Dental fusion In 7 year in primary teeth
Abstract
Tooth fusion is defined as the developmental dental anomaly in which two different tooth buds are fused into one during the development stage.
Introduction
In the deciduous dentition, as well as in the permanent dentition, anomalies in color, shape, size or number may occur .
Fusion is one of the many different types of developmental anomalies. It is defined as the union of two normally separated tooth germs . This anomaly leads to alterations of number, as the union results in one tooth less than normal if the affected tooth is counted as one; size, since the tooth will be much larger as it is the union of two tooth buds, and shape.
Clinically, it may be difficult to differentiate a tooth fusion from another developmental anomaly, such as gemination. Gemination is the attempt of division of a single tooth germ by invagination, resulting in the incomplete formation of two teeth This particular anomaly does not affect the normal number of teeth, as the affected tooth is counted as one.
Tooth fusion may occur within the dentin, the enamel, or both. Radiographically, these teeth are observed to have one or more root canals and one or two pulp chambers On the other hand, geminated teeth present one single root and one root canal .
This anomaly has a prevalence of 0.1-2.5% in deciduous dentition, and 0.1-0.2% in permanent dentition . There is an equal distribution between females and males, and there are no significant differences in its location, affecting either maxillary or mandibular arches
Case Report
A 7-year-old boy come to dental clinic with the
chief complaint of dental caries on the
primary maxillary right central
incisor and the maxillary right lateral incisor
The patient’s medical history was unexceptional, and
there was no family history of dental abnormalities and no
parental consanguinity. No history of trauma was recorded.
The patient reported an occasional hypersensitivity to
thermal stimulation (cold and heat) and to sweet in the two
anterior carious teeth
.
General and extraoral examinations appeared to be
noncontributory.
The patient had complete primary dentition. Intraoral
examination revealed the presence of a large upper right central incisor with slightly deep and decayed buccal and
lingual grooves and the presence of extensive caries on the
distal, lingual, and incisal surfaces of the right lateral incisor (Figures 1(a) and 1(b))
Figure 1: Intraoral photographs. Carious large crown of tooth 51 associated with dental caries of tooth 52.
Periapical
radiograph
Radiographic examination revealed fusion of the maxillary right primary central incisor with lateral incisor . According to the radiographs, the fused tooth had two distinct roots, with no connection between the pulp chambers and canals. No periapical radiolucency associated with these teeth was detected
Figure 3 After Extraction
Conclusions
The presence of dental anomaly and correct diagnosis is always a challenge for the dentist. Early observation of the anomaly followed by clinical and radiographic evaluation
Dental abnormalities can cause functional and endodontic problems, but problems are mostly aesthetic if located in the upper anterior region. They represent a challenge for clinicians
Many treatment options 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
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