Multidisciplinary Management of a Permanent Central Incisor Fused with a Supernumerary Tooth: A Case Report
Multidisciplinary treatment approach of fused teeth
Abstract
Dental anomalies can be challenging for clinicians to diagnose and treat, such as fusion/gemination, which can be considered one of the most challenging anomalies to present a treatment plan for, due to esthetic, orthodontic, and periodontal problems they can cause in most cases. This case report describes an 8-year-old patient who complained of the unpleasant appearance of her right central incisor. Oral and radiographic examinations revealed a supernumerary tooth unilaterally fusing with the maxillary permanent central incisor. Two major factors in choosing a treatment plan in this case included: patient's age and presence of anomaly in the esthetic zone. This case report describes a treatment approach involving endodontic, periodontal, and restorative interventions for preserving a tooth in a child who could not undergo routine treatments such as implant placement due to incomplete growth of her dentoalveolar region, and bone deficiency caused by the dental anomaly.
1. Bernardi S, Bianchi S, Bernardi G, Tchorz JP, Attin T, Hellwig E, et al. Clinical management of fusion in primary mandibular incisors: a systematic literature review. Acta Odontol Scand. 2020 Aug;78(6):417-24.
2. Upadhyay N SI, Mishra R. Twinned lateral incisors. J Dent Spec. 2022;10(2):72.
3. Shah P, Chander JM, Noar J, Ashley PF. Management of 'double teeth' in children and adolescents. Int J Paediatr Dent. 2012 Nov;22(6):419-26.
4. Cunha RS, Junaid A, Mello I. Unilateral fusion of a supernumerary tooth to a maxillary permanent lateral incisor: a report of a rare case. J Endod. 2015 Mar;41(3):420-3.
5. Chen F, Wang S, Bai N, Li X, Wang L, Xia X, et al. Management of fused anterior teeth: Review and clinical report. J Prosthodont. 2022 Apr;31(4):282-8.
6. Hattab FN. Double talon cusps on supernumerary tooth fused to maxillary central incisor: Review of literature and report of case. J Clin Exp Dent. 2014 Oct;6(4):e400-7.
7. Levitas TC. Gemination, fusion, twinning and concrescence. J Dent Child (Chic). 1965;32:93-100.
8. AlKlayb SA, Devang Divakar D. An uncommon tooth fusion of mandibular primary lateral incisor with canine. Clin Pract. 2021 Feb;11(1):106-9.
9. Ben Salem M, Chouchene F, Masmoudi F, Baaziz A, Maatouk F, Ghedira H. Fusion or gemination? Diagnosis and management in primary teeth: A report of two cases. Case Rep Dent. 2021 Jun;2021:6661776.
10. Mader CL. Fusion of teeth. J Am Dent Assoc. 1979 Jan;98(1):62-4.
11. Arulraj P, Manoharan GMG, Vijayalakshmi D, Ramamoorthy K, Kedarnath PS, Senthilkumaran M. Double labial talon cusp on permanent incisior-An unusual occurrence. J Pharm Bioallied Sci. 2023 Jul;15(Suppl 1):S789-91.
12. Cárcamo-España V, Cuesta Reyes N, Flores Saldivar P, Chimenos-Küstner E, Estrugo Devesa A, López-López J. Compromised teeth preserve or extract: A review of the literature. J Clin Med. 2022 Sep;11(18):5301.
13. Steinbock N, Wigler R, Kaufman AY, Lin S, Abu-El Naaj I, Aizenbud D. Fusion of central incisors with supernumerary teeth: a 10-year follow-up of multidisciplinary treatment. J Endod. 2014 Jul;40(7):1020-4.
14. Kalgeri SH, Shivkumar AT, Prasanna S, Shankar PM. Cone beam computed tomography tool for assessment of unilateral fusion of permanent and supernumerary tooth - a case report. J Evolution Med Dent Sci. 2021;11(04):521-4.
15. Seo DG, Lee D, Kim YM, Song D, Kim SY. Biocompatibility and mineralization activity of three calcium silicate-based root canal sealers compared to conventional resin-based sealer in human dental pulp stem Cells. Materials (Basel). 2019 Aug;12(15):2482.
16. Oh H, Kim E, Lee S, Park S, Chen D, Shin SJ, et al. Comparison of biocompatibility of calcium silicate-based sealers and epoxy resin-based sealer on human periodontal ligament stem cells. Materials (Basel). 2020 Nov;13(22):5242.
17. Kim JH, Cho SY, Choi Y, Kim DH, Shin SJ, Jung IY. Clinical efficacy of sealer-based obturation using calcium silicate sealers: A randomized clinical trial. J Endod. 2022 Feb;48(2):144-51.
18. Santamaria MP, Saito MT, Casati MZ, Nociti Junior FH, Sallum AW, Sallum EA. Gingival recession associated with noncarious cervical lesions: combined periodontal-restorative approach and the treatment of long-term esthetic complications. Gen Dent. 2012 Jul-Aug;60(4):306-11.
19. De Bruyne MA, De Moor RJ. The use of glass ionomer cements in both conventional and surgical endodontics. Int Endod J. 2004 Feb;37(2):91-104.
20. Dragoo MR. Resin-ionomer and hybrid-ionomer cements: part II, human clinical and histologic wound healing responses in specific periodontal lesions. Int J Periodontics Restorative Dent. 1997 Feb;17(1):75-87.
21. Sculean A, Romanos G, Schwarz F, Ramanauskaite A, Keeve PL, Khoury F, et al. Soft-tissue management as part of the surgical treatment of periimplantitis: A narrative review. Implant Dent. 2019 Apr;28(2):210-6.
