rdcjournalRoyal Dental College JournalE-Volume 8 Issue 1MultidisciplinaryEnglishJanuary- DecemberNNY2025071Pediatric and Preventive Dentistry Surgical Extraction of Mesiodens under general Anesthesia- A Case ReportEnglishY15AthiraTP1EnglishNAnjanaG2EnglishYAnoopHarris3EnglishYAmruthaJoy3EnglishYThis 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.EnglishBuccal approach, Hypertonia, Inverted mesiodens, Midline diastema, Orthodontic tractionhttps://www.rdcjournal.org/abstract?id=275References16191. Kumar V, Bhaskar A, Kapoor R, Malik P. Conservative surgical management of a supernumerary tooth in the nasal cavity. BMJ Case Reports CP. 2020 Jul 28;13(7):e235718. doi: 10.1136/bcr-2020-235718. 2. Rahman S, Madan T, Goyal RJ, Goyal S, Bhalla V Prabhu MS. The Teeth in the Nasal Cavity. Bengal Journal of Otolaryngology and Head Neck Surgery.2024;32(2):99-103. doi.org/10.47210/bjohns.2024.v32i2.100. 3.and;nbsp;Nazif MM, Ruffalo RC, Zullo T. Impacted supernumerary teeth: a survey of 50 cases. J Am Dent Assoc. 1983 Feb;106(2):201-4. doi: 10.14219/jada.archive.1983.0390. 4.and;nbsp;Tay F, Pang A, Yuen S. Unerupted maxillary anterior supernumerary teeth: report of 204 cases. ASDC Journal of Dentistry for Children. 1984 Jul 1;51(4):289-94. 5.and;nbsp;Henry RJ, Post AC. A labially positioned mesiodens. Case report. Pediatric Dentistry. 1989 Mar;11(1):59-63. 6.and;nbsp;Urechescu H, Banu A, Streian F, Urtila F, Cuzic C, Dinu S et al. Intraoral Approach Through the Nasal Floor for Surgical Removal of Inverted Mesiodens: Protocol and Case Series. J Clin Med. 2024 Dec 22;13(24):7831. doi: 10.3390/jcm13247831. 7.and;nbsp;Mossaz J, Kloukos D, Pandis N, Suter VG, Katsaros C, Bornstein MM. Morphologic characteristics, location, and associated complications of maxillary and mandibular supernumerary teeth as evaluated using cone beam computed tomography. Eur. J. Orthod. 2014 Dec;36(6):708and;ndash;718. doi: 10.1093/ejo/cjt101. 8.and;nbsp;Maddalone M, Rota E, Amosso E, Porcaro G, Mirabelli L. Evaluation of surgical options for supernumerary teeth in the anterior maxilla. Int J Clin Pediatr Dent 2018; July-Aug;11(4):294-298. doi: 10.5005/jp-journals-10005-1529. 9.and;nbsp;Aoun G, Nasseh I. Mesiodens within the nasopalatine canal: an exceptional entity. Clin Pract. 2016 Dec 7;6(4):903. doi: 10.4081/cp.2016.903. 10.and;nbsp;Bin SE, Roby PM. An Inverted Impacted Mesiodens Perforating the Nasal Floor with an Impacted Canine. Int J Oral Dent Health. 2019;5(1):082. doi:10.23937/2469-5734/1510082. 11.and;nbsp;Karim ZA, Musa N, Noor SN. Utilization of dental general anesthesia for children. Malays J Med Sci: 2008 Jul;15(3):31-9. 12.and;nbsp;Campbell RL, Shetty NS, Shetty KS, Pope HL, Campbell JR. Pediatric dental surgery under general anesthesia: uncooperative children. Anesth prog. 2018 Jan 1;65(4):225-230. doi: 10.2344/anpr-65-03-04. 13.and;nbsp;Puri S, Mathew PJ. General Anesthesia for Dental Procedures in Children: A Comprehensive Review. J Postgrad Med Edu Res. 2022 Feb 19;56(1):29-33. doi: 10.5005/jp-journals-10028-1555. 14.and;nbsp;Kong J, Peng Z, Zhong T, Shu H, Wang J, Kuang Y et al. Clinical analysis of approach selection of extraction of maxillary embedded mesiodens in children. Dis Markers. 2022 May 3;2022(1):6517024. doi: 10.1155/2022/6517024. 15.and;nbsp;Kim Y, Jeong T, Kim J, Shin J, Kim S. Effects of mesiodens on adjacent permanent teeth: a retrospective study in Korean children based on cone‐beam computed tomography. Int J Paediatr Dent. 2018 Mar;28(2):161-9. doi: 10.1111/ipd.12317. 16.and;nbsp;Omami M, Chokri A, Hentati H, Selmi J. Cone-beam computed tomography exploration and surgical management of palatal, inverted, and impacted mesiodens. Contemp Clin Dent. 2015 Sep 1;6(Suppl 1):S289-93. doi: 10.4103/0976- 237X.166815. and;nbsp;