Mesiodens impactado e invertido no sindrómico con quiste dentígero en el maxilar de un gemelo monocigótico. Reporte de caso

Mesiodens are supernumerary teeth located in the midline of the maxilla, frequently associated with alterations in dental eruption. Dentigerous cysts, on the other hand, are benign pathologies that occur in third molars and canines. The coexistence of an impacted and inverted mesiodens with a dentigerous cyst is rare, with a reported prevalence of only 5-6%. This report describes the case of an asymptomatic 8-year-old male pediatric patient who presented with absent eruption of the upper left central incisor. Clinical examination showed palatal swelling without mucosal color changes. The periapical radiography showed an inverted and impacted mesiodens with a pericoronal radiolucent image compatible with a dentigerous cyst. The lesion was confirmed by computed tomography and the diagnosis was corroborated histopathologically. Enucleation and extraction of the mesiodens was performed under local anesthesia, and the patient evolved favorably without complications. This case emphasizes the importance of early diagnosis and timely surgical treatment to prevent major complications such as malocclusion and root resorption of adjacent teeth. The particularity of this case lies in the fact that the patient is a monozygotic twin, whose brother did not present this anomaly, which makes it a relevant contribution to the literature on dental alterations in twins.