Abstract
Mesiodens, which emerge towards the nasal cavity, often require consultation in maxillofacial practice. Typically accessed through wide palatal flaps with ostectomy, this method involves limited visibility and poses the risk of damaging the roots and apex of adjacent dental structures. This study advocates a minimally invasive technique that involves vestibulotomy between the central incisors, facilitating direct and rapid access through nasal floor dissection, minimizing comorbidities. A systematic review was performed, following the PRISMA guidelines, apropos on ten clinical cases reported in this study. The MEDLINE/Pubmed and Web of Science databases were searched. Several variables were considered and are presented comprehensively in tables and figures. Additionally, 10 case reports with mesiodens in the maxilla were submitted to surgical treatment using a minimally invasive intraoral transnasal disinclusion. The initial literature search resulted in 37 articles, of which 9 met the inclusion criteria for the analysis. Regarding postoperative complications, no bone exposure, incisor root damage, extensive surgical approach, palatal or vestibular hematoma, or palatal necrosis was observed. However, 10% experienced superficial damage to the nasopalatine neurovascular, while 80% and 20% presented mild and moderate postoperative facial edema, respectively. Hypoesthesia in 20% of patients recovered in the first week, 40% in the first month and 40% at 3 months. The minimally invasive intraoral, transnasal, non-endoscopic approach emerges as a safe and predictable alternative to conventional surgical techniques. Presumes minimal postoperative complications, mitigating the risk of excessive bone removal and damage to adjacent structures.
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All authors contributed to the conception and design of the study. S.D., F.J. and G.M. prepared the material, collected and analyzed the data. The disagreements were resolved by consensus and discussion with a fourth reviewer, P.T., who acted as judge to resolve the disagreements generated. All authors read and approved the final manuscript.
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This study was performed in line with the principles of the Declaration of Helsinki, the identity of the patients remained anonymous according to the ethical principles. For this study, all signed informed consents were obtained from the patients; that said, approval by an ethics committee was not justified or required.
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Tapia Contreras, P., Jollán Peña, F., Díaz Abarza, S. et al. Minimally invasive intraoral removal of mesiodens via a transnasal, non-endoscopic approach: a systematic review on the purpose of 10 cases. Oral Maxillofac Surg (2024). https://doi.org/10.1007/s10006-024-01242-1
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DOI: https://doi.org/10.1007/s10006-024-01242-1