Concrescence of permanent maxillary second and third molars: case report of non-surgical root canal treatment

Abstract

Concrescence is a rare developmental anomaly with an overall incidence of 0.8% in the permanent dentition. While many case reports describe the treatment of concrescence with extraction, there are few reports of non-surgical root canal treatment (NSRCT), due to the atypical root form, canal morphology, and technical difficulties involved in concrescence. This unique case report describes a technical modification of NSRCT that can retain joined posterior maxillary teeth to maintain natural posterior occlusion without surgical intervention or dental implants, thereby avoiding the risk of damage to a large portion of the alveolar bone near the maxillary sinus. (J Oral Sci 54, [133][134][135][136] 2012)

Developmental anomalies affecting the morphology of teeth – a review

“…Concrescence is defined as the cemental union of two adjacent teeth without confluence of the underlying dentin showing independent pulp chambers and root canals [14,18]. It may occur during or after the completion of root formation.…”

Concrescence of an Erupted Maxillary Second Molar with an Impacted Third Molar: A Case Report

“…However, Foran et. al describes a unique case that was treated by non-surgical root canal treatment (NSRCT) [7].…”

Concrescence of Erupted Second Molar and Impacted Third Molar: A Rare Case Report

“…Conversely, fusion was considered the union of two normally separated tooth bud with the resultant formation of a joined tooth with confluence of dentin. Finally, concrescence represents an uncommon developmental anomaly in which juxtaposed teeth are united in the cementum but not in the dentin 1 . Concrescence is believed to occur during root formation or after the radicular phase of development is complete.…”

“…If concrescence occurs during development it is called as true concrescence and if occurs after development it is called acquired concrescence 1 . In order for concrescence to take place, the roots of the affected teeth must be in close proximity to each other, and an excess layer of cementum must be deposited to form the union between the roots of the adjacent teeth.…”