Surgical and Orthodontic Management of Fused Maxillary Central and Lateral Incisors in Early Mixed Dentition Stage

Abstract

Fusion is one of the developmental dental anomalies in which two adjacent teeth are joined at the crown level forming a single tooth with an enlarged crown. Fusion causes some clinical problems such as unaesthetic appearance, pain, caries, and malocclusion. The management of fusion often needs multidisciplinary approach to give best possible esthetic and functional outcome. This paper reports a case of 9-year-old boy with fused maxillary left central and lateral incisors who was treated with 2 × 4 fixed orthodontic appliances after surgical separation of fused teeth.

Management of Bilateral Mandibular Fused Teeth

“…There are various treatment options for fused teeth in the permanent dentition and the treatment of choice is determined by the condition of the teeth involved and each patient's particular needs [4]. In most cases, surgical division with or without endodontic therapy may be performed [2,[4][5]. In the present case, 42-43 was selected for surgical treatment as the space requirements to correct the malocclusion on the lower arch was minimal.…”

“…If contact occurs after crown formation, incomplete fusion occurs at the root level. Incomplete fused teeth may present with separate pulp chambers and root canals [1][2].…”

A Geminated Mandibular Second Molar—A Case Report

“…The irregular morphology of the crown, particularly the presence of a large occlusal table with additional fissures, as well as lingual and labial vertical grooves where the two crowns demarcate, create plaque traps that may be difficult to clean [2]. As well as this, the abnormal shape of the tooth creates oddities in the way the maxillary and mandibular teeth occlude and can cause asymmetry, which interferes with tooth alignment and may result in crowding [2,6]. These features increase the likelihood of caries.…”

“…This can include complex endodontic work, difficulty in recreating intricate and unusual anatomy for direct restorations, difficulty in achieving an aesthetic result acceptable to the patient and hardship in achieving adequate periodontal hygiene for the patient [5]. A multidisciplinary approach may be required for especially complex cases [6].…”