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In the light of own cases the authors present congenital dental anomalies--fused teeth. This abnormality was present in three boys aged 9, 10, 11 years, involving upper permanent incisors. In all these cases extraction was done for orthodontic indications. Various methods of management are discussed in these often difficult cases, and the results of orthodontic treatment.
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A case is reported documenting successful treatment of suppurative periradicular periodontitis involving a maxillary central incisor fused with a supernumerary tooth. Endodontic therapy was performed and partial resolution of the lesion was evident at the 1-yr recall and further resolution at the 16-month recall.
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In permanent and deciduous dentitions, the frequency of congenitally missing teeth, supernumerary teeth, conical teeth, fused teeth, germinate teeth, abnormal tubercles (basal ridge of incisor or canine, central cusps of molars, Carabelli's cusp, protostylid, and para-molar tubercles), and enamel hypoplasia (white spots, pigmentation, and enamel defects) were surveyed. Furthermore, mesio-distal and bucco-lingual dimensions of the crowns were measured and the relationship between developmental disturbances of dental hard tissue and tooth size was examined. For the deciduous dentition, the frequency of children with congenitally missing teeth, conical teeth and fused teeth was 7.2%, 1.1% and 5.3%, respectively. Enamel hypoplasia appears with the following frequency; white spots (16.0%), pigmentation (6.4%), and enamel defects (5.2%). Mesio-distal widths of the upper canine and lower lateral incisors of the children with congenitally missing teeth was significantly smaller than the standard values. For the permanent dentition, congenitally missing teeth, conical teeth and fused teeth were detected in 5.7%, 3.0%, and 0.5% of the children, respectively. The frequency of children with basal ridge, central cusps, Carabelli's cusp, protostylid, and para-molar tubercles was respectively, 1.1%, 2.6%, 7.1%, 0.3% and 1.3%. Children with central cusps or Carabelli's cusp tended to have larger crowns, while children with congenitally missing teeth or conical teeth tended to have smaller teeth. As for enamel hypoplasia, white spots were detected in 24.9% of the children, and pigmentation was in 8.1%, and enamel defects were in 9.2%. These results indicate that abnormality of tooth number and tooth morphology correlate with the tooth size and this tendency is more striking in permanent dentition than in deciduous dentition.
On the basis of results from animal experiments, the authors emphasize a series of factors interfering considerably with tooth eruption. It is dealt with tooth eruption disorders and dental malformations due to premature loss of teeth, fused deciduous teeth, certain dystrophies, submersion of deciduous teeth, dysembryoplasias, and rickets.
Three case reports of fusion are presented. Clinical problems relating to fusion may be unacceptable appearance or alignment of teeth, and periodontal conditions. It is suggested that all succedaneous teeth that are joined or fused together by dentin be referred to as fused teeth because of the frequent difficulty in differentiating fusion and gemination in the adult dentition.
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For the investigation of the clinical dental manifestations of inborn errors of metabolism, the oral examination of twenty one children aged from 5 months to 15 years 5 months was performed at the pediatric clinic of inborn errors of metabolism. The results were as follows: 1. In six of seven histidinemia patients, white spots, pit or hypoplasia of enamel, fused teeth, peg teeth or abnormal tubercles were observed. 2. In a patient with GM1-gangliosidosis, the upper and lower central incisors had severe white spots. 3. In one patient with osteopetrosis, one of two glycogenosis type IX and one of two homocystinuria patients, white spots or hypoplasia of enamel were observed. 4. One patient with hypophosphatemic vitamin D-resistant ricket, one with vitamin D-dependent ricket type II and one with galactosemia patient had no enamel hypoplasia. It was strongly suggested that there is a specific relationship of histidinemia and GM1-gangliosidosis to dental manifestations.
The treatment and observation of a child with fused mandibular primary lateral incisor and canine are presented. Asymmetries such as those caused by fusions can lead to serious malocclusion.
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This report documents the case of a young patient who presented with dental conjoining anomalies in both sides of the maxillary arch. One defect involved primary incisor twinning and the other a rare instance of primary incisor triplication--three conjoined teeth.
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Fusion of the permanent molars is a relatively uncommon dental anomaly. In this article, a case of fusion of a symptomatic mandibular third molar with a supernumerary fourth molar is reported. The differentiation with other forms of 'double teeth' is explained and the possibility of the initial panoramic radiograph view being misinterpreted as an artefact is discussed.
The consequences of disregarding the periodontal tissues through improper restoration design are illustrated. A geminated central incisor is aesthetically restored with a porcelain labial margin ceramometal crown and its normal counterpart with a porcelain laminate veneer to equalize proportions of the two teeth. Prior to restoration, the perio-prosthetic interdisciplinary approach is described in rehabilitation of the damaged periodontal tissues.