Additionally, there is an opinion that the removal in a mixed dentition is best served by removal around age 10 years so that proper alignment occurs and less orthodontic or surgical procedures are needed. Mesiodens are associated with dentigerous cysts that are developmental cysts of odontogenic origin. These types of cysts are found around the crowns of supernumerary teeth and mesiodens.
Mesiodens have been found in certain syndromes such as cleft lip and palate, cleidocranial dysostosis, and Gardner's syndrome. Supernumerary teeth in general have associations with Ehler-Danlos syndrome, Apert syndrome, and Down's syndrome as well.
The concerns associated with mesiodens are delayed eruption of permanent teeth, cyst formation, abnormality of the roots, multilobulated supernumerary teeth, crowding, diastemas, root dilacerations, resorption of the roots of adjacent teeth, and eruption of permanent teeth into the nasal cavity. In a study of 5,000 patients, Kumar and Gopal (2013) found 112 supernumerary teeth in 78 subjects. Twenty-nine teeth were mesiodens, or 25.8% of all supernumerary teeth found within the study.
Conclusions: Removal of the mesiodens is needed because of the above stated reasons, and researchers also point out the fact that the tooth bud displacement impedes oral hygiene and introduces the tooth to a predilection of caries defects and marginal periodontitis. The identification of medsiodens also heightens the awareness of the clinician to further evaluate the patient for other health issues, syndromes associated with mesiodens and additional supernumerary teeth that may be yet undiagnosed within the patient. Radiographs are extremely important in making a definitive diagnosis.