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Developmental anomalies may affect the number and morphodifferentiation of teeth. Development of two teeth from one tooth bud gives rise to gemination. Geminated teeth with caries may lead to pulpal pathologies for which extraction may be a preferred treatment. We report a case of geminated maxillary carious primary incisor treated with pulpectomy in a five year-old child.

The term double tooth has often replaced the clinical diagnosis of gemination or fusion. If teeth have been extracted or exfoliated, the use of the neutral term ‘double tooth’ avoids the need to arbitrarily decide if it was gemination or fusion in origin. This case reports on a 16-year-old male who presented with an UL2 ‘double tooth’ and his combined restorative, surgical and orthodontic intervention to achieve his ideal result. CPD/Clinical Relevance: A multidisciplinary approach should be adopted when treating patients with a double tooth and an appropriate protocol as cited can be used.

Gemination is a morphologic anomaly of the tooth characterized by the formation of a macrodont. Bilateral presentation is rarely reported in permanent canines. Talon's cusp is an accessory cusp projecting lingually from the cingulum to the incisal edge and may be seen facially sometimes. Simultaneous occurrence of facial and lingual talons on the same tooth is rare. Concurrent occurrence of all the three entities has not been reported. These anomalies can cause unpleasant esthetic appearance due to irregular morphology. The presence of deep grooves on these teeth increases the susceptible to caries and periodontal disease requiring an endodontic intervention. Proper clinical and radiographic examination provides an accurate diagnosis and helps the clinician in the proper treatment planning and avoiding further complications. This article presents a unique case of simultaneous occurrence of bilateral gemination in the permanent maxillary canines with labial and palatal talon's cusps, which has not been reported in the literature till date.

Double teeth refer to two teeth that are totally or partially joined by dentin and maybe their pulps. These developmental anomalies may be the result of either gemination or fusion. This is a case of a 15-year-old Indo-Trinidadian male who presented with the fusion of a mandibular third molar with a distomolar as an incidental finding. The patient had his general dental care provided by a paediatric dentist and was referred to an oral and maxillofacial radiologist, orthodontist, and oral surgeon for consultation. A Cone-beam CT was taken to supplement the plain film periapical and orthopantomogram radiographs. It showed the three-dimensional orientation of the double molar and the extent of joining. This is the first case of fusion of a mandibular third molar to a distomolar being reported in the Caribbean.

Dental anomalies such as fusion, germination, double teeth are frequently encountered during routine dental examination often leading to crowding or abnormal spacing in dental arches or increased susceptibility to dental caries and aesthetic problems in pediatric dental patients. Tooth fusion is illustrated when there is the union between dentin and / or enamel of two or more separate developing teeth. Since the fused tooth may pose a wide spectrum of dental problems hence managing such cases requires thorough knowledge and technical skills of dental practitioners. Most of the clinicians advocate minimal intervention technique and preventive approach along with a regular and a long term follow up for the management of fused teeth Keywords: Fusion, Gemination, Double tooth, Dental anomaly, Mandibular incisors, Dentition.

The presence of a double-tooth requires specific complex management due to the need for differential diagnosis and following treatment choices. The aim of this report was to present a rare case of a geminated mandibular lateral incisor, treated with an orthodontic approach. A Caucasian 10.9-year-old girl presented a lower right double-tooth incisor, with a class 1 molar and a class 2 cuspid tendency on both sides. The upper arch was constricted as shown by bilaterally tendencies to cross-bite, a slightly lower midline deviation was reported and a lack of space for all four permanent cuspids was confirmed also by the panoramic X-ray. In the lower arch, there was a severe crowding of about 14 mm and a buccally ectopic left canine. Overbite was normal and Overjet minimally increased. The double-tooth was identified like a geminated tooth, for the presence of one root and one pulp canal of increased size, as shown by the radiographic examinations. The anomalous tooth was managed with an orthodontic approach associated with a progressive stripping to reshape the crown. A two-phase treatment plan was performed, based on first maxillary expansion and lip bumper and then fixed appliances, in order to achieve a proper occlusion and a better aesthetic.

