Case report

Mesiodens: An Unusual Cause of a Facial Sinus

Report of a Case

A 19-year-old female patient of Indian extraction was referred to the maxillofacial surgery department with a persistent, pigmented draining sinus in the philtrum region. This had been causing intermittent pain for the last 6 months. She had been referred to the same department 3 years before this presentation for removal of a horizontally erupting mesiodens. As this was asymptomatic at the time, she declined treatment. Her medical history was unremarkable.

On examination, the patient had a

Discussion

The mesiodens is the most common of all supernumerary teeth in humans² and is a common cause of malocclusion in the anterior maxillary region.³ Although the most common position for a mesiodens is palatal, usually with the crown in an inverted position, only 6% of mesiodens are found in a horizontal position.⁴ Common complications include malpositioned teeth, delayed eruption of teeth, and resorption of surrounding teeth. With long-term review, dentigerous cysts have been found to be associated