title: Preserving pulpal health of a geminated maxillary lateral incisor through multidisciplinary care.
abstract: OBJECTIVE
  To report the multidisciplinary care of an unaesthetic geminated maxillary lateral incisor tooth, which allowed its preservation in the mouth.
  
  
  CONCLUSIONS
  Preoperative examination of an unsightly geminated maxillary lateral incisor (tooth 22) demonstrated two pulp chambers and open apices, with normal pulp sensitivity responses. At surgery, a periodontal mucoperiosteal flap was reflected and the distal part of the geminated tooth was removed. The exposed root canal of the preserved tooth was sealed with mineral trioxide aggregate (MTA). The extraction socket and osseous defect was grafted with decalcified freeze-dried bone allograft (DFDBA) before flap closure. During follow-up, distal caries in tooth 22 and a diastema between tooth 22 and 23 were managed with composite resin restorations. Forty-two months postoperatively, normal thermal and electrical pulp sensitivity tests confirmed pulp health. Convincing apexogenesis and dentinogenesis of the developing root was confirmed by radiographic examination. Acceptable periodontal health including 3-4 mm clinical probing depths was achieved. Optimizing aesthetics and occlusion was accomplished without orthodontic treatment.
authors.affiliation: Division of Periodontics, Chang Gung Memorial Hospital Lin-Kou Medical Center, Gueishan, Taiwan.
authors.forename: H-H
authors.initials: HH
authors.lastname: Hong
authors.forename: A I
authors.initials: AI
authors.lastname: Tsai
authors.forename: C-H
authors.initials: CH
authors.lastname: Liang
authors.forename: S-B
authors.initials: SB
authors.lastname: Kuo
authors.forename: C-C
authors.initials: CC
authors.lastname: Chen
authors.forename: T-P
authors.initials: TP
authors.lastname: Tsai
authors.forename: C-F
authors.initials: CF
authors.lastname: Lu
mesh_terms: D017607:Aluminum Compounds / Q000627:therapeutic use; D001857:Bone Matrix / Q000637:transplantation; D017610:Calcium Compounds / Q000627:therapeutic use; D002648:Child; D003188:Composite Resins; D003731:Dental Caries / Q000150:complications / Q000628:therapy; D003789:Dental Pulp Exposure / Q000209:etiology / Q000628:therapy*; D003793:Dental Restoration, Permanent / Q000379:methods; D003809:Dentin, Secondary / Q000254:growth & development; D003970:Diastema / Q000628:therapy; D004338:Drug Combinations; D005671:Fused Teeth / Q000150:complications / Q000601:surgery*; D005889:Gingival Recession / Q000209:etiology; D006801:Humans; D007180:Incisor / Q000002:abnormalities*; D008297:Male; D008437:Maxilla; D010087:Oxides / Q000627:therapeutic use; D010348:Patient Care Team; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D017640:Silicates / Q000627:therapeutic use; D012822:Silicon Dioxide; D019227:Tooth Apex / Q000254:growth & development; D014092:Tooth Root / Q000601:surgery; D015040:Zirconium
chemical_list: D017607:Aluminum Compounds; D017610:Calcium Compounds; D003188:Composite Resins; D004338:Drug Combinations; D010087:Oxides; D012387:Root Canal Filling Materials; D017640:Silicates; C083568:Z100 composite resin; C086631:mineral trioxide aggregate; D012822:Silicon Dioxide; D015040:Zirconium