Author:
Nandekar D, Dwivedi S, Patel V, Akote M, Mohanty S, Bhojwani S.
Published Online:
November 30, -0001
Background: Tooth fusion involving supernumerary teeth is an uncommon
developmental dental anomaly, particularly in the permanent dentition. It may
present as an esthetic and functional concern, often requiring interdisciplinary
management. Early diagnosis and a tailored treatment plan are essential to
preserve oral health and achieve satisfactory cosmetic outcomes.
Case Presentation: A 9-year-old male presented with an esthetic complaint
due to an abnormally shaped maxillary right central incisor. Clinical and
radiographic evaluation revealed fusion of a supernumerary tooth with the
permanent central incisor, accompanied by palatal displacement of the right
lateral incisor. A multidisciplinary treatment plan was executed, including
endodontic therapy, surgical hemisection, auto-transplantation of the lateral
incisor, and reimplantation of the hemisectioned central incisor. Regenerative
aids including platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) were
used. Esthetic rehabilitation was completed with a three-unit anterior fixed
prosthesis.
Conclusion: Fusion involving supernumerary teeth presents a diagnostic and
therapeutic challenge in pediatric patients. A multidisciplinary approach
combining endodontics, surgery, regenerative therapy, and prosthetic
rehabilitation can lead to successful functional and esthetic outcomes.
1. Steinbock N, Wigler R, Kaufman AY,
Lin S, Abu-El Naaj I, Aizenbud D.
Fusion of central incisors with
supernumerary teeth: a 10-year followup of multidisciplinary treatment. J
Endod. 2014 Jul;40(7):1020-4. doi:
10.1016/j.joen.2013.12.004. PMID:
24935556.
2. Demircioglu Guler D, Sen Tunc E,
Arici N, Ozkan N. Multidisciplinary
management of a fused tooth: a case
report. Case Rep Dent.
2013;2013:634052. doi:
10.1155/2013/634052. PMID:
24396611; PMCID: PMC3874312.
3. Ozden B, Gunduz K, Ozer S, Oz A,
Otan Ozden F. The multidisciplinary
management of a fused maxillary
central incisor with a talon cusp. Aust
Dent J. 2012 Mar;57(1):98-102. doi:
10.1111/j.1834-7819.2011.01637.x.
PMID: 22369566.
4. Gautam G, Kumari VS, Jayashankar
CM, Hadge P, Garg G.
Interdisciplinary management of
dental anomalies: fusion and
supernumerary teeth. Orthodontics
(Chic.). 2011 Summer;12(2):140-7.
PMID: 21935508.
5. Kulkarni VK, Reddy S, Duddu M,
Reddy D. Multidisciplinary
management of multiple maxillary
anterior supernumerary teeth: a case
report. Quintessence Int. 2010
Mar;41(3):191-5. PMID: 20213018.
6. Ammari AB, Young RG, Welbury RR,
Fung DE. A report of treatment of a
fused permanent central incisor and
supplemental lateral incisor. Dent
Update. 2008 Nov;35(9):636-8, 640-1.
doi: 10.12968/denu.2008.35.9.636.
PMID: 19065881. 7. Ozalp SO, Tuncer BB, Tulunoglu O,
Akkaya S. Endodontic and orthodontic
treatment of fused maxillary central
incisors: a case report. Dent Traumatol.
2008 Oct;24(5):e34-7. doi:
10.1111/j.1600-9657.2008.00635.x.
PMID: 18557749.
8. Cetinbas T, Halil S, Akcam MO, Sari
S, Cetiner S. Hemisection of a fused
tooth. Oral Surg Oral Med Oral Pathol
Oral Radiol Endod. 2007
Oct;104(4):e120-4. doi:
10.1016/j.tripleo.2007.03.029. PMID:
17656128.
9. Karacay S, Guven G, Koymen R.
Management of a fused central incisor
in association with a macrodont lateral incisor: a case report. Pediatr Dent.
2006 Jul-Aug;28(4):336-40. PMID:
16903442.
10. Ballal NV, Kundabala M, Acharya S.
Esthetic management of fused carious
teeth: a case report. J Esthet Restor
Dent. 2006;18(1):13-7; discussion 18.
doi: 10.2310/6130.2006.00002. PMID:
16426503.