PMC4367045_01
Intraoral photograph-frontal and lateral view : proclination and rotation of central incisors due to double mesiodentes (column width)
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F1
The patient had full complement set of teeth, which had yellowish fluorosis stains [Figure 1]. Two mesiodens were present, one palatal and the other labial to 11 and 21 resulting in proclination and rotation of the maxillary central incisors [Figures 1 and 2].
Intraoral photograph of the maxilla and mandibleocclusal view. Relative position of the two mesiodens with floret like appearance. Deranged occlusion and crowding in the mandibular arch (column width)
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F2
Two mesiodens were present, one palatal and the other labial to 11 and 21 resulting in proclination and rotation of the maxillary central incisors [Figures 1 and 2].
Orthopantomographic and lateral cephalogram view of the patient with double mesiodens and no signs of cystic formation or any other supernumerary teeth (column width)
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F3
The occlusion and arrangement of anterior teeth was disturbed both in maxillary and mandibular arch due to the presence of mesiodentes [Figures 3 and 4]. No other supernumerary teeth or abnormalities were observed in the OPG examination [Figure 3]. The lateral cephalogram examination was explored to rule out the possibility of crossover of mesiodens from labial to palatal side and also the direction of eruption of mesiodens [Figure 3].
Intraoral periapical radiography with two separate clear images of the periodontal ligament with mesiodens represented by dotted lines green and red separately (column width)
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F4
The occlusion and arrangement of anterior teeth was disturbed both in maxillary and mandibular arch due to the presence of mesiodentes [Figures 3 and 4]. The periodontal ligament shadow was clear around both teeth ruling out ankylosis [Figure 4].
Extracted specimen of the two conical shaped mesiodens and post extraction occlusal view of the maxilla with two separate sockets (column width)
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F5
It was decided to evaluate the case after alignment to make a choice between first and second premolars for extraction to improve the esthetics as well as function [Figure 5].