Abstract
The presence of a double-tooth requires specific complex management due to the need for differential diagnosis and following treatment choices. The aim of this report was to present a rare case of a geminated mandibular lateral incisor, treated with an orthodontic approach. A Caucasian 10.9-year-old girl presented a lower right double-tooth incisor, with a class 1 molar and a class 2 cuspid tendency on both sides. The upper arch was constricted as shown by bilaterally tendencies to cross-bite, a slightly lower midline deviation was reported and a lack of space for all four permanent cuspids was confirmed also by the panoramic X-ray. In the lower arch, there was a severe crowding of about 14 mm and a buccally ectopic left canine. Overbite was normal and Overjet minimally increased. The double-tooth was identified like a geminated tooth, for the presence of one root and one pulp canal of increased size, as shown by the radiographic examinations. The anomalous tooth was managed with an orthodontic approach associated with a progressive stripping to reshape the crown. A two-phase treatment plan was performed, based on first maxillary expansion and lip bumper and then fixed appliances, in order to achieve a proper occlusion and a better aesthetic.
Highlights
Double-tooth is generally used to define fusion or gemination, two dental developmental abnormalities, which may require treatment for aesthetic, orthodontic, or functional reasons [1, 2]
Fusion is defined as the union between the dentin and/or enamel of two or more separated tooth germs and its prevalence, in the permanent dentition, is about 0.1% [3 5]
Fusion and gemination are represented in different ways
Summary
Double-tooth is generally used to define fusion or gemination, two dental developmental abnormalities, which may require treatment for aesthetic, orthodontic, or functional reasons [1, 2]. Fusion is defined as the union between the dentin and/or enamel of two or more separated tooth germs and its prevalence, in the permanent dentition, is about 0.1% [3 5]. According to the tooth development stage at the time of union, dental fusion can be partial or total and it may occur between the teeth of the same dentition or between supernumerary teeth [9, 10, 12]. The fused teeth show an anomalous size and shape of the crown and are characterized by separated roots, distinct pulp chambers, and two independent endodontic. The prevalence of geminated teeth is about 0.6% in primary dentition and 0.1% in the permanent one [10, 11]
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