Fusion and gemination are not entirely uncommon dental anomalies that may also be named ‘double teeth’. This is due to their unusual presentation in a twin-like fashion. Teeth with these irregularities may appear clinically similar, presenting as large and bulbous in shape with unusual anatomy and fissure patterns. The exact aetiology of these anomalies is uncertain, but many potential local or systemic disturbances during the morphodifferentiation stage of odontogenesis have been considered. Gemination occurs rarely in the permanent dentition and even less frequently in the posterior region of the oral cavity. This report presents a case of a geminated mandibular second molar and discusses the importance of early recognition and diagnosis of such teeth so that adequate preventative care and treatment can be provided.

This report illustrates a rare case of a geminated maxillary right second molar tooth using CBCT in a 23‐year‐old man with severe pain. Nonsurgical endodontic treatment was performed, which gave rise to an asymptomatic tooth at the 12‐month follow‐up.

Fusion and germination are the anomalies that occur due to some developmental eccentricity during the time of morpho-differentiation of the tooth bud and have a close resemblance to each other. The gemination is an attempt of the division of a single tooth into two and, hence, appears as an enlarged single tooth while the tooth count is normal when the affected tooth is counted as one. Its exact pathogenesis is ambiguous. This anomaly has been observed mostly in deciduous dentition as compared to that in permanent dentition. Gemination is rarely associated with the third molar and, hence, the terminology is arguable when this condition is seen in relation to the third molar. In the present article, a case of germination of mandibular third molar has been reported.

This case report describes the diagnosis and treatment of a non-syndromic unilateral geminated second premolar complicated by hypodontia of three second premolars. Gemination is defined as a developmental disturbance of the shape of teeth and is usually recognized as a partial cleavage of a single tooth germ resulting in one root and one pulp space with two partially or totally separated crowns. Hypodontia is defined as the developmental absence of one or more teeth, excluding the third molars. Geminations of maxillary second premolars are rarely reported. These dental anomalies can cause local malocclusion manifesting as crowding or spacing. CPD/Clinical Relevance: Diagnosis of dental anomalies such as gemination can be difficult. This paper discusses the diagnosis and management of one such case which involved CBCT.

Dental anomalies of form, such as gemination and fusion, are conditions rarely observed in the permanent dentition. Multiple anomalies of form are seldom found in one patient. This report describes the rare case of a 9-year-old boy with two dental anomalies, a geminated maxillary right central incisor and a fused maxillary left central incisor. The treatment plan included extraction of the geminated central incisor, and endodontic treatment and surgical separation of the fused central incisor. The correction of the smile was obtained by orthodontic movement of the mesial half of the fused tooth through the midpalatal suture and subsequent aesthetic and prosthetic rehabilitation procedures. A multidisciplinary approach was essential for the proper planning of complex cases to achieve the best result.

It is not uncommon to find dental anomalies in routine practice. Developmental dental anomalies may be seen in tooth number, size, shape, and structure. Gemination and fusion are anomalies of shape with close similarity but with different etiology. Differential diagnosis is difficult and so the term “double teeth” is often used. The incidence of double teeth is less than 1% and even more so in permanent dentition. Here, we present a unique case of gemination in mandibular third molar diagnosed effectively with the help of three-dimensional imaging and managed with the surgical technique.

Primary double teeth (PDT), referring to either gemination or fusion, are one of the most important and frequent developmental dental anomalies that can affect children’s oral health. Many clinical complications are correlated with these anomalies, such as dental caries, malocclusions, periodontal problems, and dental anomalies in permanent dentition. The aim of this report was to describe, through two cases, a case of gemination and another of fusion, the clinical management, the consequent effects, and the possible repercussions of these two developmental abnormalities on permanent successors. The first case involved gemination of the primary maxillary left central incisor (#61) in a 6-year-old boy. The patient presented with dental caries in the geminated tooth and its contiguous primary left lateral incisor (#62). The radiological examination revealed a slight developmental delay in the permanent left lateral incisor (#22). The treatment plan involved performing a pulpotomy and restoring the dental crowns of the affected teeth. The second clinical case describes a 6-year-old girl with unilateral fusion between a primary mandibular lateral incisor (#72) and a supernumerary tooth (#72’). The treatment included restoration of the deep grooves of the fused teeth using flowable composite and coronal restoration of the contiguous left primary canine (#73). Clinical and radiological follow-ups were performed every 3 months to monitor the development of teeth. No clinical and radiological symptoms were noted during the follow-up visits. PDT may require a multidisciplinary treatment. They should be diagnosed early to avoid and treat any possible complications in both the primary teeth and their permanent successors.

