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Impacted / delayed / malpositioned / extra teeth
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Orthogonal views of normal tooth 12
These orthogonal cross-sectional images demonstrate the mesiodistal and buccolingual dimensions of the crown of the unerupted, but normal, tooth 12. The tooth is 6.8 mm wide mesiodistally and 6.5 mm wide buccolingually. These dimensions are useful for comparing the normal tooth 22 to the two teeth that resemble lateral incisors in the anterior second quadrant in order to determine which tooth to remove.
Large crown of tooth 22a
One unerupted tooth that resembles a lateral incisor (labeled 22a) is positioned distopalatally to the crown of tooth 21. This crown has a large mesiodistal dimension of 8.1mm and a slightly enlarged buccolingual dimension of 6.8 mm. The crown of the tooth is more similar to a central incisor than a lateral incisor. No signs of malformation or damage are present in this crown. This tooth can be surgically accessed from the palatal aspect of the alveolar process in the region palatal to the roots of teeth 61 and 62.
Small crown of tooth 22b
A tooth that resembles a peg lateral incisor (labeled 22b) is present at the distal aspect of site 22 in the region distobuccal to the crown of tooth 22a. This tooth has a smaller mesiodistal dimension than normal, and also has a slightly reduced buccolingual dimension. The crown of the tooth appears normal otherwise, and does not exhibit any signs of malformation. Tooth 22b is positioned in the pericoronal region of tooth 23, and would likely impede the eruption of tooth 23. This tooth can be surgically accessed from the palatal aspect of the alveolar process in the periapical region of tooth 63.
Impacted tooth 21
The eruption of tooth 21 has been prevented by a the presence of tooth 22a in the region palatal and coronal to its crown. Tooth 21 has been buccally and superiorly displaced by tooth 22a. The crown of tooth 21 appears normal radiographically. The root of the tooth is partially formed, and does not exhibit any signs of malformation or damage.
Normal physiologic resorption of tooth 61
Tooth 61 exhibits normal physiologic root resorption, and is on the verge of exfoliation. The position of the crown of tooth 22a in the region coronal and palatal to the crown of the unerupted tooth 21 is evident in these images.
No significant resorption of tooth 62
Tooth 62 does not exhibit any significant pathology or root resorption. Tooth 22a is positioned palatally to the apical half of the root of tooth 22.
No significant resorption of tooth 63
Tooth 63 does not exhibit any significant root resorption. Tooth 22b is positioned distopalatally to the root of tooth 63. Tooth 22a is positioned mesiopalatally to tooth 63.
Axial views of anterior second quadrant
These axial cross-sectional images demonstrate the impacted teeth 21, 22a and 22b, and 23, as well as the mild resorption at tooth 61 and the absence of any significant resorption of teeth 62 and 63.