Analysis of the characteristics and complications of mesiodens with cone beam computed tomography: A retrospective study

Aim: The aim of this study was to investigate the three-dimensional characteristics of mesiodens with Cone-beam Computed Tomography (CBCT) and to analyze the eruption status, direction, shape and complications of mesiodens in pediatric patients. Material and Methods: In the study, 473 children between the ages of 7-14 years who were diagnosed with mesiodens from the patients who applied to Erciyes University Pediatric Dentistry Department for dental examination between 2012-2020 were evaluated retrospectively. CBCT images of 122 mesiodens from 94 patients who met the inclusion criteria were analyzed. Demographic indicators, the number of mesiodens, crown shape, position, mesiodens eruption status, eruption direction, and dentition stages of the patient were recorded in patients with mesiodens. Clinical complications caused by mesiodens (diastema, eruption delay, rotation, hyperplastic follicle, cyst, root resorption) and their positions in the sagittal, frontal and axial planes were classified. Results: The mean age of patients with mesiodens was 8.75(%1.92) years and 22 (%23.40) of the patients were female and 72 (%76.60) were male. The percentages of patients with 1 and 2 mesiodens were 70.21, 29.79%, respectively. None of the patients had three or more mesiodentes. Of the 122 mesiodentes examined, 95 were conical and conical mesiodens was the most common (77.90%). When the directions of the mesiodens were examined according to their shapes, it was seen that the conical mesiodentes were positioned more inverted (n=30) and those with tubercles were positioned vertically (n=15) (p<0.05). Type 3 mesiodens (impacted and in contact with the central incisor) (n=65,53.30%), evaluated in the sagittal plane, was found to cause more rotation (p<0.05). Discussion: Mesiodentes are difficult to diagnose, especially when they are impacted, and can be overlooked in routine clinical dental examinations. In cases where they are not diagnosed, they can cause orthodontic problems. It is necessary to increase the awareness of dentists about mesiodens, especially when examining pediatric patients.