Introduction: A double tooth can be a consequence of fusion or gemination and is characterized by a size increasing of the tooth and a morphological modification. This anomaly concerns the anterior teeth and occurs in temporary and permanent dentition. Double teeth causes various problems (aesthetic, occlusal, endodontic, orthodontic, periodontal…). The management of clinical situations involving such abnormalities is often complex. Our aim is to present a reasoned analysis based on a systematic review of therapeutic attitudes used in different clinical situations when the abnormal tooth is located at the anterior maxillary region. Material and Methods: We carried out electronic research via Pubmed and Sciencedirect to collect case reports published during the 20 recent years (1999-2020). We included 46 articles corresponding to 57 relevant case report that we classified based on Aguilo and coll. Classification (1999). Results: Partial crown and root section is indicated for type I. Stipping is indicated for type II. The management of type III is compromised by the canal morphology. Extraoral and entraoral hemisection are only indicated for type IV. Coronoplasty is usually unavoidable. Endodontic, orthodontic, or periodontal treatment can be indicated depending on the situation. The extraction is considered as a last resort, the space is restored by autotransplantation of a supernumerary tooth, a prosthetic restoration, or an implant by the end of the craniofacial growth. Conclusion: The management of double teeth is a therapeutic challenge, every case is different, a multidisciplinary approach is recommended.

During the analysis of a skeletal assemblage from a medieval cemetery in Nubia (c. AD 500–1550), a young adult female with abnormally developed maxillary incisors was discovered. The possible causes of the two dental anomalies found in this individual and their archaeological context are discussed. The remains are from a medieval assemblage from the Fourth Cataract region of Nubia, which forms part of the Nubian collection curated at the British Museum. The left central incisor has a twinned crown with two root canals, and a supernumerary tooth is present on the right side between the central incisor and lateral incisors. Although two different dental anomalies are present, the bilateral expression suggests that the same biological mechanism could be responsible.

Fusion is known as a developmental anomaly described by the union of two neighbouring teeth. The worldwide prevalence of bilaterally fused teeth in the primary dentition is about 0.02% which is considered very rare. Only few cases of bilateral fusion have been reported in Indian population. This paper presents a rare case of three-year-old boy with bilateral fusion of primary mandibular lateral incisors and canine teeth. Treatment consisted of pit and fissure sealants and topical fluoride application. To conclude, fused primary teeth are considered as harmless asymptomatic abnormality.

Objective To describe two maxillary deciduous bi-rooted canines, one archeological and one modern, and examine the possible etiology of this condition. Design Two cases of bi-rooted canines were described and compared to published examples. Both specimens were radiographed and measured and compared to one-rooted samples. The archeological specimen was scanned using CBCT to facilitate detailed examination of the deciduous teeth. The extracted modern tooth was embedded in epoxy resin and two coronal sections were cut, one through the crown and one through the roots and examined with a light microscope. Results The bi-rooted canines were larger than the control samples. They showed none of the features commonly associated with gemination. The radiographs and scans showed that the canine roots in the archeological case diverged mesio-distally like the buccal roots in the adjacent first deciduous molar. In the clinical case, the root trunk was elongated mesio-distally and the furcation was located very close to the apex with a C-shaped root canal. Conclusions Both variants of the condition described above are rare in deciduous canines. They do not seem to be associated with fusion or gemination. However, as the teeth are relatively flattened bucco-lingually and we tentatively propose that this form results from spatial constraints during the early stages of crown development that have contributed to the development of additional roots. The megadont dimension of the recent bi-rooted deciduous canine may affect root development and the necessity of two mesio-distally located roots for anchorage in the maxilla.

The fusion of adjacent tooth buds and the formation of a single tooth or the gemination of a single tooth are rare and occur less often bilaterally in the permanent dentition. Following a brief literature review, this case report describes the multidisciplinary treatment of an adolescent patient who presented with the bilateral gemination of the permanent central incisors. It was planned to restore the teeth using porcelain laminated veneers after the completion of orthodontic treatment. The wide crown of the geminated incisors was restored, to mimic the morphology of two teeth, comprising a wider central and a narrower lateral incisor. In carefully selected cases, this conservative treatment option preserves the physiologic function of the teeth and the periodontal ligament.

