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diagnosticadas precocemente. Este trabalho teve como finalidade relatar o caso clínico de uma paciente de três anos, gênero feminino, cuja queixa principal era a estética dos dentes anteriores superiores,devido ao tamanho desproporcional de um elemento dentário, que se apresentava também com coloração alterada. Ao exame clínico e radiográfico diagnosticou-se uma anomalia denominada fusão dentária, união de dois dentes adjacentes, na região anteros superior. O tratamento consistiu na secção dos dois dentes e exodontia do supranumerário, seguida do tratamento restaurador do incisivo central direito que apresentava lesão de cárie. Concluiu-se que, por meio de adequado diagnóstico e planejamento, o tratamento proposto foi efetivo na reabilitação da função e da estética,assim como na prevenção de complicações clínicas e ortodônticas que poderiam advir da anomalia dentária descrita, caso não tratada. A autoestima da criança foi restabelecida.

Dental anomalies can cause serious disorders in the development of teeth if not diagnose dearly. This study aimed to report a case of a three-year-old patient, female, who together with her responsible, whose main complaint was the aesthetics of the upper front teeth due to disproportionatesize and altered staining. During the clinical and radiographic examinations, ananomaly called teeth merger, which is the union of two adjacent teeth, was diagnosed in the upper anterior region. The treatment included the sectioning of the two teeth and extraction of the super numerary, followed by restorative treatment of the right central incisor that had caries lesions. It was concluded that, through proper diagnosis and planning, the proposed treatment was effective in the rehabilitation of function and aesthetics, as well as in the prevention of clinical and orthodontic complications that could result from the dental anomaly described, ifuntreated. The child’s self-esteem was re-established.

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Concrescence is a rare dental anomaly whereby adjacent teeth are united by cementum. It has been reported to occur in around 0.8% of permanent dental extractions and a correct diagnosis prior to surgical intervention is important to ensure that patients can make an informed decision about their treatment and to reduce the potential for dentolegal action against the responsible clinician. An 83-year-old woman was referred to the Oral and Maxillofacial Surgery Department at the Wirral University Teaching Hospital, for extraction of her upper left first molar tooth. The operator noted that, when the upper left first molar was extracted, the upper left second molar tooth was also removed. Clinically, the roots of the adjacent teeth appeared fused and a diagnosis of concrescence was established. The patient was informed of the complication and provided with a 1-week review appointment, at which stage she was discharged.

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BACKGROUND: Fusion is defined as the union between dentine and/or enamel of two normally separated teeth. Gemination is the cleavage of the forming dental germ to produce two partial teeth. The distinction between the conditions is often determined by the number of teeth present. However, this can be confused if supernumerary teeth are considered. AIM: The present case report describes the treatment of a patient who presented with dental fusion and macrodontia involving both upper central incisors. Besides the central incisors displaying characteristics of macrodonts, tooth 21 also showed aspects of fusion. METHODS: Management consisted of the extraction of 11 and 21 and orthodontic mesialisation of the maxillary dentition. Treatment was planned in two phases and at the end of the orthodontic phase, the upper anterior teeth were to be reshaped using composite resin. RESULTS: Orthodontic space closure is a treatment option in the clinical management of an extracted maxillary central double and/or macrodontic tooth. As no permanent teeth were absent, it was presumed that the fusion of 21 occurred with a supernumerary tooth. CONCLUSIONS: Multidisciplinary treatment following the extraction of maxillary central incisors is reported with special attention to the orthodontic and restorative considerations required to improve the aesthetic outcome.

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Fusion has been described as a developmental anomaly characterized by the union of two adjacent teeth. Few cases of this rare anomaly in primary dentition have been reported in Indian population. A rare case of bilateral fusion between primary mandibular lateral incisors and canines is presented in this report.

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PURPOSE: To assess the feasibility of magnetic resonance imaging (MRI) of dental abnormalities in children. MATERIALS AND METHODS: The study included 16 patients (mean age, 10.8 yr) prospectively selected from 1,500 orthodontic patients. The selected patients included 3 with a mesiodens, 9 with supernumerary teeth other than a mesiodens, 1 with gemination, 1 with dilacerations, 1 with transmigration, and 1 with transposition. Three-dimensional (3D) images were acquired on a 1.5-T MRI scanner using a 3D turbo spin echo pulse sequence with a voxel size of 0.8 × 0.8 × 1 mm. The measurement time was 4 to 5 minutes. RESULTS: Using natural MRI contrast, the teeth, dental pulp, mandibular canal, and cortical bone could be clearly delineated. The position and shape of malformed teeth could be assessed in all 3 spatial dimensions. CONCLUSION: MRI was found to be a well-tolerated imaging modality for the diagnosis of dental abnormalities in children and for orthodontic treatment and surgical planning. Compared with conventional radiography, dental MRI provides the advantage of 3-dimensionality and complete elimination of ionizing radiation, which is particularly relevant for repeated examinations in children.

