Triplication in permanent teeth: A rare case report

Abstract

Fusion is an anomaly manifested in both deciduous and permanent dentitions. Triple tooth refers to the union of three separate tooth entities. It can involve the normal dentition or supernumerary teeth. Triplication is rarely encountered in deciduous and permanent dentition with an incidence of 0.02%. The case presented herein describes a rare case of triplication in permanent maxillary incisors and supernumerary teeth in a 15-year-old female.

Keywords: Concrescent triplet; double tooth; fused teeth; odontoplasia; supernumerary tooth; tooth abnormalities.

Figure 1

The extraoral (a) and intraoral (b) picture showing mild swelling on the left maxillary anterior region. The orthopantomogram revealing a fusion of the teeth (c)

Figure 2

Cone beam computed tomography in three-dimensional reconstruction (a), axial view (b) and panoramic view (c), shows abnormal tooth structure in maxillary left anterior region

Figure 3

Upon surgical exploration, the three roots depicting triplication of maxillary central incisor (a) are apparent. After curettage of the granulation tissue, a fragment of tooth was removed to maintain the bony contour (b). The cavity was packed with a hydroxyapatite bone graft and following that a plasma-rich fibrin membrane was placed (c) which acted as scaffold (d)

Figure 4

Photomicrograph of decalcified section and ground section of a tooth showing fusion of teeth in low power (a and c) and high power (b and d)