Concurrence of Gemination and Fusion in Maxillary Central Incisors A Case Report - Exam 75
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by Worthy, Wilson, Hudson
This case reports the concurrence of gemination and fusion affecting the
maxillary central incisors of a twelve-year-old patient and the collaboration of the
pediatric dentist, endodontist, orthodontist and oral and maxillofacial surgeon.
Developmental dental anomalies can occur in both primary and permanent dentitions as a result of conjoining defects. Double teeth, or cases of gemination or fusion, are not exceedingly rare, but the presence of both anomalies in a single patient is a rarity. Gemination is the division of a single tooth bud, resulting in a large single tooth with a bifid crown and common root and root canal. Fusion is the union of two separate tooth buds, resulting in a joined tooth with confluence of dentin and separate root canals. Labial apexogenesis with MTA, composite resin placement, re-contouring and orthodontic care allowed proper alignment with long-term monitoring of growth and development for possible incisor replacement.

Questions:
 1) Clinical problems often associated with these
anomalies can include:
  1. Occlusal interferences
  2. Endodontic implications
  3. Esthetic concerns for the patient and dental provider
  4. Susceptibility for caries
  5. All of the above
 2) Which treatment modality would be considered a last resort in this case:
  1. Re-contouring for esthetics
  2. Endodontic therapy
  3. Orthodontic treatment
  4. Extraction of central incisors
 3) The prevalence of gemination and fusion is less
than _____ %.
  1. 1
  2. 3
  3. 5
  4. 12
 4) In a study of children ages 2-12, fusion was found to be _______ times more prevalent than gemination.
  1. 2
  2. 5
  3. 13
  4. 20
 5) Anomalies in the primary dentition are rarely
correlated with anomalies in the permanent
dentition.
  1. True
  2. False