This is a report of gemination type premolar double teeth in patients who were referred for orthodontic consultation in the Eastern Health Board, Ireland. Prevalence was low (0.06%) with just three patients presenting with this dental anomaly. The premolar double teeth involving two maxillary and one mandibular premolar are illustrated.

The 'Two Brothers', two 4,000-year-old Egyptian mummies, were discovered buried alongside each other in an ancient Egyptian tomb in 1907, and were later relocated to the Manchester Museum. The hieroglyphic inscriptions on the coffins indicate that the mummies, Nakht-Ankh and Khnum-Nakht, were brothers but when the mummies were unwrapped and investigated in 1908, the skeletal morphologies were found to be quite different, suggesting an absence of family relationship. In 2017, their teeth were re-examined and, similar to most ancient Egyptian teeth, they display evidence of excessive tooth wear but there is little indication of carious lesions. Khnum-Nakht presents the rare developmental disorder of fusion of the left maxillary incisor and gemination of the right incisor, probably the earliest recorded instance of this irregularity. Analysis of the DNA from their molar teeth has been able to shed some light on the longstanding question of the kinship of the Two Brothers.

Introduction: The development of tooth is a complex process wherein there is series of interactions between the ectoderm and ectomesenchyme. The role of genes in determining the shape and form of a specific tooth has already been defined, the alterations in which can lead to a variety of anomalies in regards to number, size, form, shape, structure, etc. Objective: To review the literature on the developmental anomalies of teeth. Literature review: The developmental anomalies affecting the morphology exists in both deciduous & permanent dentition and shows various forms such as gemination, fusion, concrescence, dilacerations, dens evaginatus, dens invaginatus, enamel pearls, taurodontism or peg laterals. These anomalies have clinical significance concerning esthetics, malocclusion and more importantly predisposing the development of dental caries and periodontal diseases. Conclusion: Knowledge of various diagnostic criteria for identification of these developmental anomalies is significant for early diagnosis and pertinent treatment.

An uncommon developmental anomaly such as a triple tooth may result from fusion, gemination, or concrescence that may occur between two and more teeth or between normal tooth and a supernumerary tooth. This anomaly may occur as a result of conjoining or twining defects that affect both primary and permanent dentition. In this article, we report an unusual case of triplication of primary teeth occurring unilaterally between the lower left lateral incisor and the canine, where the lateral incisor is geminated and it is fused to the canine. The triple tooth was extracted under local anesthesia and its crown portion was sectioned at three levels that are coronal, middle, and cervical one-third, respectively, following which, the sections were observed under a stereomicroscope. Based on the clinical and histologic findings, final diagnosis of gemination of lateral incisor with fusion to the canine is confirmed.

Objective To report a conservative treatment of a rare developmental anomaly. Case report A 73-year-old patient with previously initiated therapy and acute apical abscess of a maxillary right central incisor fused with the supernumerary tooth sought treatment. The conservative approach included nonsurgical root canal treatment and composite restoration. Conclusion This case illustrates the importance of an individual approach when treating anomalous teeth. Priorities in pain and infection management to properly and functionally restore teeth should be unaffected by age.

Fusion and gemination are developmental anomalies of teeth that may require endodontic treatment. Fusion may cause various clinical problems related to esthetics, tooth spacing, and other periodontal complications. Additional diagnostic tools are required for the diagnosis and the treatment planning of fused tooth. The present case report describes a case of unilateral fusion of a supernumerary root to an upper permanent central incisor with large periapical lesion in which a conservative approach was used without extraction of supernumerary tooth and obturated with mineral trioxide aggregate to reach a favorable outcome.

