Early Removal of Mesiodens Is Not Associated With Permanent Incisor Root Damage

Background: Managing impacted mesiodens poses a significant challenge in pediatric oral and maxillofacial surgery. Early intervention carries the risk of iatrogenic injury to developing dental structures. In contrast, delayed surgery can lead to irreversible harm to neighboring permanent teeth, such as disrupted root formation and eruption issues. Objective: To examine the surgical timing of removal of impacted mesiodens. Design: Narrative review. Methods: A systematic quantitative analysis of the literature is used to determine the best strategy for timing. Literature published between 1980 and 2025 was studied based on the following criteria: (1) clinical studies reporting on the outcome of mesiodens management, (2) radiographic studies using cone-beam CT (CBCT) scans, (3) outcome results comparing early versus delayed intervention, (4) studies with clear age-based requirements, and (5) studies with ≥5 patients. Results: No difference was noted in surgical injury to the adjacent more...