Geminated Maxillary Incisors: The Success of an Orthodontic Conservative Approach: 15 Years Follow-Up Study

Abstract

Tooth gemination is often presented clinically and radiologically as merged crowns or “megadonts” with or without a longitudinal fissure, single root, and a single pulp chamber. The increased mesiodistal width of these teeth results in poor anterior aesthetics, anterior crowding, and incisor rotation. Our aim is to present a conservative non-extraction orthodontic approach that provides both good aesthetics and long-term stability. It aims to achieve extra space to incorporate the megadonts into the dental arch and to exceed “super” class I dental relationships. Accordingly, this study shows that geminated teeth were successfully retained by means of conservative non-extraction orthodontic mechanotherapy and without premolar extractions or enamel reduction. It demonstrated stability during a long-term 15-year follow-up, in addition to high patient satisfaction, good aesthetics, and periodontal health. The solution protocol is definitive and achieved the aesthetic, psychological, and functional objectives at a feasible cost. Thus, this treatment has proven to be preferable to other alternative surgical prosthodontic and endodontic approaches in terms of its long-term stability, and by providing a solution that does not necessitate further multidisciplinary interventions. Dental practitioners in the fields of pediatric dentistry, endodontics and prosthodontics should be well aware of this option.