This study investigated the prevalence and distribution of anomalies of permanent dentition in the current Japanese population by examining an unbiased sample. We conducted a survey of dental anomalies by mass dental screening at eight high schools in 2012. Participants were all students with permanent dentition. Dental anomalies were classified as hypodontia, supernumerary teeth, peg-shaped teeth, fused teeth, and talon cusps. Students with one or more dental anomalies on oral examination were given a differential diagnosis by three specialists. The final sample comprised 9584 participants (5062 boys, 4522 girls). Hypodontia was present in 372 students (3.88 %) with no significant sex difference (191 boys, 181 girls). Frequent sites were the right or left mandibular second premolar, right or left maxillary second premolar, and right or left maxillary lateral incisor. Supernumerary teeth were observed in three boys (0.06 %) and one girl (0.02 %). Peg-shaped teeth were observed in 74 students (0.77 %; 27 boys, 47 girls), differing significantly between sexes; they were most prevalent among maxillary lateral incisors. Of affected students, 18 students (0.19 %) also had hypodontia (3 boys, 15 girls). Fused teeth were present in two boys (0.04 %) and three girls (0.07 %) (gemination in one boy and fusion in the remaining four students). Sites were limited to maxillary and mandibular central and lateral incisors. Talon cusps were observed in two boys (0.04 %) and four girls (0.09 %). The present survey of a large unbiased sample can be considered to reflect the prevalence and distribution of anomalies of permanent dentition in the current Japanese population.

Twinning is referred to the development of two separate teeth that arose from the complete separation of one tooth bud. To the best of our knowledge very few cases of twinning in primary or permanent dentition have been previously reported. Here, we report an additional case of twinning involving primary maxillary left lateral incisor and a literature review of clinical and radiographic findings of previous reported cases of gemination and twinning is also discussed. A six-year-old male patient reported to the dental clinic with the complaint of decay in the left front teeth region of the upper jaw. On clinical examination, dentinal caries was observed on the labial surface of primary maxillary left lateral incisor. The tooth showed a deep groove present in relation to the labial surface and incisal edge and continued cervically as a shallow groove. The patient had normal compliment of teeth for his age. The intra-oral periapical radiograph of the maxillary anterior region revealed large crown and a radiolucent notch was observed in relation to the incisal edge of the maxillary left primary lateral incisor. Relatively one pulp chamber and two root canals were observed in relation to the primary maxillary left lateral incisor, which was suggestive of a case of twinning involving primary maxillary left lateral incisor. This present case is the first case report of twining seen in primary dentition.

Fusion may be defined as a union of two separately developing tooth germs typically leading to one les s tooth than normal in the affected arch. This phenomenon has been described by several different terms, such as ge mination, double teeth and twinning. Factors which have been implicated as possible etiologies for fused teeth i nclude hypervitaminosis, pressure from physical contact of young tooth buds, and genetic factors. This articl e reports two cases of unilateral fused primary maxillary incisor s in siblings, with a discussion covering further e laboration of definitions of gemination and fusion, clinical impl ementation and review of literature.

Developmental anomalies in the hard tissue are seen frequently in dental practice. Gemination and fusion are the most commonly encountered anomalies, and distinction between the two is always challenging. Gemination, also called double tooth, is an anomaly exhibiting two joined crowns and usually a single root. It represents an incomplete attempt of a single tooth germ to split. It is considered multifactorial in etiology, with genetic and environmental causes. This paper discusses a rare example of bilateral gemination (prevalence 0.04%) of maxillary central incisors with completely separated roots. Multidisciplinary care ensured a successful esthetic and functional outcome.

Fusion is a common dental anomaly affecting both primary as well permanent dentitions. Fusion is the union between two normally separated tooth germs. The problems associated with fused teeth are esthetics, arch symmetry, spacing, and malocclusion. These problems require cosmetic and orthodontic consideration.

Double tooth is a dental anomaly consequent to fusion of two or more teeth or gemination of a single tooth. This report describes a unique case of double tooth in relation to a mandibular lateral incisor exhibiting the presence of four root canals. The role of conventional radiography and advanced three-dimensional imaging techniques in the better assessment of complex root canal systems and their aid in endodontic management has also been highlighted.

Triple teeth may result from fusion, gemination or concrescence causing transient esthetic and functional problems in primary dentition and retardation or alteration of development and eruption of permanent successors. We report an unusual case of a boy aged five with fusion among maxillary left primary central incisor, lateral incisor and a supernumerary tooth concomitant with agenesis of permanent lateral incisor. A review of literature on triple tooth was done along with a proposed classification of the triple teeth.

