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Article: Volume 47 Number 3 Page 247 - March 2020

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  Dent Update 2020; 47: 247-251

Orthodontics/Dental Anatomy:  A Case of Mistaken Identity of a Mesiodens

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Abstract: This case report discusses the characteristics, sequelae and management of the supernumerary tooth in a developing dentition, particularly the mesiodens. The case describes when an eruption of a mesiodens was misdiagnosed as a microdont maxillary central incisor, leading to ectopic and late eruption of the permanent maxillary incisor. This case highlights the importance of clinical and radiographic investigation where tooth size asymmetry is observed in the upper anterior region.

Clinical relevance: The incidence of a single microdont maxillary central incisor is rare and is not known to be documented in the literature. If a small tooth erupts in the midline it should be considered a supernumerary tooth until proven otherwise. Further clinical and radiographic investigation should be performed to determine the presence and location of the maxillary central incisor(s).

Author notes: Queenie Ong, BDS, MFDS(Glasg), Dental Core Trainee in Orthodontics and Oral and Maxillofacial Surgery, Nottingham University Hospitals NHS Trust (email: and Andrew Flett, BDS, MJDF RCS(Eng), MClinDent(Orth), MOrth RCS(Eng), FDS(Orth) RCSEng, Consultant Orthodontist, Nottingham University Hospitals NHS Trust, Nottingham, UK.

Objective: To recognize the possible clinical presentations of a mesiodens to allow its early diagnosis and intervention.

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