Pediatric Dentistry · single question
A 5-year-old has mobility of teeth E and F. A radiograph reveals a mesiodens between E and F, and root resorption on F. What would you do?
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Correct answer: B. Extract the mesiodens only
Extract the mesiodens only (B). The management of a mesiodens depends on its effects:
• The mesiodens is causing pathology (root resorption of F, mobility of E and F) → it must be extracted.
• However, E and F are primary teeth with mobile/resorbing roots. This mobility may be NATURAL resorption due to the permanent successors erupting + complicated by the mesiodens.
• Extract the mesiodens to eliminate the cause; the primary teeth (E, F) may remobilize naturally as permanent teeth erupt, or they may need monitoring.
• Extracting E and F (C): premature loss of primary teeth → space loss → crowding of permanent dentition. Only extract if they are severely symptomatic or cannot be maintained.
• Conservative approach: address the cause (mesiodens) first, monitor the primary teeth.
• The mesiodens is causing pathology (root resorption of F, mobility of E and F) → it must be extracted.
• However, E and F are primary teeth with mobile/resorbing roots. This mobility may be NATURAL resorption due to the permanent successors erupting + complicated by the mesiodens.
• Extract the mesiodens to eliminate the cause; the primary teeth (E, F) may remobilize naturally as permanent teeth erupt, or they may need monitoring.
• Extracting E and F (C): premature loss of primary teeth → space loss → crowding of permanent dentition. Only extract if they are severely symptomatic or cannot be maintained.
• Conservative approach: address the cause (mesiodens) first, monitor the primary teeth.
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