Gemination is an anomaly in size, shape, and structure of the teeth. The primary dentition is more frequently affected, but gemination may occur in permanent dentitions, usually in the maxillary-incisal region. In geminated teeth, incomplete development of two teeth from a single bud results in a larger tooth crown with a single root and canal. In this study, a gemination case in a male patient, 13-year-old, with an ancestry of Aymara, who visited a private clinic in Antofagasta, Chile, for a routine check is presented. On intra-oral clinical examination of the coronary anatomy, the tooth 4.1 was observed with a large crown, bifurcated in the center of incisal zone. In addition, a groove extending from the bifurcation to the cementoenamel junction was noted. Radiographic examination revealed the presence of a single root canal and a single root. The pulp cavity was separated in two cavities, in accordance with the division caused by the observed bifurcation. This report describes a unique case of dental gemination of mandibular permanent central incisor in a subject with Aymara ancestry and discusses the differential diagnosis and possible future treatment options anticipated for this particular case.

Developmental dental disorders may be due to anomalies in tooth number, size, shape and structure. Gemination and fusion are anomalies of shape with close similarity but with different etiology. Gemination and fusion are anomalies of shape with close similarity but with different etiology. The etiology of germination is not fully understood environmental factors such as trauma, vitamin deficiencies, systemic diseases and certain genetic predisposition have been suggested as possible causes. A 9 year old male patient reported to the department of pedodontics and preventive dentistry Dr R Ahmed Dental College & Hospital with the chief complaint of unaesthetic upper front teeth on clinical examination. It was found that the upper central incisors were markedly large in size with buccolingual grooves present partially separating two halves of crown. The incisors were caries free and there was no history of pain or any discomfort. Since the roots were not completely formed the patient was kept on follow up for the treatment to be delivered.

Tooth transposition is a disorder in which a permanent tooth develops and erupts in the normal position of another permanent tooth. Fusion and gemination are developmental disturbances presenting as the union of teeth. This article reports the nonsurgical retreatment of a very rare case of fused teeth with transposition. A patient was referred for endodontic treatment of her maxillary left first molar in the position of the first premolar, which was adjacent to it on the distobuccal side. Orthopantomography and periapical radiography showed two crowns sharing the same root, with a root canal treatment and an associated periapical lesion. Tooth fusion with transposition of a maxillary molar and a premolar was diagnosed. Nonsurgical endodontic retreatment was performed. At four yr follow-up, the tooth was asymptomatic and the radiolucency around the apical region had decreased, showing the success of our intervention. The diagnosis and treatment of fused teeth require special attention. The canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Thermoplastic techniques were useful in obtaining hermetic obturation. A correct anatomical evaluation improves the set of treatment options under consideration, leading to a higher likelihood of esthetically and functionally successful treatment.

Developmental tooth abnormalities in dogs are uncommon in general veterinary practice but understanding thereof is important for optimal management in order to maintain masticatory function through preservation of the dentition. The purpose of this review is to discuss clinical abnormalities of the enamel and general anatomy of dog teeth encountered in veterinary dental referral practice and described in the literature. More than 900 referral cases are seen annually between the two referral practices. The basis of the pathogenesis, resultant clinical appearance, and the principles of management for each anomaly will be described. Future research should be aimed toward a more detailed analysis of these conditions so rarely described in the literature.

Developmental tooth abnormalities in dogs are uncommon in general veterinary practice but understanding thereof is important for optimal management in order to maintain gnathic function through conservation of the dentition. The purpose of this review is to discuss abnormalities of enamel structure and macroscopic tooth anatomy in dogs encountered in veterinary dental referral practice in South Africa and the United Kingdom. The basis of the pathogenesis, resultant clinical appearance and the management principles of each anomaly will be considered. Future research should aim to provide a detailed individual tooth mineralization schedule for dogs.

This paper reports a case of gemination in a maxillary lateral incisor with two root canals and crown-root dilaceration. A 16-year-old male patient was referred for endodontic treatment of the maxillary left lateral incisor and evaluation of esthetic and functional complaints in the anterior region. The patient reported trauma to the anterior primary teeth. There was no spontaneous pain, but the tooth responded positively to the vertical percussion test and negatively to the pulp vitality test. Clinical examination showed esthetic and functional alterations and normal periodontal tissues. CBCT imaging confirmed the suspicion of gemination and crown-root dilaceration and also revealed the presence of two root canals and periapical bone rarefaction. The root canals were instrumented with Reciproc R40 and 1% NaOCl irrigation and were filled by lateral condensation of gutta-percha and AH Plus sealer. The tooth was definitely restored with composite resin to recover esthetics. Continued follow-up over 6 months has shown absence of pain or clinical alterations as well as radiographic image suggestive of apical repair.

