The Effect of Palatally Impacted Mesiodens on the Inclination of Fully Erupted Maxillary Permanent Central Incisors: A CBCT Study

This study aimed to quantitatively evaluate the association between palatally impacted mesiodens and the inclination of the adjacent maxillary central incisor. A retrospective analysis was performed on 158 pediatric patients with a single unilaterally and palatally impacted mesiodens and fully erupted maxillary central incisors at Nolla stage 8 or higher. The inclinations of incisors adjacent to the palatally impacted mesiodens and those on the contralateral sides were compared using cone beam computed tomography (CBCT) images, considering the vertical position, orientation, and angulation of the mesiodens. Overall, the maxillary central incisors adjacent to the palatally impacted mesiodens were more palatally inclined than contralateral incisors (p < 0.0001). Differences in inclination between the maxillary central incisors decreased when mesiodens were located above the apex (p = 0.033) or had an intermediate angulation (p = 0.012). Multiple linear regression analysis revealed that palatal inclination of the adjacent maxillary central incisor was significantly and positively associated with coronally positioned mesiodens (p = 0.044), mesiodens positioned parallel to central incisors (p = 0.002), large crown size of the mesiodens (p < 0.0001), and younger patient age (p < 0.0001). These findings indicate a significant association between the characteristics of palatally impacted mesiodens and an increase in palatal inclination of the adjacent maxillary central incisors.