title: Fusion of central incisors with supernumerary teeth: a 10-year follow-up of multidisciplinary treatment.
abstract: BACKGROUND
  Macrodontia of anterior teeth may occur as an isolated condition or as a result of fusion or gemination and may cause clinical problems such as tooth crowding and esthetic problems. Preliminary planning and careful management are often required by a dental team comprising an orthodontist, an endodontist, a prosthodontist, and an oral surgeon. A multidisciplinary treatment approach in a case with fused teeth is presented.
  
  
  METHODS
  A 9-year-old girl presented with macrodontia of a left maxillary central incisor. The patient was referred to the orthodontic department because of a large central incisor as a result of fusion with an unspecific supernumerary tooth. The surgical procedure included sectioning off the mesial segment as far as possible, both apically and subgingivally, and extracting 1 of the fused supernumerary teeth. During the sectioning procedure, the pulp of the remaining tooth was exposed at the middle third of the root. Direct pulp capping was performed by an endodontist using mineral trioxide aggregate. Twelve weeks later, orthodontic treatment was commenced, and finally after a 26-month orthodontic treatment period, the central incisors' crown was restored using composite material.
  
  
  RESULTS
  A 10-year clinical and radiographic follow-up revealed that the remaining resected central incisor kept its vitality, and the patient was pleased with the esthetic result.
  
  
  CONCLUSIONS
  Proper interdisciplinary treatment planning of complicated cases such as anomalous teeth, which involve fusion to a supernumerary tooth, may lead to minimal invasive conservative procedures that maintain tooth vitality and result in a pleasing esthetic result.
authors.affiliation: Departments of Endodontics and Dental Traumatology, School of Graduate Dentistry, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel.
authors.forename: Nelly
authors.initials: N
authors.lastname: Steinbock
authors.affiliation: Departments of Endodontics and Dental Traumatology, School of Graduate Dentistry, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel.
authors.forename: Ronald
authors.initials: R
authors.lastname: Wigler
authors.affiliation: Departments of Endodontics and Dental Traumatology, School of Graduate Dentistry, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel.
authors.forename: Arieh Y
authors.initials: AY
authors.lastname: Kaufman
authors.affiliation: Departments of Endodontics and Dental Traumatology, School of Graduate Dentistry, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel.
authors.forename: Shaul
authors.initials: S
authors.lastname: Lin
authors.affiliation: Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel.
authors.forename: Imad
authors.initials: I
authors.lastname: Abu-El Naaj
authors.affiliation: Department of Orthodontic and Cranofacial, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel. Electronic address: aizenbud@ortho.co.il.
authors.forename: Dror
authors.initials: D
authors.lastname: Aizenbud
mesh_terms: D017607:Aluminum Compounds / Q000627:therapeutic use; D017610:Calcium Compounds / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D003188:Composite Resins / Q000737:chemistry; D003442:Crowns; D003764:Dental Materials / Q000737:chemistry; D003785:Dental Pulp Capping / Q000379:methods; D004338:Drug Combinations; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D005671:Fused Teeth / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007180:Incisor / Q000002:abnormalities* / Q000601:surgery; D008312:Malocclusion, Angle Class II / Q000628:therapy; D010087:Oxides / Q000627:therapeutic use; D010347:Patient Care Planning; D010348:Patient Care Team; D057872:Pulp Capping and Pulpectomy Agents / Q000627:therapeutic use; D017640:Silicates / Q000627:therapeutic use; D019228:Tooth Crown / Q000002:abnormalities / Q000601:surgery; D014087:Tooth Movement Techniques / Q000379:methods; D014092:Tooth Root / Q000002:abnormalities / Q000601:surgery; D014096:Tooth, Supernumerary / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D017607:Aluminum Compounds; D017610:Calcium Compounds; D003188:Composite Resins; D003764:Dental Materials; D004338:Drug Combinations; D010087:Oxides; D057872:Pulp Capping and Pulpectomy Agents; D017640:Silicates; C086631:mineral trioxide aggregate
keywords: Central incisor; mineral trioxide aggregate; orthodontic; tooth sectioning