Gemination, a relatively uncommon dental anomaly, is characterized by its peculiar representation as a tooth with a bifid crown and a common root and root canal. It usually occurs in primary dentition. To come across gemination in a supernumerary tooth is a rare phenomenon. The purpose of this paper is to present a unique case of hyperdontia wherein gemination in an impacted supernumerary tooth resulted in a trifid crown unlike the usual bifid crown. The role of conventional radiographs as well as computed tomography, to accurately determine the morphology and spatial location, and to arrive at a diagnosis, is also emphasized in this paper.

Variation in the size and form of teeth is not an uncommon finding. Twinned teeth have been described under different terms and the terminology is often confusing. It occurs more frequently in the primary dentition than in the permanent dentition with no gender preference. Gemination may be defined as the incomplete division of a single tooth bud during development, resulting in increased tooth material, but not number, of teeth. The term schizodontia would only fit complete splitting, which results in “twinning” and thus leading to hyperdontia. Twinning is usually asymptomatic and is associated with poor esthetics, caries, malocclusions, arch-length discrepancies, periodontal disease, hyperdontia or hypodontia of the permanent successors, and eruption abnormalities.

Gemination and fusion are morphological dental anomalies, characterized by the formation of a clinically wide tooth. Gemination occurs when one tooth bud tries to divide, while fusion occurs if two buds unite. The terms double teeth, double formation, conjoined teeth, geminifusion, vicinifusion and dental twinning are often used to describe fusion and gemination. Double teeth are associated with clinical problems such as poor esthetics, spacing problems and caries susceptibility. Management of such cases requires a comprehensive knowledge of the clinical entity as well as the problems associated with it. This report presents a case of primary double tooth in a 6-year-old boy involving maxillary left central incisor. The anomalous tooth was carious and pulpally involved. This was treated conservatively by endodontic treatment and esthetic rehabilitation was done with direct composite restoration using a silicone buildup guide. The treated tooth was followed up until exfoliation.

This report describes the two-phase orthodontic treatment of a 7-year-, 6-month-old girl who presented with bilateral gemination of the central incisors. The left side demonstrated a complete gemination, resulting in two separate teeth (#9 and #9a). On the right side the gemination was incomplete, resulting in a large tooth mass (#8) that was 11.5 mm wide with a large pulp chamber and two apices. The tooth mass was extracted and the left central incisor (#9) was successfully moved across the midline (through the midpalatal suture area). The supernumerary incisor (#9a) was then used in the upper left central incisor area.

Geminated teeth are the consequences of developmental anomalies leading to the eruption of joined elements. According to current definitions, gemination occurs when one tooth bud tries to divide, while fusion occurs if two buds unite. Clinical experience shows, however that diagnosis can be complicated due to superimposed anomalies. This report describes a unique case of bilateral gemination of permanent maxillary central incisors. The esthetic rehabilitation of the geminated incisors accomplished utilizing all ceramic crowns. It is important that in these types of cases, reaching to the available esthetics and avoiding the complication of caries and periodontal problems with prosthetic application is satisfactory. (Eur J Dent 2007;1:188-191)

Geminated teeth are the consequences of developmental anomalies leading to the eruption of joined elements. According to current definitions, gemination occurs when one tooth bud tries to divide, while fusion occurs if two buds unite. Clinical experience shows, however that diagnosis can be complicated due to superimposed anomalies. This report describes a unique case of bilateral gemination of permanent maxillary central incisors. The esthetic rehabilitation of the geminated incisors accomplished utilizing all ceramic crowns. It is important that in these types of cases, reaching to the available esthetics and avoiding the complication of caries and periodontal problems with prosthetic application is satisfactory.

El tratamiento endodóntico-quirúrgico en dientes con quistes inflamatorios radiculares es un desafío clínico debido a su complejidad, y más aún si están en piezas con anomalías de desarrollo dental, como lo es la geminación dentaria. A continuación se presenta un caso clínico en el que se logra la reparación de una lesión apical mediante una necropulpectomía de la pieza geminada y enucleación del quiste adyacente. The surgical-endodontic treatment of teeth with an inflammatory radicular cyst is a clinical challenge due to its great complexity. Even more so, if they are in teeth with development anomalies such as gemination. The case below shows the repair of an apical lesion by a necro-pulpectomy of the geminated tooth and the enucleation of the adjacent cyst.

