Multidisciplinary approach to fused maxillary central incisors: a case report

Journal of Medical Case Reports

Oreste Trosino¹  Francesco Riccitiello¹  Roberta Gasparro¹  Vincenzo Cerone¹  Gilberto Sammartino¹ 

[1] University of Naples Federico II, Naples, Italy

关键词: Orthodontic treatment;    Gemination;    Fused tooth;    Endodontic treatment;    Dental abnormalities;   

Others  :  1180955
DOI  :  10.1186/1752-1947-8-398

 received in 2014-07-30, accepted in 2014-09-23,  发布年份 2014

【 摘 要 】

Introduction

The fusion of permanent teeth is a development anomaly of dental hard tissue. It may require a hard multidisciplinary approach with orthodontics, endodontics, surgery and prosthetics to solve aesthetic and functional problems.

Case presentation

A 20-year-old Caucasian man presented to our Department to solve a dental anomaly of his upper central incisors. An oral investigation revealed the fusion of his maxillary central incisors and dyschromia of right central incisor. Vitality pulp tests were negative for lateral upper incisors and left central incisor. Radiographic examinations showed a fused tooth with two separate pulp chambers, two distinct roots and two separate root canals. There were also periapical lesions of central incisors and right lateral incisor, so he underwent endodontic treatment. Six months later, OPT examination revealed persistence of the periapical radiolucency, so endodontic surgery was performed, which included exeresis of the lesion, an apicoectomy and retrograde obturation with a reinforced zinc oxide-eugenol cement (SuperEBA) Complete healing of the lesion was obtained six months postoperatively. Fused teeth crowns were separated and orthodontic appliances were put in place. When correct teeth position was achieved (after nine months), the anterior teeth were prosthetically rehabilitated.

Conclusion

Many treatment options have been proposed in the literature to solve cases of dental fusion. The best treatment plan depends on the nature of the anomaly, its location, the morphology of the pulp chamber and root canal system, the subgingival extent of the separation line, and the patient compliance. Following an analysis of radiographical and clinical data, it was possible to solve our patient’s dental anomaly with a multidisciplinary approach.

【 授权许可】

   
2014 Sammartino et al.; licensee BioMed Central.

【 图 表 】

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