title: Clinical problems with a double tooth and a macrodont in the maxillary anterior area: a case report.
abstract: BACKGROUND
  Fusion is defined as the union between dentine and/or enamel of two normally separated teeth. Gemination is the cleavage of the forming dental germ to produce two partial teeth. The distinction between the conditions is often determined by the number of teeth present. However, this can be confused if supernumerary teeth are considered.
  
  
  OBJECTIVE
  The present case report describes the treatment of a patient who presented with dental fusion and macrodontia involving both upper central incisors. Besides the central incisors displaying characteristics of macrodonts, tooth 21 also showed aspects of fusion.
  
  
  METHODS
  Management consisted of the extraction of 11 and 21 and orthodontic mesialisation of the maxillary dentition. Treatment was planned in two phases and at the end of the orthodontic phase, the upper anterior teeth were to be reshaped using composite resin.
  
  
  RESULTS
  Orthodontic space closure is a treatment option in the clinical management of an extracted maxillary central double and/or macrodontic tooth. As no permanent teeth were absent, it was presumed that the fusion of 21 occurred with a supernumerary tooth.
  
  
  CONCLUSIONS
  Multidisciplinary treatment following the extraction of maxillary central incisors is reported with special attention to the orthodontic and restorative considerations required to improve the aesthetic outcome.
authors.affiliation: Department  or Oral Health Sciences - Orthodontics, KU Leuven & Dentistry, Belgium.
authors.forename: Ellen
authors.initials: E
authors.lastname: Ghijselings
authors.forename: Jan
authors.initials: J
authors.lastname: van Gastel
authors.forename: An
authors.initials: A
authors.lastname: Verdonck
authors.forename: Carine
authors.initials: C
authors.lastname: Carels
mesh_terms: D002648:Child; D005500:Follow-Up Studies; D005671:Fused Teeth / Q000175:diagnosis*; D006801:Humans; D007180:Incisor / Q000002:abnormalities*; D008297:Male; D008310:Malocclusion / Q000628:therapy; D008437:Maxilla / Q000473:pathology; D019516:Orthodontic Space Closure / Q000295:instrumentation / Q000379:methods; D057887:Overbite / Q000628:therapy; D010347:Patient Care Planning; D014081:Tooth Extraction / Q000379:methods; D014096:Tooth, Supernumerary / Q000175:diagnosis