Subclinical Radiographic Alterations in Maxillary Central Incisors Adjacent to Impacted Mesiodens Without Clinical or Radiographic Complications: A Cone‐Beam Computed Tomography Study

BACKGROUND: The subclinical effects of impacted mesiodens without clinical or radiographic complications on adjacent permanent incisors remain unclear. AIM: This study aimed to assess whether impacted mesiodens without clinical or radiographic complications are associated with quantitative radiographic changes in adjacent maxillary central incisors (MCIs). DESIGN: This cross-sectional study analyzed cone-beam computed tomography images of 53 patients aged 10-15 years with a unilateral impacted mesiodens using an intraindividual contralateral control design. Mesiodens morphology, position, length, and minimum distance to the adjacent tooth were recorded. Root canal volume and dentin gray values were quantified in the adjacent and contralateral MCIs; associations were tested with nonparametric correlation and multivariable regression analyses (p < 0.05). RESULTS: Adjacent MCIs showed lower canal volumes and higher dentin gray values than contralateral controls (p < 0.001). Shorter mesiodens-tooth distance was associated with greater canal volume reduction (p = 0.006) and higher dentin gray values (p = 0.002). Mesiodens length was significantly associated with root canal volume reduction (p = 0.013) but not with dentin gray values (p > 0.05), whereas no significant associations were observed for morphological or positional classifications (p > 0.05). CONCLUSIONS: Impacted mesiodens without clinical or radiographic complications may be associated with subclinical radiographic alterations in adjacent MCIs, warranting consideration beyond routine clinical and radiographic assessment.