Impacted Maxillary Central Incisors Associated with Bilateral Mesiodentes: A Case Report

The purpose of this paper was to present the surgical exposure and orthodontic treatment of an 11-year-old boy with horizontally impacted permanent maxillary central incisors associated with bilateral mesiodentes. Panaromic and upper anterior occlusal radiographs showed horizontally impacted maxillary central incisors, vertically impacted molariform mesiodens, and rotated mesiodens located at the site of the maxillary right central incisor. The treatment plan included extraction of the erupted mesiodens, surgical extraction of the impacted mesiodens, surgical exposure of the permanent central incisors, and orthodontic traction and alignment to achieve a normal occlusion. After 14 months of treatment, the central incisors erupted into the oral cavity. The impacted maxillary central incisors were successfully positioned to their proper alignment via surgical crown exposure and orthodontic traction. Ideal overjet, overbite, and Class I molar and canine relationships were also achieved. At the completion of treatment, the exposed incisors exhibited an acceptable gingival contour and attached gingiva. After 2 years of follow-up, a stable occlusion was maintained with only minor relapse at the right central incisor.