Abstract: PURPOSE: To analyze the relationship between the position of embedded mesiodens in maxilla and surgical approach in children, and provide reference for surgical design. METHODS: A total of 740 patients aged 4-16 years old with maxillary embedded mesiodens admitted to the Department of Stomatology, Shenzhen Children's Hospital from January 2018 to December 2022 were selected. According to preoperative CBCT data, the position of the mesiodens in the maxilla and the characteristics of the surgical approach were statistically analyzed. SPSS 26.0 software package was used for statistical analysis. RESULTS: There were 991 embedded mesiodens in 740 children. The selected cases were classified according to the axial angle relationship in sagittal plane between mesiodens and adjacent normal teeth or tooth germs, including 95 cases of acute angle type (including synclastic) (12.8%), 78 cases of vertical type (10.5%), 138 cases of obtuse angle type (18.7%), 328 cases of inverted type (44.3%), and 101 cases of mixed type (13.7%). The palatal gingival margin approach was the most selected surgical approach for the cases of acute angle (including synclastic), obtuse angle and inverted type, and palatal gingival margin approach and combined labial-palatal approach were the most selected surgical approach for the cases of vertical and mixed type. CONCLUSIONS: A new classification method was established based on CBCT data, and the relationship between the new classification method and various surgical approaches for extraction was analyzed, which helped to better guide clinical diagnosis and treatment of children's maxillary mesiodens.

Key words: Children, Maxilla, Embedded mesiodens, Classification method