Odontomes are considered to be hamartomatous malformation rather than true neoplasm and are generally asymptomatic. Here is a case presentation of compound composite odontome with impacted deciduous teeth in an 11-year-old girl. A calcified mass was revealed in the radiograph and the case was finally diagnosed to be compound composite odontome. The mass was surgically excised.
SummaryMesiodens, a common supernumerary tooth, is found in the midline in anterior maxilla between the incisors. Its occurrence as multiples is termed as 'mesiodentes'. Double mesiodentes, a rare phenomenon, is seldom reported in literature and show a plethora of manifestations as described in the case report. They may not be apparent clinically, necessitating the use of imaging modalities and require careful evaluation to prevent complications. This paper presents a report of six double mesiodentes cases with negative family history for supernumerary teeth and absence of any syndromes. This is an effort to educate dentists about signs, symptoms, complications and management of mesiodentes.BMJ Case Reports 2011; doi:10.1136/bcr.07.2011.4420 2 of 5 mesiodens. 5 However, very little literature is available on cases of double supernumerary teeth as they do not occur frequently.The aetiology of supernumerary teeth is not known. The literature reports three theories concerning the cause of mesiodentes but this subject remains controversial. It was originally postulated that mesiodentes represented a phylogenetic relic of extinct ancestors who had three central incisors known as phylogenetic reversion (atavism). 4 6 A second theory known as dichotomy suggests that the tooth bud is split to create two teeth, one of which is the mesiodens. Supporters of this theory believe that dichotomy represents complete gemination, which also occurs frequently in the anterior maxilla. 4 7 The third theory, involving hyperactivity of the dental lamina, is the most widely supported. According to this theory, remnants of the dental lamina or palatal offshoots of active dental lamina are induced to develop into an extra tooth bud, which results in a supernumerary tooth. Thus, the localised and independent hyperactivity of the dental lamina is the most accepted cause for the development of supernumerary teeth. 3 4 The observation that supernumerary teeth are more common in family members suggests heredity as an aetiologic factor; however, it does not follow a simple Mendelian pattern. It has been suggested that environmental factors might have infl uence on genetic susceptibility 2 8 which could probably be a cause for negative family history in our case series.In the present report all six patients were males. This suggests that males are predominantly affected by mesiodentes as discussed by Asaumi et al (M: F =2.8:1) 9 . Roychoudhury et al 10 in their retrospective study of 30 cases of mesiodens found male preponderance of 1.5:1.Supernumerary teeth are classifi ed according to their morphology and location. In the permanent dentition, there are four different morphological types: conical, tuberculate, supplemental and odontoma. 11 12 Case 1 presented with both mesiodentes as tuberculate type, while in cases 4, 5 and 6 both were of conical variety. In case 3 both mesiodentes were supplemental but case 2 was unique in morphology as one mesiodens was tuberculate and other one conical.In some subjects, mesiodens erupt normally, but us...
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