Elsevier

Journal of Endodontics

Volume 36, Issue 2, February 2010, Pages 345-349
Journal of Endodontics

Case Report/Clinical Techniques
Endodontic and Esthetic Management of Maxillary Lateral Incisor Fused to a Supernumerary Tooth Associated with a Talon Cusp by Using Spiral Computed Tomography as a Diagnostic Aid: A Case Report

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Abstract

The aim of this case report is to present an endodontically and esthetically managed maxillary left lateral incisor fused to a supernumerary tooth associated with a talon cusp. This case report describes a multidisciplinary approach involving endodontic and restorative considerations for a successful, functional, and esthetic rehabilitation of the fused tooth. In the present case, we have used spiral computed tomography for better understanding of the complicated root canal morphology of the fused tooth and successful management of this rare case.

Section snippets

Case Report

A 22-year-old male patient presented to the Department of Conservative Dentistry and Endodontics with pain to hot and cold food in the left maxillary anterior region. On clinical examination, the maxillary left lateral incisor exhibited abnormal crown morphology. The tooth was wider mesiodistally and had a talon cusp on the lingual side (Fig. 1A, B). Caries in the developmental groove on the distal side of the talon's cusp was evident.

There was no history of trauma or any hereditary conditions.

Management

Local anesthesia was administered, and a rubber dam was applied. Endodontic access cavity was done on the palatal surface by using a no. 2 round bur and EX 24 bur (non end cutting tapered fissure; Mani, Tochigi, Japan). Pulp extirpation was performed by using a barbed broach (Dentsply Maillefer, Ballaigues, Switzerland) and K-files (Mani Inc, Tochigi, Japan). The canal was thoroughly debrided with copious irrigation of sodium hypochlorite (2.5%), followed by saline (0.9%). Coronal flaring of

Discussion

A malformed tooth often is a challenge to the dentist. Fused teeth afford a striking clinical manifestation of the differentiable and morphogenetic processes of tooth development. Clinically, it might be difficult to differentiate between fusion and gemination when a supernumerary tooth is fused with a permanent tooth. Fusion between supernumerary and permanent teeth occurs less frequently than fusion between other types of teeth. The incidence of unilateral occurrence is estimated in the

Conclusion

With the advent of newer tomographic scanners like cone beam computed tomography (CBCT) or digital volume tomography specifically for maxillofacial and dental use, conventional scanners like SCT will be less preferred for dental imaging purposes. CBCT is advantageous in that it has a low effective dose in the same order of magnitude as conventional dental radiographs (37). Nevertheless, the value of SCT as a diagnostic tool cannot be undermined. This case discussed above uses SCT as a

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