should the mesiodens be extracted?Yes Xin, I would typically refer for extraction of the supernumerary at this time. The roots of 8 and 9 are fully formed and you would not have the same risk as is the case with partially developed roots. Thank you for sharing. As always, you continue to impress me with your documentation and level of conscientiousness. You are my kind of guy!
Timothy Shaughnessy, D.D.S., M.S.
Diplomate of the American Board of Orthodontics
Xin Wei, DDS, PhD, MS 1st edition 10/17/2014, last revision 10/24/2014