Mesiodense

Classification according to ICD-10
K00.1	Hyperdontia
ICD-10 online (WHO version 2019)

Mesiodens between the upper deciduous incisors that are still present.

A mesiodens (from Greek μέσος (mésos) "middle-sided", "towards the middle of the dental arch") and ( Latin dens "tooth", synonym: odontoid (from Greek: ὀδούς (odous) "tooth" and Greek εἶδος) (eídos) "appearance")) is a surplus, mostly atypically shaped or stunted tooth between the upper front teeth 11 and 21 , in rare cases between the lower front teeth 31 and 41 . The prevalence is given in the literature as 0.15 to 1.9%. Men are about twice as likely to be affected than women.

Diagnosis

Because a mesiodense breaks through spontaneously only in rare cases, it is usually only detectable by X-ray . In adulthood, the mesiodense can occur as an incidental finding in an OPG . In children, ectopic , asymmetric, or delayed eruption of one or both central incisors is generally suspect and should be investigated further. As a rule, the detection is carried out by means of two apical tooth film recordings in different projections in order to determine the position of the surplus tooth in relation to the roots of the neighboring teeth. A mesiode can also be inverted (i.e. the tip of the root points towards the oral cavity).

Alternatively, a mesiode can also be represented by computer tomography . In general practice , this rarely occurs due to the (still) higher radiation exposure and the fact that these devices are not yet widely used.

Classification

Mesiodentes can be classified based on their appearance in the deciduous dentition ( supplementary) or permanent dentition (rudimentary). In addition, based on their shape, mesiodentes can be divided into:

• conical
• tubular
• molar shape

therapy

If the mesiode breaks through spontaneously, it can easily be extracted . As a rule, however, only surgical removal remains . The time for the removal must be carefully chosen here. With an early intervention there is a risk of damaging the growing roots of the permanent teeth in the operating area. On the other hand, there is a risk of cyst formation or that the mesiodense resorbs the roots of the neighboring teeth . If the mesiodense is not an obstacle to the eruption of the neighboring teeth or an obstacle to orthodontic treatment , it is possible to wait (despite a diastema ) until the roots of the neighboring teeth have finished growing. This procedure requires regular x-ray controls . Even if a mesiodense can remain symptom-free throughout its life, it should be removed at the latest after the root growth is complete, if only to avert the risk of cyst formation .

Emergence

There are three different theories, some of which are controversial, about the origin ( etiology ) of Mesiodentes:

• Phylogenetic reversion : The basis of this theory was the assumption that the mesiodense is an atavism . Accordingly, humans had ancestors with three central incisors . The occasional occurrence of a mesiode is thus the result of an accidental expression of old genes. This theory could be refuted by embryological studies.
• Dichotomy : This theory assumes that one of the tooth systems divides in the course of its development, creating an additional tooth system.
• Tissue hyperactivity : This theory, which is the most widespread today, assumes that the additional tooth system is caused by hyperactivity in the dental lamina. A small encapsulation of active cells forms the additional tooth system.

See also

• Diastema
• Hyperdontia
• Tooth scheme
• Change of teeth

literature

• David Haunfelder, Lorenz Hupfauf, Werner Ketterl , Gottfried Schmuth: Dental Practice , Section B3 by W. Ritter.

Individual evidence

1. ^ Wilhelm Gemoll : GEMOLL, Greek-German school and manual dictionary. G. Freytag Verlag, Munich
2. ↑ Kathleen A. Russell, Magdalena A. Folwarczna: Mesiodens - Diagnosis and Management of a Common Supernumerary Tooth. In: J Can Dent Assoc. 2003; 69 (6), pp. 362-366.
3. ^ LD Rajab, MAM Hamdan: Supernumerary teeth: review of the literature and a survey of 152 cases. In: Int J Pediatr Dent. 2002 Jul; 12 (4), pp. 244-254.
4. ↑ Kathleen A. Russell, Magdalena A. Folwarczna: Mesiodens - Diagnosis and Management of a Common Supernumerary Tooth. In: J Can Dent Assoc. 2003; 69 (6), pp. 362-366.
5. ↑ Jüri Kurol: Early treatment of tooth-eruption disturbances. In: Am J Orthod Dentofacial Orthop. 2002 Jun; 121 (6), pp. 588-591.
6. ↑ Jüri Kurol: Impacted and ankylosed teeth: Why, when and how to intervene. In: Am J Orthod Dentofacial Orthop. 2006 Apr; 129 (4 Suppl), pp. S86-S90
7. ↑ L. Leyland, P. Batra, F. Wong, R. Llewelyn: A retrospective evaluation of the eruption of impacted permanent incisors after extraction of supernumerary teeth. In: J Clin Pediatr Dent. 2006 Spring; 30 (3), pp. 225-231.
8. ^ JD Smith: Hyperdontia: Report of a case. In: J Am Dent Assoc . 1969 Nov; 79 (5), pp. 1191-1192.
9. ^ GS Taylor: Characteristics of supernumerary teeth in the primary and permanent dentition. In: Dent Pract Dent Rec. 1972 Jan; 22 (5), pp. 203-208.
10. ^ RE Primosch: Anterior supernumerary teeth - assessment and surgical intervention in children. In: Pediatr Dent. 1981 Jun; 3 (2), pp. 204-215.

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !