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Chen F, Wang S, Bai N, Li X, Wang L, Xia X, Liu J, Tan F. Management of Fused Anterior Teeth: Review and Clinical Report. J Prosthodont 2022; 31:282-288. [PMID: 35000263 DOI: 10.1111/jopr.13478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 01/03/2022] [Indexed: 01/02/2023] Open
Abstract
The phenomenon of fusion is a type of tooth dysplasia, but few studies have systematically described the treatment of this kind of abnormality. This paper summarizes the treatment methods for fused teeth and classifies the management schemes according to whether the pulp is fused. Then, the treatment for a patient with bilateral anterior tooth fusion is reported. After orthodontic treatment, porcelain veneers were used to restore the normal shape and aesthetic appearance of the anterior teeth. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Fangbing Chen
- Dental Medical Center, Qingdao West Coast New District People's Hospital, Qingdao, 266000, People's Republic of China.,Department of Prosthodontics, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People's Republic of China
| | - Shaolei Wang
- Department of Prosthodontics, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People's Republic of China.,School of Stomatology of Qingdao University, Qingdao, 266003, People's Republic of China
| | - Na Bai
- Department of Prosthodontics, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People's Republic of China
| | - Xue Li
- Department of Prosthodontics, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People's Republic of China
| | - Lizhe Wang
- Department of Prosthodontics, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People's Republic of China.,School of Stomatology of Qingdao University, Qingdao, 266003, People's Republic of China
| | - Xiaomin Xia
- Department of Prosthodontics, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People's Republic of China.,School of Stomatology of Qingdao University, Qingdao, 266003, People's Republic of China
| | - Jie Liu
- Department of Prosthodontics, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People's Republic of China
| | - Fei Tan
- Department of Prosthodontics, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People's Republic of China
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2
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Bernardi S, Bianchi S, Bernardi G, Tchorz JP, Attin T, Hellwig E, Karygianni L. Clinical management of fusion in primary mandibular incisors: a systematic literature review. Acta Odontol Scand 2020; 78:417-424. [PMID: 32125202 DOI: 10.1080/00016357.2020.1734233] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: Dental anomalies occurring in deciduous teeth can affect the eruption of the permanent dentition and the occlusion stability. The occurrence of dental anomalies such as double teeth during the primary dentition in the daily practice might be frequent. The study aimed to qualitatively summarize the therapeutic management of double teeth in primary incisors.Material and Methods: A systematic review regarding the therapy of primary fused incisors in the mandible was performed and the obtained data were assessed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following electronic databases were screened from 1st January, 1996 until 30th July, 2019: PubMed, Scopus, EBSCO and the archives of paediatric dental journals. The search terms were grouped in anatomic entity: (tooth OR teeth OR incisor), pathological condition: (fused OR fusion OR geminated OR double), intervention: (treatment OR intervention OR therapy OR prevention OR control OR management OR restoration), observed parameters: (primary dentition OR primary tooth OR primary teeth).Results: Ten articles met all inclusion criteria. The data disclosed the occurrence of double teeth in mandibular incisors. The main management of this clinical condition is either preventive or surgical involving the extraction of fused teeth, based on the deciduous nature of the teeth, the degree of caries and malocclusion development risk.Conclusion: An early diagnosis of dental anomalies is fundamental for the application of proper preventive strategies to avoid a potential malocclusion in permanent dentition and to maintain these teeth sound and caries-free until the eruption of the permanent dentition.
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Affiliation(s)
- Sara Bernardi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Serena Bianchi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | | | - Jörg Philipp Tchorz
- Department of Operative Dentistry, Periodontology and Endodontology, University of Dental Medicine and Oral Health, Danube Private University (DPU), Krems-Stein, Austria
| | - Thomas Attin
- Clinic for Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Elmar Hellwig
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Lamprini Karygianni
- Clinic for Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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3
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Marra PM, Nucci L, Femiano L, Grassia V, Nastri L, Perillo L. Orthodontic Management of a Mandibular Double-tooth Incisor: A Case Report. Open Dent J 2020. [DOI: 10.2174/1874210602014010219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The presence of a double-tooth requires specific complex management due to the need for differential diagnosis and following treatment choices. The aim of this report was to present a rare case of a geminated mandibular lateral incisor, treated with an orthodontic approach.
A Caucasian 10.9-year-old girl presented a lower right double-tooth incisor, with a class 1 molar and a class 2 cuspid tendency on both sides. The upper arch was constricted as shown by bilaterally tendencies to cross-bite, a slightly lower midline deviation was reported and a lack of space for all four permanent cuspids was confirmed also by the panoramic X-ray.
In the lower arch, there was a severe crowding of about 14 mm and a buccally ectopic left canine. Overbite was normal and Overjet minimally increased.
The double-tooth was identified like a geminated tooth, for the presence of one root and one pulp canal of increased size, as shown by the radiographic examinations.
The anomalous tooth was managed with an orthodontic approach associated with a progressive stripping to reshape the crown. A two-phase treatment plan was performed, based on first maxillary expansion and lip bumper and then fixed appliances, in order to achieve a proper occlusion and a better aesthetic.
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Da Costa GC, Chalakkal P, De Souza N, Gavhane S. Bilateral Complete and Incomplete Fusion of Incisors and its Management. Contemp Clin Dent 2017; 8:171-174. [PMID: 28566874 PMCID: PMC5426155 DOI: 10.4103/ccd.ccd_1090_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This case report highlights the management of a case of bilateral complete and incomplete fusion of maxillary incisors in a 10-year-old child. A mock-up was done on the diagnostic cast. Pretreatment esthetic evaluation was done using bis-acryl composite temporaries which were transferred intraorally from the diagnostic cast using a putty index. An incisal overlap veneer preparation was done, following which, an IPS e-max veneer was cemented. A digital mock-up was carried out using the Adobe Photoshop and Corel Draw softwares to aid in laboratorial fabrication of the veneer.
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Affiliation(s)
| | - Paul Chalakkal
- Department of Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Neil De Souza
- Department of Pedodontics and Preventive Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Sanket Gavhane
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, Goa, India
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5
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Smail-Faugeron V, Terradot J, Muller Bolla M, Courson F. Management of non-syndromic double tooth affecting permanent maxillary central incisors: a systematic review. BMJ Case Rep 2016; 2016:bcr-2016-215482. [PMID: 27307427 DOI: 10.1136/bcr-2016-215482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
To assess management of non-syndromic double tooth affecting permanent maxillary central incisors, we performed a systematic review and also present 2 case reports. We searched MEDLINE via PubMed and the reference lists of included reports. Eligible studies were any type of clinical studies describing the management of non-syndromic double tooth affecting the crown of a permanent maxillary central incisor. We included 68 studies corresponding to 72 relevant case reports. Therapeutic options in descending order of priority were restorative dentistry (35%), hemisection (33%), abstention (17%) or extraction (15%). Orthodontic management resulted in 57% of cases. We report an 11-year-old boy with bilateral fusion of the two maxillary central incisors and a 9-year-old boy with a double left central incisor and a supernumerary lateral right incisor. A multidisciplinary approach is key to management of permanent maxillary central incisors affected by coronary anomalies.
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Affiliation(s)
| | - Jeanne Terradot
- Universite Paris Descartes Faculte de Chirurgie Dentaire, Montrouge, Île-de-France, France
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Ozcan G, Sekerci AE, Soylu E, Nazlim S, Amuk M, Avci F. Role of cone-beam computed tomography in the evaluation of a paradental cyst related to the fusion of a wisdom tooth with a paramolar: A rare case report. Imaging Sci Dent 2016; 46:57-62. [PMID: 27051641 PMCID: PMC4816773 DOI: 10.5624/isd.2016.46.1.57] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 01/13/2016] [Accepted: 01/16/2016] [Indexed: 11/18/2022] Open
Abstract
Fusion is an abnormality of tooth development defined as the union of two developing dental germs, resulting in a single large dental structure. This irregular tooth morphology is associated with a high predisposition to dental caries and periodontal diseases. As a result of recurring inflammatory periodontal processes, disorders such as periodontal pocket, pericoronitis, and paradental cysts may develop. A rare mandibular anatomic variation is the retromolar canal, which is very significant for surgical procedures. The fusion of a paramolar and mandibular third molar associated with a paradental cyst co-occurring with the presence of a retromolar canal is rare, and the aim of the present study is to describe the evaluation of this anatomical configuration using cone-beam computed tomography.
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Affiliation(s)
- Gozde Ozcan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Ahmet Ercan Sekerci
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Emrah Soylu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gaziosmanpasa University, Tokat, Turkey
| | - Sinan Nazlim
- Department of Pathology, Yozgat State Hospital, Yozgat, Turkey
| | - Mehmet Amuk
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Fatma Avci
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Shanthraj SL, Mallikarjun SB, Kiran S, Wilson B. 'Triplication' defect in deciduous teeth: an unusual odontogenic anomaly. BMJ Case Rep 2015; 2015:bcr-2014-205185. [PMID: 25743857 DOI: 10.1136/bcr-2014-205185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Developmental odontogenic anomalies can occur in primary as well as in permanent dentition leading to morphological variations in shape, size and structure and numerical variations such as hypodontia. The most commonly reported odontogenic anomaly in primary dentition is conjoined teeth. Conjoined teeth can be due to fusion or gemination. Relevant clinical and radiographic evaluation is a must to differentiate between the two. Occurrence of double fusion as an anomaly may not be infrequent, but triple fusion is a rare odontogenic anomaly. We report a case of a 7.5-year-old girl who clinically had a large crown due to triple fusion in her dentition, between two normal primary teeth and a supernumerary tooth. This paper gives a brief insight into the incidence, associated quandaries and diagnosis and treatment modalities of a triple fusion.
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Affiliation(s)
- Srinivas L Shanthraj
- Department of Pedodontics and Preventive Dentistry, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India
| | - Shanthala B Mallikarjun
- Department of Pedodontics and Preventive Dentistry, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India
| | - Shital Kiran
- Department of Pedodontics and Preventive Dentistry, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
| | - Bobby Wilson
- Department of Pedodontics and Preventive Dentistry, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India
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8
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Endodontic treatment and esthetic management of a geminated central incisor bearing a talon cusp. Case Rep Dent 2014; 2014:123681. [PMID: 24715989 PMCID: PMC3970080 DOI: 10.1155/2014/123681] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 01/21/2014] [Indexed: 12/31/2022] Open
Abstract
Gemination with talon cusps is an uncommon morphologic dental anomaly, characterized by the formation of clinically wide tooth that can cause significant aesthetic and clinical problems including esthetic impairment, pain, caries susceptibility, and tooth crowding. These morphological dental anomalies have specific treatment needs due to the abnormal morphology and need virtuous radiologic diagnosis. Multidisciplinary approach can supply success of the treatment plan that can provide esthetic and occlusal requirements. In this case report, the multidisciplinary approach for the treatment of geminated tooth with talon cusp is presented with the clinical and radiographic findings.
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9
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Shokri A, Baharvand M, Mortazavi H. The largest bilateral gemination of permanent maxillary central incisors: Report of a case. J Clin Exp Dent 2013; 5:e295-7. [PMID: 24455098 PMCID: PMC3892257 DOI: 10.4317/jced.51197] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 08/24/2013] [Indexed: 11/15/2022] Open
Abstract
Gemination is defined as an attempt to make two teeth from one enamel organ. Bilateral presentation of this phenomenon is very rare, with prevalence of 0.01% to 0.04% in the primary, and 0.05% in the permanent dentition.
This paper describes a rare case of huge bilateral gemination of permanent maxillary central incisors in a nine-year-old Iranian boy with poor aesthetic. The patient did not have history of anomaly in his primary dentition and in his family either. This type of dental anomaly can cause clinical problems in the form of malocclusion, poor aesthetic, and impaction of adjacent teeth, caries, and periodontal destruction.
Key words:Gemination, central incisor, bilateral.
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Affiliation(s)
- Abbas Shokri
- Assistant professor, Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Baharvand
- Associate professor, Department of Oral Medicine, Dental School, Shahid Beheshti University of Medical Sciences,Tehran, Iran
| | - Hamed Mortazavi
- Associate professor, Department of Oral Medicine, Dental School, Shahid Beheshti University of Medical Sciences,Tehran, Iran
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10
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Abstract
BACKGROUND Abnormally, large teeth are often referred to as 'double teeth'. These can pose numerous challenges for the clinician. There is no published protocol on the management of double teeth. AIM To review the published literature and also patients managed at the Eastman Dental Hospital (EDH) and to develop a clinical protocol for the management of double teeth in children and adolescents. DESIGN Literature was searched (Medline and Embase) and data collated. Patient notes of cases managed at the EDH were reviewed. RESULTS Eighty-one teeth from 53 papers and 22 patients were included in the review. Success criteria were only reported in 32 papers and were variable. Twenty-three papers had no follow-up period. The main factor in determining the management of a double tooth was root and root canal system morphology. The treatment of choice in teeth with separate roots was hemisection and in those with a single root was crown modification or extraction. CONCLUSION It was not possible to determine the best management strategies because of the variable reporting in the literature. The authors have proposed a protocol for management and a data collection sheet for essential information needed when reporting on double teeth cases.
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11
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Prabhakar AR, Kaur T, Nadig B. Bilateral fusion of permanent mandibular incisors with Talon's cusp: A rare case report. J Oral Maxillofac Pathol 2011; 13:93-6. [PMID: 21887010 PMCID: PMC3162869 DOI: 10.4103/0973-029x.57678] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Whenever nature diverts from the "normal or usual" it gives rise to something called "abnormal or unusual," which we call "a Disorder". Fusion of two teeth is a common developmental disorder that is seen by a clinician. However, bilateral fusion along with Talon's cusp is very rarely seen and reported in literature. This article describes a rare case of the bilateral fusion of permanent mandibular central and lateral incisors, along with presence of Talon's cusp on the left fused teeth.
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Affiliation(s)
- Attiguppe Ramasetty Prabhakar
- Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere - 577 004, Karnataka, India
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12
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Schulz M, Reichart PA, Stich H, Lussi A, Bornstein MM. Bilateral malformation of maxillary third molars. ACTA ACUST UNITED AC 2009; 108:e25-31. [PMID: 19615641 DOI: 10.1016/j.tripleo.2009.04.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Accepted: 04/10/2009] [Indexed: 11/19/2022]
Abstract
A case of bilateral compound odontomas in the region of the third molars in the maxilla is reported. The differential diagnosis for this case is discussed.
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MESH Headings
- Adolescent
- Cone-Beam Computed Tomography
- Diagnosis, Differential
- Female
- Functional Laterality
- Fused Teeth/diagnostic imaging
- Fused Teeth/pathology
- Humans
- Maxilla
- Molar, Third/abnormalities
- Molar, Third/diagnostic imaging
- Molar, Third/pathology
- Neoplasms, Multiple Primary/diagnostic imaging
- Neoplasms, Multiple Primary/pathology
- Odontoma/diagnostic imaging
- Odontoma/pathology
- Radiography, Panoramic
- Tooth Abnormalities/diagnostic imaging
- Tooth Abnormalities/pathology
- Tooth Crown
- Tooth, Impacted/diagnostic imaging
- Tooth, Impacted/pathology
- Tooth, Supernumerary/diagnostic imaging
- Tooth, Supernumerary/pathology
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Affiliation(s)
- Malte Schulz
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
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13
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Sivolella S, Bressan E, Mirabal V, Stellini E, Berengo M. Extraoral endodontic treatment, odontotomy and intentional replantation of a double maxillary lateral permanent incisor: case report and 6-year follow-up. Int Endod J 2008; 41:538-46. [PMID: 18363700 DOI: 10.1111/j.1365-2591.2008.01391.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To describe combined endodontic, surgical and orthodontic treatment of a maxillary lateral incisor fused with a supernumerary. SUMMARY Double tooth is a dental irregularity consequent to fusion of two or more teeth or dental gemination. The teeth most commonly involved are deciduous, but in 0.1% of cases permanent teeth are affected, in which case aesthetic, functional and periodontal problems can result. This paper reports a clinical case of a double tooth in the position of the maxillary right lateral permanent incisor. Combined orthodontic, endodontic and surgical treatment (intentional replantation) allowed the tooth to be retained without periodontal compromise and with a positive orthodontic result both immediately and 6 years following intervention. *A conservative approach that addresses periodontal, pulpal and tooth tissues, can result in the retention of a double tooth. *Maintenance of the root and alveolar bone in young adults at least until full skeletal maturation should be the main treatment objective.
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Affiliation(s)
- S Sivolella
- Department of Oral Surgery, University of Padova, Institute of Clinical Dentistry, Padova, Italy.
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Liu S, Fan B, Peng B, Fan M, Bian Z. Endodontic treatment of an unusual connation of permanent mandibular molars: a case report. ACTA ACUST UNITED AC 2006; 102:e72-7. [PMID: 16997098 DOI: 10.1016/j.tripleo.2006.01.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2005] [Revised: 12/27/2005] [Accepted: 01/05/2006] [Indexed: 10/24/2022]
Abstract
A 27-year-old patient with an anomalous mandibular molar was referred for endodontic therapy. Clinical and radiographic examination revealed the connation of a second mandibular molar with a third molar. Challenging endodontic therapy was performed in the unusual connated molars. A 2-year recall showed good treatment result.
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