PMC4672842_01
(a) Pre-operative showing unesthetic smile due to fusion and transposition of maxillary left lateral incisor, (b) palatal view of fusion with buccolingual groove and transposition, (c) intraoral periapical radiograph showing fusion between central and lateral incisor, (d) markings of model to simulate the surgical and restorative corrections, (e) frontal view during surgery and restorative correction, (f) Follow-up after 6 months showing proper healing, and (g and h) post-operative and radiograph showing successful restoration at the end of 12 months.
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F1
Clinical examination of the tooth in question revealed a maxillary central incisor fused to lateral incisor (Figure 1a). On the buccal and palatal aspects, deep grooves separating both crowns extended into the gingival sulcus (Figure 1b). An initial radiograph indicated that the teeth were joined coronally and extending toward the cervical area (Figure 1c). A diagnostic dental stone model was prepared to simulate the planned surgical and restorative corrections (Figure 1d). Periodontal surgery was performed, as step two and a full thickness mucoperiosteal flap was elevated (Figure 1e). Tooth preparation and final restoration with porcelain fused to the metal crown was done at the end of 1-month post surgically (Figure 1f). Subsequent 6 months and 12 months (Figure 1g and h) follow-up indicated uneventful healing with satisfactory esthetics.