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. 2014:2014:503478.
doi: 10.1155/2014/503478. Epub 2014 Feb 11.

A fused maxillary central incisor and its multidisciplinary treatment: an 18-year follow-up

Lluís Brunet-Llobet  1 , Jaume Miranda-Rius  2 , Eduard Lahor-Soler  3 , Abel Cahuana  1
Affiliations

A fused maxillary central incisor and its multidisciplinary treatment: an 18-year follow-up

Lluís Brunet-Llobet et al. Case Rep Dent. 2014.

Abstract

Fused teeth may cause aesthetic, spacing, periodontal, eruption, and caries problems. The present case report describes a 7-year-old boy patient with a chief complaint of unerupted maxillary incisor. Radiographic examination indicated a fused tooth which had two fused roots but two independent root canals. A complex management of a fused tooth is really difficult to standardize. In this case an orthodontic, endodontic, and surgical treatment (intentional replantation) allowed the tooth to be retained until 18 years following intervention. 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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Figures

Figure 1
Figure 1
Clinical images of the fused right maxillary central incisor in eruption. Notice its broad crown with a talon cusp.
Figure 2
Figure 2
Panoramic radiography. Notice the fused tooth with two root canals.
Figure 3
Figure 3
Intraoperative images. (a) After extraction, hemisection was performed. (b) Gutta-percha exposure was filled with silver amalgam. (c) The tooth's remaining portion was then replanted into the socket.
Figure 4
Figure 4
Clinical images. (a) Orthodontic treatment for Class II malocclusion; (b) dental cosmetic treatment of the right maxillary lateral and central incisors.
Figure 5
Figure 5
Clinical images after 18 years since the diagnosis. Notice a progressive pathological migration in buccal direction.
Figure 6
Figure 6
Periapical and panoramic radiographs showed a severe vertical bone defect.
See this image and copyright information in PMC

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