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The term double tooth corresponds to a binding dental anomaly and refers, therefore, to two teeth together, and includes gemination and fusion. Gemination is an attempt to divide a developing germ, without affecting the final number of pieces. Fusion is the pre-eruptive or embryological union of two adjacent tooth germs, resulting in a piece down in the formula of the arcade hit. Both anomalies show similar clinical features and can occur in both dentitions. This report presents a case of double tooth in mandibular anterior dentition, with diagnosis of dental fusion in a 4 years old patient, explains the features of the case and finally identifies the importance of differential diagnosis between fusion and gemination as pathological entities of similar clinical presentation which according to the literature, can involve almost the same teeth, with potential effects on permanent dentition.

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In the primary dentition, traumatic injuries affecting the tooth-supporting structures are common due to increased bone resilience in children. Crown-root fracture, defined as a fracture involving enamel, dentin, and cementum, is uncommon in the primary dentition, comprising only 2% of dental traumas. This article reports the treatment and follow-up of a 2-year-old boy who suffered a traumatic crown-root fracture involving a primary anterior incisor that was fused to a supernumerary tooth.

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This study investigated the recurrence in the permanent dentition of dental anomalies of the primary dentition. A sample of 189 subjects (100 males, 89 females, mean age of 5 years and 7 months) with anomalies of primary teeth (tooth hypodontia, supernumerary teeth, geminated teeth, and fused teeth) was selected and re-analyzed at a mean age of 11 years and 2 months for the recurrence of the dental anomalies in the permanent dentition. As a control group, 271 subjects (123 males, 148 females) without dental anomalies in the primary dentition were selected. The recurrence in the permanent dentition of the dental anomalies in the primary dentition was evaluated by measures of diagnostic performance. The results showed high values for the repetition of hypodontia (positive likelihood ratio = 102.0); low score for the repetition of hyperdontia (positive likelihood ratio = 6.5); low positive likelihood ratio (9.1) for gemination of primary teeth resulting in supernumerary permanent teeth; high positive likelihood ratio (47.0) for fusion of primary teeth followed by missing permanent teeth. Dental anomalies in the primary dentition are associated with an increased likelihood of anomalies of the succedaneous permanent.

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Concomitant hypo-hyperdontia is a rare condition of coexisting missing teeth and supernumerary teeth in the same subject. Its etiology is still not exactly known. Permanent dentition is usually affected. Presented here are two uncommon cases of bimaxillary concomitant hypo-hyperdontia during the mixed dentition period. Early diagnosis of the condition and multidisciplinary approach for management of such cases is recommended.

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Introdução: a fusão dentária é caracterizada pela união entre dois germes dentários durante o estágio de desenvolvimento,em consequência de aberração da camada germinativa do ectoderma e do mesoderma. Objetivo:o objetivo desse artigo foi descrever o tratamento endodôntico de incisivo inferior fusionado com dente extranumerário.Métodos: o paciente procurou atendimento com dor espontânea e severa no dente 41. O elemento dentário apresentou coroa atípica com aspecto de dente fusionado e, radiograficamente, observou-se a presença de raiz única e dois canais. Foi determinada a necessidade de tratamento endodôntico, realizado por instrumentos de níquel-titânio. A cada troca de instrumento foi efetuada a irrigação com solução de hipoclorito de sódio a 2,5%e, após o preparo do canal radicular, inundação com EDTA 17% por 5 minutos, com posterior irrigação final com a solução irrigante. A obturação foi realizada por meio da técnica de condensação lateral ativa da guta-percha, associada ao cimento obturador, complementada por termo condensação.Foi realizada a tomografia computadorizada para verificação da qualidade da obturação e a arquitetura da anatomia interna. A paciente retornou para controle clínico e radiográfico de um ano, com o dente evidenciando sinais de normalidade. Conclusão: o cirurgião-dentista deve desenvolver competência no diagnóstico e tratamento adequado das anomalias dentárias, promovendo condições de melhora à saúde bucal dos pacientes

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Fusion is a developmental anomaly of dental hard tissues. Most cases occur in the anterior region of both the primary and permanent dentitions. Occasionally, fusion of permanent and supernumerary teeth may occur in the maxillary anterior region; however, a supernumerary tooth fused with a premolar is a rare case. Developmental lateral periodontal cyst is also an uncommon developmental odontogenic cyst with no clinical symptoms, and the lesion is often discovered on routine radiographic examination. In the present case, we report the uncommon fusion of teeth and lateral periodontal cyst in a Chinese girl. Using cone beam computed tomography we are able to acquire a better understanding of the complicated root canal morphology of the fused tooth and successfully manage the lateral periodontal cyst.

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The rare anomaly of fusion in primary dentition has very little documentation in Indian population. Two rare cases of bilateral fusion between primary mandibular lateral incisors and canines and primary mandibular central incisors and lateral incisors have been presented in this report. A minimal intervention approach, preventive procedures, and a long-term follow-up have been discussed.

