PMC3967802_01
Clinical images of the fused right maxillary central incisor in eruption. Notice its broad crown with a talon cusp.
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However, morphologically this central incisor showed macrodontia as a result of a fusion with a supernumerary tooth with a talon cusp (Figure 1).
Panoramic radiography. Notice the fused tooth with two root canals.
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At that moment periapical and panoramic radiographic examination confirmed the diagnostic of a fused maxillary central incisor which had two fused roots but two independent root canal and two pulp chambers (Figure 2).
Intraoperative images. (a) After extraction, hemisection was performed. (b) Gutta-percha exposure was filled with silver amalgam. (c) The tooth's remaining portion was then replanted into the socket.
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No orthodontic force was applied to it for 30 days (Figure 3).
Clinical images. (a) Orthodontic treatment for Class II malocclusion; (b) dental cosmetic treatment of the right maxillary lateral and central incisors.
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At the end of orthodontics a dental cosmetic treatment of these central and lateral incisors was indicated (Figure 4).
Clinical images after 18 years since the diagnosis. Notice a progressive pathological migration in buccal direction.
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Clinical exploration confirmed the buccal migration, a grey discoloration, an incremented probing depth (11 mm) at the interproximal area with right lateral incisor, some pus exudation from this periodontal pocket, and no dental vitality of this lateral incisor (Figure 5).
Periapical and panoramic radiographs showed a severe vertical bone defect.
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Periapical radiograph showcased an apical image involving lateral right incisor and a severe vertical bone defect between right central and right lateral incisor, but the alveolar mesial bone level was preserved (Figure 6).