DOUBLE INVERTED MESIODENSES DIAGNOSED USING CBCT: AN EXCEPTIONAL ENTITY
Mesiodensler maksilla orta hat bölgesinde oluşan sürnümerer dişlerin en büyük oranını oluşturan diş benzeri yapılardır.. Birçok sendromla ilişkili olabildiği gibi sağlıklı bireylerde de ortaya çıkabilmektedir. Gömülü veya sürmüş şekilde, vertikal, horizontal ya da inverted pozisyonda olabilirler. Komşu dişlerde kök rezorpsiyonu, çapraşıklık, diastema, kist oluşumu gibi birçok komplikasyona sebep olabilirken hayat boyu asemptomatik ve fark edilmeden de kalabilirler. Gömülü mesiodensler bir komplikasyona sebep oluyorsa çekilmeleri gerekmektedir. Diğer yönden semptomsuz mesiodenslerin gereksiz çekimlerinden ise operasyon sırasında komşu dişler ve anatomik yapılarda oluşabilecek zararlar düşünülerek kaçınılmalıdır. Rutin dental pratikte iki boyutlu görüntüleme yöntemleri tercih edildiği için mesiodensler her zaman teşhis edilemeyebilirler. Günümüzde CBCT gibi 3 boyutlu görüntüleme teknikleri sayesinde detaylı morfolojileri, konumları, anatomik oluşumlarla ilişkileri ve herhangi bir patoloji oluşturup oluşturmadıkları gibi faktörler net olarak tespit edilebilmektedir. Böylece cerrahi müdahale yapılıp yapılmayacağına kar-zarar dengesi açısından daha kolay karar verilebilir.. Bu olgu sunumunda literatürde oldukça az sayıda rapor edilmiş olan ve 61 yaşındaki bayan hastada CBCT sayesinde tespit edilebilmiş çift inverted mesiodens vakası rapor edilmektedir
DOUBLE INVERTED MESIODENSES DIAGNOSED USING CBCT: AN EXCEPTIONAL ENTITY
Mesiodenses are tooth-like structures which occur in maxillary midline and have the major ratio of the supernumerary teeth. They are related to several syndromes, however may occur on healthy individuals, as well. They may be unerupted or erupted, in vertical, horizontal or inverted positions. They may lead to several complications such as root resorption of adjacent teeth, crowding, diastema and cyst formation whereas they may remain both asymptomatically and unnoticed for a lifetime. Unerupted mesiodenses are needed to be extracted if they cause any complications. However, unnecessary extractions of asymptomatic mesiodenses should be avoided, considering possible damages on adjacent teeth and anatomic structures. In routine dental practice, mesiodenses may be misdiagnosed due to the using of two dimensional radiographies. Nowadays, by means of three dimensional imaging methods such as CBCT, the morphology, location, relationship with anatomical structures of mesiodense and any pathology related with them can be identified precisely. Therefore, it can be easier to decide whether a surgical operation is needed in terms of profit/loss balance. The aim of this case report is to present a doubleinverted mesiodenses diagnosed using CBCT in a 61-yearold female patient, which reported in a small number of cases in the literature
___
- [1] Gallas MM, Garcia A. Retention of
permanent incisors by mesiodens:
a family affair. Br Dent J. 2000;188:63-4.
- [2] Parolia A, Kundabala M, Dahal M,
Mohan M, Thomas MS. Management of
supernumerary teeth. J Conserv Dent.
2011;14:221-4.
- [3] Mossaz J, Kloukos D, Pandis N,
Suter VG, Katsaros C, Bornstein MM.
Morphologic characteristics, location,
and associated complications of maxillary
and mandibular supernumerary teeth
as evaluated using cone beam computed
tomography. Eur J Orthod. 2014;36:708-18.
- [4] Rajab LD, Hamdan MA. Supernumerary
teeth: review of the literature and a survey of
152 cases. Int J Paediatr Dent.
2002;12:244-54.
- [5] Russell KA, Folwarczna MA. Mesiodens--
diagnosis and management of a common
supernumerary tooth. J Can Dent Assoc.
2003;69:362-6.
- [6] Aoun G, Nasseh I. Mesiodens Within the
Nasopalatine Canal: An Exceptional Entity.
Clin Pract. 2016;6:903.
- [7] Kapila S, Conley RS, Harrell WE, Jr. The
current status of cone beam computed
tomography imaging in orthodontics.
Dentomaxillofac Radiol. 2011;40:24-34.
- [8] Agrawal JM, Agrawal MS, Nanjannawar LG,
Parushetti AD. CBCT in orthodontics:
the wave of future. J Contemp Dent Pract.
2013;14:153-7.
- [9] Canoglu E, Er N, Cehreli ZC. Double
inverted mesiodentes: report of an unusual
case. Eur J Dent. 2009;3:219-23.
- [10] Dinkar AD, Dawasaz AA, Shenoy S.
Dentigerous cyst associated with multiple
mesiodens: a case report. J Indian Soc
Pedod Prev Dent. 2007;25:56-9.
- [11] Fernandez Montenegro P, Valmaseda
Castellon E, Berini Aytes L, Gay Escoda C.
Retrospective study of 145 supernumerary
teeth. Med Oral Patol Oral Cir
Bucal. 2006;11:E339-44.
- [12] Ferres-Padro E, Prats-Armengol J,
Ferres-Amat E. A descriptive study
of 113 unerupted supernumerary teeth in
79 pediatric patients in Barcelona. Med Oral
Patol Oral Cir Bucal. 2009;14:E146-52.
- [13] Van Buggenhout G, Bailleul-Forestier
I. Mesiodens. Eur J Med Genet.
2008;51:178-81.
- [14] Asaumi JI, Shibata Y, Yanagi Y, Hisatomi
M, Matsuzaki H, Konouchi H, et al.
Radiographic examination of mesiodens and
their associated complications.
Dentomaxillofac Radiol. 2004;33:125-7.
- [15] Ersin NK, Candan U, Alpoz AR, Akay C.
Mesiodens in primary, mixed and permanent
dentitions: a clinical and radiographic study.
J Clin Pediatr Dent. 2004;28:295-8.
- [16] Hattab FN, Yassin OM, Rawashdeh MA.
Supernumerary teeth: report of three
cases and review of the literature.
ASDC J Dent Child. 1994;61:382-93.
- [17] Nazif MM, Ruffalo RC, Zullo T. Impacted
supernumerary teeth: a survey of 50 cases.
J Am Dent Assoc. 1983;106:201-4.
- [18] Giancotti A, Grazzini F, De Dominicis F,
Romanini G, Arcuri C. Multidisciplinary
evaluation and clinical management of
mesiodens. J Clin Pediatr Dent. 2002;26:233-7.
- [19] Hyun HK, Lee SJ, Lee SH, Hahn SH, Kim
JW. Clinical characteristics and
complications associated with mesiodentes.
J Oral Maxillofac Surg. 2009;67:2639-43.