urth molar (distomolar). Unfortunately, most of these fusions require surgical removal because of their abnormal morphology and excessive mesiodistal width, which cause problems with spacing, alignment and function (6,8). In the anterior region this anomaly also causes an unpleasant aesthetic tooth shape due to the irregular morphology. These teeth also tend to be greatly predisposed to caries and periodontal disease and, in some cases, endodontic treatment is very complicated (7,10). Fusion can occur between teeth of the same dentition or mixed dentitions, and between normal and supernumerary teeth (3,7-9,11,12). In these cases, the number of teeth in the dental arch is also normal and differentiation from gemination is clinically difficult or impossible. A diagnostic consideration, but not a set rule, is that supernumerary teeth are often slightly aberrant and present a cone-shaped clinical appearance. Thus, fusion between a supernumerary normal tooth will generally show differences in the two halves of the joined crown. However, in gemination cases the two halves of the joined crown are commonly mirror images. Fused teeth usually present asymptomatically. In fact, the co-operation of practitioners with expertise in multiple areas of dentistry is important to create or achieve functional and esthetic success in these cases. Several treatment methods have been described in the

上一页  [1] [2] [3] 下一页