Management of Two Erupted Mesiodens Associated with Maxillary Central Incisor Malposition: A Case Report

¹Associate Professor, Department of Dentistry, Ibn El Jazzar University Hospital, Kairouan, Faculty of Dental Medicine of Monastir. Tunisia

²Laboratory of Biological, Clinical and Dento-Facial Approach, University of Monastir, Monastir, Tunisia

³Specialist in Pediatric Dentistry. University of Monastir, Monastir, Tunisia

^*Correspondent author: Farah Chouchene, Associate Professor, Department of Dentistry, Ibn El Jazzar University Hospital, Kairouan, Faculty of Dental Medicine of Monastir. Tunisia, Email: [email protected]

Received Date: September 02, 2026
Publication Date: September 22, 2026

Citation: Chouchene F, Sboui N. (2026). Management of Two Erupted Mesiodens Associated with Maxillary Central Incisor Malposition: A Case Report. Dental. 8(2):27.

Copyright: Chouchene F and Sboui N, et al. © (2026).

¹Associate Professor, Department of Dentistry, Ibn El Jazzar University Hospital, Kairouan, Faculty of Dental Medicine of Monastir. Tunisia

²Laboratory of Biological, Clinical and Dento-Facial Approach, University of Monastir, Monastir, Tunisia

³Specialist in Pediatric Dentistry. University of Monastir, Monastir, Tunisia

^*Correspondent author: Farah Chouchene, Associate Professor, Department of Dentistry, Ibn El Jazzar University Hospital, Kairouan, Faculty of Dental Medicine of Monastir. Tunisia, Email: [email protected]

ABSTRACT

Mesiodens are supernumerary teeth that may interfere with the eruption, position, and alignment of permanent maxillary incisors. The occurrence of two erupted mesiodens associated with established displacement and rotation of the permanent central incisors presents a particular diagnostic and therapeutic challenge. An 11-year-old girl presented with two erupted, palatally positioned mesiodens associated with ectopic positioning, axial displacement, and rotation of the permanent maxillary central incisors. One mesiodens was conical and the other showed mild dilaceration. Periapical radiography confirmed their position and relationship with the adjacent incisors. Both mesiodens were surgically removed under local anesthesia. An approximately 8-mm maxillary midline diastema with persistent central incisor malposition and rotation remained after extraction. Sectional fixed orthodontic treatment was initiated two weeks later. Following a change in the axial inclination of the central incisors during treatment, the orthodontic mechanics were modified and a transpalatal arch was introduced to reinforce posterior anchorage. After 12 months of active orthodontic treatment, complete closure of the diastema and satisfactory alignment of the maxillary central incisors were achieved. This case highlights that removal of erupted double mesiodens may not be sufficient when significant positional abnormalities of the permanent incisors have already developed. Sequential surgical removal followed by individualized orthodontic treatment and appropriate anchorage control can provide satisfactory correction while avoiding surgical exposure and traction of the permanent incisors.

Keywords: Mesiodens, Supernumerary Teeth, Double Mesiodens, Maxillary Central Incisors, Orthodontic Treatment, Dental Malalignment, Case Report