The clinical photograph shows an extra tooth erupting in the maxillary anterior midline region. What is this finding?

Correct answer: B. A supernumerary tooth (mesiodens)

• A. Gemination is a single tooth germ that partially split — the tooth count remains NORMAL when the anomalous tooth is counted as one.
• B. CORRECT. A SUPERNUMERARY tooth in the maxillary midline is a MESIODENS — the most common supernumerary tooth. It typically has a conical crown and short root. Consequences include failure of eruption or delayed eruption of the permanent central incisors, midline diastema, rotation and displacement of adjacent teeth, and occasionally dentigerous cyst formation. Management is surgical removal, with timing based on the risk to the developing permanent incisors.
• C. A natal tooth is present at birth, usually a prematurely erupted primary mandibular incisor.
• D. Fusion joins two germs, producing a REDUCED tooth count.

Note: Counting rule: gemination = normal count; fusion = one fewer; supernumerary = one extra.