Dens invaginatus (DI) and gemination are two developmental abnormalities that are well reported in the dental literature, but their coexistence in a single tooth is rare. Such situations worsen the risk factors associated with these anomalies, and the treatment plan should be customised as they possess altered morphology and anatomy. A 19-year-old girl came for evaluation of a cracked tooth in the front region of the upper jaw. The tooth showed clinical features of gemination and radiographic features of DI, and was diagnosed as DI in geminated maxillary lateral incisor. The differential diagnoses based on clinical appearance without radiographic investigation may warrant the treatment approach if these two abnormalities coexist in a single tooth. The report also highlights the importance of three-dimensional imaging in diagnosis and treatment planning of teeth with altered pulp canal anatomy. There are few reported cases in the literature detailing the treatment options for these two anomalies occurring in the same tooth.

Gemination and fusion are two rare entities which can be found in human dentition caused as result of aberration in any step of its development. Fusion mainly occurs in primary teeth with incisors and canines being the commonest location especially in the mandibular arch. In the literature, very few cases of fusion of posterior teeth have been reported along with being nonsyndromic and with a normally developing successional tooth. The present case report depicts one such case in which there is fusion between mandibular first molar with an atypical canine like tooth of primary dentition. The resultant tooth is large and had anomalous occlusal anatomy. The macromolar presented with caries which was removed and the tooth was treated endodontically and restored with a semi permanent restoration.

Supernumerary teeth may be defined as any teeth or tooth substance in excess of the usual configuration of 20 deciduous and 32 permanent teeth. Gemination is defined as an attempt by a single tooth bud to divide, with a resultant formation of either a large tooth with a bifid crown or two completely divided teeth throughout the crown and root. Geminated supernumerary premolar is a rarity and the possibility of multiple occurrences is even rarer. An exhaustive review of English literature and a PubMed search conducted using the terms “gemination’’ and “multiple geminated supernumerary” revealed no case of multiple geminated supernumerary premolars. We report a case of multiple geminated supernumerary premolars in a 23-year-old male.

Dental Fusion is developmental anomaly due to the union of two tooth germs resulting in a single tooth. It is an infrequent phenomenon but may cause caries, periodontal, cosmetic and malocclusion abnormalities. OSMF (OSMF) is a chronic inflammatory disorder and a precancerous condition affecting oral mucosa causing inability to open the mouth, burning sensation and leathery consistency. This manuscript describes a case of OSMF and dental fusion., Dental füzyon iki dişin tek diş şeklinde birleşmesinden kaynaklanan bir gelişim anomalisidir. Ender görülen bir fenomendir fakat periodontal, kozmetik ve maloklüzyon anormallikleri yanı sıra çürüklere neden olabilir.

Odontogenesis is a complex process wherein more than 200 genes are known to play a significant role in tooth development. An imbalance can lead to an abnormality in the number, size, shape or structure of the developing tooth/teeth. The presence of an extra dental lamina forms a supernumerary tooth. The supernumerary teeth are of two types: A rudimentary tooth where the supernumerary tooth does not resemble any tooth in the normal series or a supplemental tooth in which this anomalous tooth resembles one in the normal series. It is also very rare to encounter triple teeth in primary dentition. The union of these teeth may be through fusion, gemination, concrescence or a combination of fusion and gemination. Presented is a rare case of concrescence involving maxillary deciduous incisors and a supplemental tooth in a 7-year-old boy. The differential diagnosis, etiology, and complications of primary anterior triple teeth are discussed.

Gemination refers to an attempt by a single tooth bud to divide, with a resultant formation of either a large tooth with a bifid crown or two completely divided teeth throughout the crown and root. This report describes a rare case of bilateral gemination of permanent mandibular second premolar tooth giving rise to molarization of premolars. The mesiodistal width of these teeth is similar to mandibular molars, but the cervicoocclusal width is lesser than that of the molar tooth. This paper also discusses the potential orthodontic, periodontal, and endodontic complications of premolar molarization.