The treatment of each case was planned, after con-
sideration of all clinical and radiological findings. However,
in the clinical management of mesiodens, very often there
can be confusion about whether and when they should be
surgically removed, or whether they should be retained and
followed up radiologically. Irrespective of whether an
immediate or delayed surgical approach is adopted, early
diagnosis is critical (3-7,10,15,16). Immediate surgical
removal is indicated after diagnosis of mesiodens because
intra- or postoperative complications are less likely to
ocur in younger patients (3). Therefore, surgical removal
was indicated in 66 (77.6%) of the cases in this study that
had associated complications. The other 19 (22.3%)
mesiodentes were followed up radiographically, and no
complications due to the presence of mesiodens were
found. Early detection of this anomaly does not, in our
opinion, automatically require early removal of the
supernumerary; but when pathological changes or
interference with the normal teeth are diagnosed, removal
should be performed .
The prevelance of mesiodens has been estimated to be
0.15% to 2.2% of the population. It occurs more frequently
in boys than in girls, the ratio being approximately 2:1. In
this series, the male:female ratio was 2.1:1 and the
prevelance of mesiodens was 0.3. Sixteen (23.1%) of the
69 patients had 2 mesiodens bilateral to the midline