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PURPOSE: Dental fusion is defined as the union of two dental germs at some stage of their development. The aim of this article is to report the endodontic treatment of two clinical cases of dental fusion. CASE DESCRIPTION: In the first case, the patient was referred by an orthodontist for endodontic treatment of tooth 12, which was fused to 13. Surgical separation and later replacement of the involved elements in the dental arch was indicated. In the second case, the patient sought dental attendance due to spontaneous pain. In the radiographic exam, gemination in tooth 11 and fusion of 21 with a supernumerary tooth was observed. The fused teeth were endodontically treated, and patients were referred to other dental specialties to reestablish esthetics and function. CONCLUSION: The dentist must be able to diagnose, differentiate and treat these dental anomalies adequately, with the goal of maintaining patients' oral health.

OBJETO: Fusão dental é definida como sendo a união de dois germes dentais em algum momento do estágio de desenvolvimento. O objetivo desse artigo foi descrever o tratamento endodôntico de dois casos de fusão dental. DESCRIÇÃO DO CASO: No primeiro caso clínico, o paciente foi orientado pelo ortodontista a realizar tratamento endodôntico do dente 12, o qual estava fusionado ao dente 13. Foi realizada a separação cirúrgica dos elementos dentais e posterior reposicionamento no arco dental. No segundo caso clínico, o paciente procurou atendimento relatando dor espontânea na região anterior superior. Por meio do exame radiográfico, foi observado geminação do dente 11 e fusão do dente 21 com dente extranumerário. Em ambos os casos os dentes fusionados foram tratados endodônticamente e os pacientes encaminhados para restabelecimento da estética e função. CONCLUSÃO: O cirurgião dentista deve ter habilidade de diagnosticar, diferenciar e tratar adequadamente as anomalias dentárias, objetivando a manutenção da saúde oral dos pacientes.

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Purpose: Synodontia or fusion is a developmental anomaly of shape of tooth formed by union of two independently developing primary or secondary teeth. Prevalence of tooth fusion is estimated at 0.5-2.5% in the primary dentition and less in permanent dentition. The bilateral type of fusion in the primary dentition is rare and is about 0.02%. This paper describes a rare case of bilateral fusion of primary mandibular lateral and canine teeth. Case description: An 8 year old girl had a complaint of unusually large sized teeth in her mandible. After physical examination and use of periapical radiographs and study models bilateral fused teeth in the mandibular lateral incisor and canine region was diagnosed. Conclusion: The bilateral fusion of primary mandibular lateral and canine teeth is a rare condition and should be carefully evaluated to diagnose any associated pathology.

Objetivo: Sinodontia ou fusão é uma anomalia de desenvolvimento da forma do dente formado pela união de dois dentes decíduos ou permanentes em desenvolvimento de forma independente. A prevalência de fusão dental é estimada em 0,5 a 2,5% na dentadura decídua e menor na permanente. O tipo de fusão bilateral na dentadura decídua é rara e aproximadamente de 0,02%. Este artigo descreve um caso raro de fusão bilateral de dentes decíduos incisivos laterais e caninos inferiores. Descrição do caso: Uma menina de 8 anos de idade tinha uma queixa clínica de dentes de tamanho grande anormal em sua mandíbula. Após exame físico e uso de radiografias periapicais e modelo de estudo, a fusão bilateral de dentes decíduos incisivos laterais e caninos inferiores foi diagnosticada. Conclusão: A fusão bilateral de dentes decíduos incisivos laterais e caninos na mandíbula é uma condição rara e deve ser cuidadosamente avaliada para diagnosticar quaisquer patologias associadas.

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La fusión dental es la unión de dos gérmenes dentales normalmenteseparados, mientras que la geminación se define como el intentode división de un único germen dental.La fusión y geminación de molares es poco frecuente en la dentición permanente.Describimos un caso clínico de un tercer molar inferior derecho fusionadoa un cuarto molar supernumerario en un paciente varón de 36 años queha presentado repetidos episodios de pericoronaritis. Tras el estudio radiológicose realiza la exodoncia del cordal semiincluido bajo anestesia local.Llevamos a cabo una revisión bibliográfica al respecto(AU)

Dental fusion is the union of two tooth buds that normallyare separated, while gemination is defined as an attempt by a singletooth bud to divide.The fusion and gemination of molars is uncommon in permanentteeth.We report a clinical case of a right lower third molar fused to asupernumerary fourth molar in a 36-year-old male patient withrepeated episodes of inflammation. After the radiologic study, thesemi-impacted third molar was extracted under local anesthesia.The literature was reviewed(AU)

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La fusión y la geminación son anomalías de forma que presentan las piezas dentales. La fusión es la unión de dos piezas en desarrollo y la geminación es el nacimiento de un segundo diente a partir de un único brote. Las radiografías panorámicas son de utilidad para establecer un diagnóstico diferencial. Si bien no se conoce cuál es la etiología de estas anomalías, se les confieren múltiples causas. Como conclusión, es importante la elaboración de un plan de tratamiento individualizado para cada caso.

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