A 23-year-old female who completed orthodontic treatment at age 16 now has a radiograph showing an impacted tooth with no caries, no resorption, and no mobility. What is the appropriate management?

Correct answer: A. Surgically extract

• A. Correct. A supernumerary tooth (mesiodens) in a young adult, even if currently asymptomatic, carries risk of displacement, root resorption of adjacent teeth, dentigerous cyst formation, and continued eruption failure. Surgical extraction is the recommended treatment.
• B. Periodic monitoring may be appropriate for some asymptomatic impacted teeth, but at age 23 with evidence of being a mesiodens (supernumerary causing crowding), the current standard leans toward surgical removal.
• C. Non-surgical extraction is not appropriate for an impacted (non-erupted) tooth.
• D. Orthodontic eruption is not applicable for supernumerary teeth.