Escolar Documentos
Profissional Documentos
Cultura Documentos
Case Report
Abstract
Fused teeth present a high predisposition to caries, which occurs
due to the possibility of bacterial plaque accumulation in the fissures or
grooves in the union between the teeth involved. This paper reports the case
of a 2-year-old boy presented with a fused left maxillary central and lateral
incisors which crown was destroyed by caries, and the endodontic and
composite resin based restorative treatment performed, that restored aesthetics,
function and preserved the primary teeth in the dental arch until their natural
exfoliation.
Introduction
Fused teeth are recognized as the union of two
normally separated tooth germs. It is supposed that
pressing or physic strength can produce the contact
of the developing teeth and their subsequent fusion.
Depending upon the stage of the development, the
union may be complete or incomplete. Geminated
teeth are anomalies which arise from an attempt by
a single tooth germ to divide by an invagination,
with resultant incomplete formation of two teeth1).
Clinical differential diagnosis between fusion
and gemination is difficult when a normal tooth and
a supernumerary tooth are involved2,3). Radiographically, two root canals and one or two roots may be
evident in fused teeth and a single root with a single
canal is observed in geminated teeth4).
In the primary dentition, the reported prevalence
of fusion varies amongst different studies. It depends
on the criteria used to classify fused teeth, the
examination methods with or without radiographs
Received on October 7, 2010
Accepted on January 7, 2011
Key words
Dental caries,
Fused teeth,
Oral rehabilitation
Case Report
A 2-year-old boy was referred to the Pediatric Clinic
of the Dentists Syndicate of So Paulo State for
dental treatment. Clinical examination showed a
carious involvement of several of his primary teeth,
including the fused left maxillary central and lateral
incisors. The carious involvement of the fused teeth
appeared to have initiated along the fusion line,
and the radiograph examination revealed pulpal
involvement. It was possible to see in the radiograph
that the two roots were fused and the two root canals
85
86
87
Discussion
According to Shafer1), in fused teeth, separate pulp
chambers and root canals are typically seen and in
geminated teeth there is only one pulp chamber and
one root canal. On the radiograph made after the
endodontic treatment in this present case, it is easy
to observe that the root is fused and the root canals
are shared. Because of the severely damaged fused
teeths crown, it is impossible to know if the pulp
chambers were shared, but we can believe that they
were because of the presence of two root canals
entrance. It is a complete fusion of the left maxillary
central and lateral primary incisors.
Due to the possibility of bacterial plaque accumulation in the fissures or grooves in the union
88
15)
16)
17)
18)
89