Primary triple teeth: histological and CT morphological study of two case reports

Abstract

The macromorphology and micromorphology of two specimens of primary triple teeth using histological and CT analysis approach is analyzed. A single morphological pattern of triple teeth has been found and described: three nearly separate crowns with three separate pulp chambers, and three joined roots with three connected root canals. The characteristic triple teeth appearance occurred because a labial supernumerary tooth is the junction element between two teeth of normal series: the central incisor on the mesial side and the lateral incisor on the distal side. Primary triple teeth suggest an idiophatic abnormality in the distribution of the dental material originated very soon in the dental development. They can be considered as an early double fusion between three tooth germs, initially separate but in close proximity and developing synchronically.

Triple tooth in primary dentition: A proposed classification

“…[20] Six cases (of available data for 13 cases) showed absence of the corresponding succedaneous teeth. [91015161920] In the present case, there is agenesis of left maxillary permanent lateral incisor.…”

“…[5] Only one study with computerized tomography (CT) description of triple tooth that describes a single morphological pattern of three nearly separate crowns with separate pulp chambers and three joined roots with three connected root canals. [16] Only three reports provided histological findings of triple teeth cases and Aguilo et al . reported that the histological findings were similar to the CT findings.…”

“…If there are no missing permanent teeth, the cause of triple teeth could be hyperactive dental lamina and if the succedaneous teeth are missing, the cause could be disproportionate activity of dental lamina leading to a combination of hyperdontia-hypodontia state. [16]…”

“…Type I with three pulp chambers and three root canals due to fusion; Type Ia - fusion of two normal teeth with a supernumerary tooth as in cases described by Aguilo et al ., Rao,[1516] and others; Type Ib - fusion of three normal teeth as in the cases described by Bennett, Kurihara, Fukushima, Kurosu and Mochizuki et al . [614] and Type II with two pulp chambers and two root canals which can be Type IIa, a combination of one geminated (double tooth) tooth and a supernumerary tooth; or Type IIb, one geminated tooth (double tooth) and a normal tooth as in the case described by Trubman and Silberman.…”

Triple and Double Teeth in the Same Quadrant: Report of a Rare Case with Literature Review

“…Malformation under this category includes gemination, fusion and concrescence also known as twinned, connated, double, or triple teeth [3]. The term triple tooth is used to describe a rare dental abnormality in which three primary teeth appear to be joined which have been considered the result of fusion or gemination of teeth [4]. The first such case was reported by Bennett back in year of 1887 followed by Sprawson in year 1931.…”