Abordaje quirúrgico de supernumerario invertido en paciente pediátrico. Reporte de caso.

Abstract

Inverted mesiodens represent a clinical challenge due to their abnormal orientation, which can cause short- or medium-term complications. In this case report, the tooth's crown is directed towards the nasal floor, while the root points towards the oral cavity, opposite to normal teeth. This study aimed to present the clinical case of a 7-year-old male pediatric patient referred for the surgical extraction of an inverted intraosseous mesiodens located between the upper central incisors (1.1 and 2.1) and the nasopalatine canal. Radiological and tomographic evaluations identified the inverted position of the supernumerary tooth, which obstructed the normal eruption of the permanent incisor. A surgical approach was performed, which included an anesthetic block, palatal festooned incision, and flap elevation. The mesiodens were exposed through osteotomy, followed by the controlled luxation and avulsion of the tooth. Subsequently, the site was closed with sutures. Postoperative follow-up after 15 days showed favorable healing and partial eruption of incisor 2.1. No complications were related to the nasopalatine nerve or any hemorrhage, highlighting the importance of proper planning and precise surgical execution. This case emphasizes the relevance of early intervention in cases of supernumerary teeth, with proper planning of the pre-surgical, surgical, and post-surgical phases to prevent future complications such as malocclusion, delayed eruption, or dentigerous cysts.

Keywords: Mesiodens, inverted mesiodens, supernumerary teeth, surgical extraction, dental anomalies