DOUBLE TEETH IN MAXILLARY PERMANENT INCISORS : CASE REPORTS

Kim, Mi-Ni; Kim, Young-Jae; Kim, Jung-Wook; Jang, Ki-Taek; Kim, Chong-Chul; Hahn, Se-Hyun; Lee, Sang-Hoon

Journal of the Korean Academy of Pediatric Dentistry 2009;36(1):119-125.
Published online February 28, 2009.

DOUBLE TEETH IN MAXILLARY PERMANENT INCISORS : CASE REPORTS

Mi-Ni Kim, Young-Jae Kim, Jung-Wook Kim, Ki-Taek Jang, Chong-Chul Kim, Se-Hyun Hahn, Sang-Hoon Lee

Department of Pediatric Dentistry, College of Dentistry and Dental Research Institute, Seoul National University

상악 전치부에 발생한 이중치: 증례보고

김미니, 김영재, 김정욱, 장기택, 김종철, 한세현, 이상훈

서울대학교 치과대학 소아치과학교실 및 치의학연구소

Correspondence: Sang-Hoon Lee, Tel: 02-2072-2682, Email: musso@snu.ac.kr

Received: 1 September 2008 • Accepted: 21 November 2008

Abstract

Fusion and gemination are irregularities in tooth development. It is often difficult to differentiate between gemination and fusion and it is common to refer to these anomalies as 'double teeth'. The deciduous teeth are most commonly involved, but in 0.1% of cases permanent teeth are affected, in which case aesthetic, funtional and periodontal problems can result. Double teeth present great difficulties in management and required a multidisciplinary approach. The central groove on the labial and palatal surfaces of a double tooth is extremely prone to caries, therefore early 'fissure sealing' is essential. In permanent dentition, surgical separation of fused teeth may be possible with subsequent orthodontic alignment and restorative treatment as needed to reshape the crown. Reshaping or reduction of a double tooth with a single canal may be attempted by modifying the appearance of the labial groove and the use of composite tints but is often impossible and extraction may be the only alternative. Orthodontic treatment and prosthetic replacement is then required. Implants may be an option for adolescents. The present study describes three clinical cases of double teeth in the position of the maxillary permanent incisors. The first case demonstrates an example of multidisciplinary care including surgical intraoral hemisection, root canal therapy, restorative and orthodontic treatment. The second and third cases describe the external and internal morphology of the two fused teeth by means of three dimensional dental computer tomography.

Key Words: Double tooth, Fusion, Hemisection, 3 dimensional dental computer tomography, Maxillary anterior teeth