PMC8589522_01
CBCT examination: (a) vestibular and palatal views, (b) transverse sections, and (s) frontal sections.
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In order to make an objective assessment and choose which pair of incisors to be surgically extracted to alleviate the accumulation, a CBCT examination was ordered (Figure 1).
Treatment progress.
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After extraction of the temporary and redundant incisors, the two ectopically located incisors spontaneously changed their position and erupted (Figure 2).
PMC8589522_02
Before and after treatment: reduction of the dens evaginatus.
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PMC8589522_03
X-ray image and intraoral picture from the first clinical examination and 4 months later.
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Our first guess was about the second mesiodens, which erupted palatally in the immediate vicinity of the right lateral (Figure 4).
CBCT examination and transverse sections.
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CBCT examination for the exact localization of supernumerary teeth (mesiodens) was ordered (Figure 5).
X-ray from the first clinical examination and 2 years later.
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A follow-up with subsequent X-ray ascertained a double tooth (Figure 6).
Development of the lower dental arch. (a) Initial state. (b) After extraction of temporary first molars. (c) Placed lingual arch. (d) Eruption of the lower right first and second premolars and left first premolar:double tooth. (e) Spontaneous eruption of the lower left second premolar, after extraction of tooth 34. (f) Complete eruption of the lower left second premolar.
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The orthodontic treatment plan included the following: extraction of double tooth 34, preservation of the perimeter of the lower dental arch, levelling of the two dental arches, and normalization of the occlusion (Figure 7).
CBCT: 3D vestibular and lingual view and transverse sections.
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This was unfavourable due to the root and pulp morphology of the tooth (Figure 8).