A rare case of dental fusion between a supernumerary tooth and a permanent tooth, treated with hemisection and reimplantation.
Extract
[...] This study focused on cases of fusion between permanent teeth and supernumerary teeth, consequently, articles dealing with fusion between permanent teeth were also excluded. Similarly, we did not retain cases of fusion of primary teeth, which present different therapeutic objectives, and also excluded fusions of molars, a much rarer case in the literature according to Akitomo et al 6 and requiring different treatments. Finally, given the diversity and specificity of cases of teeth fused with supernumerary teeth presented in the literature, we only selected articles that had at least evaluated the therapeutic option of external hemisection and/or reimplantation, even if they were not retained in the final therapeutic choice. [...]
[...] This type of anomaly can be differentiated according to whether it is a fusion and/or gemination, similar anomalies in shape, which can induce some confusion, but having different etiologies.7 Fusion is the union of one or more teeth during development, while gemination occurs when two distinct morphological units are created by the division of the dental germ (Table 1). The prevalence of these anomalies is not clearly established given the difficulty in distinguishing them precisely clinically. FUSION GÉMINATION Definition Two adjacent dental buds forming a single tooth. Enlarged crown and two distinct roots. A single dental bud attempts to divide into two distinct teeth. Results in a single tooth with an enlarged crown. Characteristics Unusual morphology. [...]
[...] 2020; 14:219-255. doi:10.2174/1874210602014010219 9. Steinbock Wigler Kaufman Lin Naaj Aizenbud D. Fusion of Central Incisors with Supernumerary Teeth: A 10-year Follow-up of Multidisciplinary Treatment. Journal of Endodontics. 2014;40. doi: 10.1016/j.joen.2013.12.004 10. Assadian Bolhari Khoshkhounejad Chitsaz Babaahmadi M. Management of a supernumerary tooth fused to the labial surface of a permanent maxillary central incisor. Clin Case Rep. 2023;11(11): e8179. doi:10.1002/ccr3.8179 11. [...]
[...] Autotransplantation as a Treatment Modality of Macrodontia: A Case Report. Oral Health and Dental Management. 2014; 13:1081-1085. doi:10.4172/2247-2452.1000733 31. Badole GP, Shenoi PR, Parlikar A. Endodontic management of central incisor associated with large periapical lesion and fused supernumerary root: a conservative approach. Restor Dent Endod. 2018;43(4): e44. doi:10.5395/rde.2018.43. e44 32. Sato Garcia-Sanchez Sanchez Chen IP. Use of 3-dimensional-Printed Guide in Hemisection and Autotransplantation of a Fusion Tooth: A Case Report. [...]
[...] The avulsion of the fused tooth was performed under general anesthesia, given the patient's medical history. According to the recommendations of the IADT 18, In order to achieve a successful reimplantation of the displaced tooth 21, a para-apical anesthesia without vasoconstrictor was performed during the operation, in order to preserve the vascularization of the periodontal ligament and to avoid any potentially harmful effects on the healing and survival of the reimplanted tooth. An endodontic treatment was applied to the fused tooth with a working length of 25 mm. [...]
