A mesiodens is identified in the anterior maxillary region. Which nerve would most likely be affected by surgical extraction of this supernumerary tooth?

Correct answer: B. Nasopalatine nerve

• A. INCORRECT. The greater palatine nerve supplies the hard palate posterior to the canines. While it may be involved in posterior palatal procedures, it is not the primary nerve at risk during mesiodens extraction in the anterior maxilla.
• B. CORRECT. The nasopalatine nerve (also called the anterior palatine nerve) exits through the incisive foramen and supplies the anterior palatal mucosa, gingiva, and the six anterior maxillary teeth. A mesiodens is located in the anterior maxillary midline, directly in the territory of the nasopalatine nerve, which is at risk during surgical access.
• C. INCORRECT. The anterior superior alveolar nerve (branch of infraorbital nerve) supplies the labial aspect of the anterior maxillary teeth and their buccal periodontium. It may be involved but is not the most commonly cited nerve at risk for the palatal/midline surgical approach to mesiodens.
• D. INCORRECT. The infraorbital nerve is the terminal branch of the maxillary division of the trigeminal nerve supplying the lower eyelid, lateral nose, upper lip, and cheek. It is not directly at risk during mesiodens extraction.