# Radiological features of double and inverted mesiodens: a systematic review of the literature and presentation of two cases

## TL;DR

This study reviews radiological features of rare double and inverted mesiodens teeth using CBCT scans and presents two pediatric cases.

## Contribution

The paper provides a systematic review and case reports highlighting the use of CBCT for diagnosing rare mesiodens variations.

## Key findings

- Double mesiodens occurs in 10-19% of mesiodens cases.
- Double inversion of mesiodens is extremely rare.
- CBCT is crucial for accurate diagnosis and management of mesiodens.

## Abstract

Mesiodens are the most prevalent supernumerary teeth, defined as a dentition anomaly. Mesiodens account for 80% of all supernumerary teeth, with a prevalence in the general population of 0.15% -1.9%. Mesiodens show a higher frequency in man than in women, it is usually found in the front upper jaw, between the midlines of maxillary central teeth. It may be normally oriented or have inverted and transverse orientation. Single or multiple mesiodens may occur; however, double mesiodens is rarer (10-19% of all patients with mesiodens), and even rarer is its double inversion, with the crown and root oriented towards the nasal and oral cavities. The aim of this study is to investigate the main cone-beam computed tomography (CBCT) radiological features of patients affected by mesiodens. Two cases of double mesiodens, one of which with double inversion, in pediatric patients are reported.

According to PRISMA guidelines, a systematic review search was conducted on PubMed, Scopus, and Web of Science. Observational studies conducted on patients with double mesiodens were selected and analyzed, including both radiological features and clinical characteristics. Furthermore, two cases of patients with double mesiodens were reported.

Fourteen studies were included, and 14 patients affected by double mesiodens were analyzed (12 males, 2 females, with a mean age of 13.5 ± 6.4 years).

The present study underscores the importance of considering the CBCT a fundamental investigation to define and appropriate diagnosis and management, and to avoid complications related to a late diagnosis and/or an unnecessary surgical approach.

Key words:Mesiodens, tooth abnormalities,cone beam computed tomography, CBCT, diagnosis.