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Oral Surgery · single question

A 23-year-old patient presents with a mesiodens (supernumerary tooth between maxillary central incisors) visible on radiograph. What is the appropriate treatment?

  1. Defer treatment indefinitely
  2. Surgical extraction
  3. Non-surgical extraction
  4. Periodic monitoring only
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Correct answer: B. Surgical extraction

  • A. Deferring treatment is inappropriate when the mesiodens is symptomatic.
  • B. A mesiodens that is impacted, causing symptoms, or likely to cause complications should be SURGICALLY EXTRACTED. In a 23-year-old with a CC of upper tooth pain from a mesiodens, surgical extraction (likely with a palatal or labial flap approach depending on position) is the definitive treatment.
  • C. A non-surgical (simple) extraction is not possible for an IMPACTED mesiodens — it is unerupted and requires surgical access.
  • D. Periodic monitoring alone is insufficient for a mesiodens in a 23-year-old — it has already caused a clinical problem (CC: upper teeth hurt) and will not resolve spontaneously.

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