PMC3874312_01
Clinical appearance of fused tooth.
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fig1
Intraoral examination revealed a large maxillary right central incisor, with a small groove observed on the labial and palatal aspects of the crown (Figure 1).
Radiographic appearance of fused tooth.
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No periapical radiolucency associated with these teeth was detected (Figures 2(a) and 2(b)).
Surgical procedures.
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The crown was sectioned with a diamond bur (Midwest, Dentsply, IL, USA), and the mesial part of the tooth was removed (Figures 3(a) and 3(b)). The root surfaces were examined, and no pulpal association was detected (Figure 3(c)). The remaining distal tooth was restored with composite resin (Gradia Direct, GC Corporation, Tokyo, Japan), and the flaps were sutured (Figure 3(d)).
Orthodontic therapy.
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fig4
Following placement of the maxillary incisor brackets, an arch wire (16 Heat Active Nickel-Titanium, 3 M Unitek) was connected to the bracket slots to correct the position of the maxillary right central tooth (Figure 4(a)). Following fixed orthodontic treatment, a Hawley appliance was constructed for retention (Figure 4(b)).
Clinical and radiographic appearance at 18-month followup.
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After an 18-month followup period, the maxillary right central tooth showed no sign of periapical pathosis (Figures 5(a) and 5(b)) and responded positively to electric pulp testing.