Royal Dental College

This clinical presentation highlights the significance of radiographic findings and the surgical decision-making process, as well as the benefits of the labial surgical approach for the extraction of an inverted, conical-shaped rudimentary supernumerary tooth (mesiodens) situated in the midline of the premaxilla, which is close to the nasal cavity. An 8-year-old male child presented to the Department of Pediatric and Preventive Dentistry at Royal Dental College, Chalissery, with a primary complaint of an extra tooth in the upper front tooth area for the past year. Clinical examination also revealed impacted left and right permanent lateral incisors. CBCT imaging showed a vertically erupted supernumerary tooth located between 11 and 21, along with an inversely and vertically impacted supernumerary tooth exhibiting dilaceration and an enlarged follicular space. Surgical removal of the mesiodens under general anesthesia was planned. A labial surgical approach was chosen for the procedure due to the proximity of the mesiodens to the nasopalatine canal; the buccal approach was selected to reduce the risk of injury to the nasopalatine nerve, followed by bracket placement and space closure between 11 and 21. This case underscores the necessity of comprehensive clinical and radiographic evaluation, highlighting the importance of interdisciplinary collaboration between medicine and dentistry to effectively meet patient needs and provide holistic care aimed at enhancing quality of life.