22. Calzavara D, Morante S, Sanz J, Noguerol F, Gonzalez J, Romandini M, et al. The apically incised coronally advanced surgical technique (AICAST) for periodontal regeneration in isolated defects: a case series. Quintessence Int. 2021 Dec;53(1):24-34.
23. Jepsen K, Sculean A, Jepsen S. Complications and treatment errors related to regenerative periodontal surgery. Periodontol 2000. 2023 Jun;92(1):120-34.
2. Upadhyay N SI, Mishra R. Twinned lateral incisors. J Dent Spec. 2022;10(2):72.
3. Shah P, Chander JM, Noar J, Ashley PF. Management of 'double teeth' in children and adolescents. Int J Paediatr Dent. 2012 Nov;22(6):419-26.
4. Cunha RS, Junaid A, Mello I. Unilateral fusion of a supernumerary tooth to a maxillary permanent lateral incisor: a report of a rare case. J Endod. 2015 Mar;41(3):420-3.
5. Chen F, Wang S, Bai N, Li X, Wang L, Xia X, et al. Management of fused anterior teeth: Review and clinical report. J Prosthodont. 2022 Apr;31(4):282-8.
6. Hattab FN. Double talon cusps on supernumerary tooth fused to maxillary central incisor: Review of literature and report of case. J Clin Exp Dent. 2014 Oct;6(4):e400-7.
7. Levitas TC. Gemination, fusion, twinning and concrescence. J Dent Child (Chic). 1965;32:93-100.
8. AlKlayb SA, Devang Divakar D. An uncommon tooth fusion of mandibular primary lateral incisor with canine. Clin Pract. 2021 Feb;11(1):106-9.
9. Ben Salem M, Chouchene F, Masmoudi F, Baaziz A, Maatouk F, Ghedira H. Fusion or gemination? Diagnosis and management in primary teeth: A report of two cases. Case Rep Dent. 2021 Jun;2021:6661776.
10. Mader CL. Fusion of teeth. J Am Dent Assoc. 1979 Jan;98(1):62-4.
11. Arulraj P, Manoharan GMG, Vijayalakshmi D, Ramamoorthy K, Kedarnath PS, Senthilkumaran M. Double labial talon cusp on permanent incisior-An unusual occurrence. J Pharm Bioallied Sci. 2023 Jul;15(Suppl 1):S789-91.
12. Cárcamo-España V, Cuesta Reyes N, Flores Saldivar P, Chimenos-Küstner E, Estrugo Devesa A, López-López J. Compromised teeth preserve or extract: A review of the literature. J Clin Med. 2022 Sep;11(18):5301.
13. Steinbock N, Wigler R, Kaufman AY, Lin S, Abu-El Naaj I, Aizenbud D. Fusion of central incisors with supernumerary teeth: a 10-year follow-up of multidisciplinary treatment. J Endod. 2014 Jul;40(7):1020-4.
14. Kalgeri SH, Shivkumar AT, Prasanna S, Shankar PM. Cone beam computed tomography tool for assessment of unilateral fusion of permanent and supernumerary tooth - a case report. J Evolution Med Dent Sci. 2021;11(04):521-4.
15. Seo DG, Lee D, Kim YM, Song D, Kim SY. Biocompatibility and mineralization activity of three calcium silicate-based root canal sealers compared to conventional resin-based sealer in human dental pulp stem Cells. Materials (Basel). 2019 Aug;12(15):2482.
16. Oh H, Kim E, Lee S, Park S, Chen D, Shin SJ, et al. Comparison of biocompatibility of calcium silicate-based sealers and epoxy resin-based sealer on human periodontal ligament stem cells. Materials (Basel). 2020 Nov;13(22):5242.
17. Kim JH, Cho SY, Choi Y, Kim DH, Shin SJ, Jung IY. Clinical efficacy of sealer-based obturation using calcium silicate sealers: A randomized clinical trial. J Endod. 2022 Feb;48(2):144-51.
18. Santamaria MP, Saito MT, Casati MZ, Nociti Junior FH, Sallum AW, Sallum EA. Gingival recession associated with noncarious cervical lesions: combined periodontal-restorative approach and the treatment of long-term esthetic complications. Gen Dent. 2012 Jul-Aug;60(4):306-11.
19. De Bruyne MA, De Moor RJ. The use of glass ionomer cements in both conventional and surgical endodontics. Int Endod J. 2004 Feb;37(2):91-104.
20. Dragoo MR. Resin-ionomer and hybrid-ionomer cements: part II, human clinical and histologic wound healing responses in specific periodontal lesions. Int J Periodontics Restorative Dent. 1997 Feb;17(1):75-87.
21. Sculean A, Romanos G, Schwarz F, Ramanauskaite A, Keeve PL, Khoury F, et al. Soft-tissue management as part of the surgical treatment of periimplantitis: A narrative review. Implant Dent. 2019 Apr;28(2):210-6.
22. Calzavara D, Morante S, Sanz J, Noguerol F, Gonzalez J, Romandini M, et al. The apically incised coronally advanced surgical technique (AICAST) for periodontal regeneration in isolated defects: a case series. Quintessence Int. 2021 Dec;53(1):24-34.
23. Jepsen K, Sculean A, Jepsen S. Complications and treatment errors related to regenerative periodontal surgery. Periodontol 2000. 2023 Jun;92(1):120-34.
| Issue | Vol 22 (Continuously Published Article-Based) | |
| Section | Case Report | |
| Keywords | ||
| Fused Incisors Tooth Supernumerary Interdisciplinary Studies | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Isaabadi M, Yaghobee S, Bolhari B, Malekpour F. Multidisciplinary Management of a Permanent Central Incisor Fused with a Supernumerary Tooth: A Case Report. Front Dent. 2025;22.
