Clinical management of fusion in primary mandibular incisors: a systematic literature review

Abstract

Objective: Dental anomalies occurring in deciduous teeth can affect the eruption of the permanent dentition and the occlusion stability. The occurrence of dental anomalies such as double teeth during the primary dentition in the daily practice might be frequent. The study aimed to qualitatively summarize the therapeutic management of double teeth in primary incisors.Material and Methods: A systematic review regarding the therapy of primary fused incisors in the mandible was performed and the obtained data were assessed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following electronic databases were screened from 1st January, 1996 until 30th July, 2019: PubMed, Scopus, EBSCO and the archives of paediatric dental journals. The search terms were grouped in anatomic entity: (tooth OR teeth OR incisor), pathological condition: (fused OR fusion OR geminated OR double), intervention: (treatment OR intervention OR therapy OR prevention OR control OR management OR restoration), observed parameters: (primary dentition OR primary tooth OR primary teeth).Results: Ten articles met all inclusion criteria. The data disclosed the occurrence of double teeth in mandibular incisors. The main management of this clinical condition is either preventive or surgical involving the extraction of fused teeth, based on the deciduous nature of the teeth, the degree of caries and malocclusion development risk.Conclusion: An early diagnosis of dental anomalies is fundamental for the application of proper preventive strategies to avoid a potential malocclusion in permanent dentition and to maintain these teeth sound and caries-free until the eruption of the permanent dentition.

Fusion or Gemination? Diagnosis and Management in Primary Teeth: A Report of Two Cases

“…Those fissures facilitate plaque accumulation and dental caries formation as they may be hard to brush [9]. Therefore, according to the clinical situation, three treatment modalities are available, including preventive measures, a restorative approach, and a surgical procedure [11].…”

“…When a primary double tooth presents a carious lesion, it should be restored with composite resin. In case of trauma or esthetic concerns as seen in maxillary anterior double teeth, guided composite resin restoration using putty silicone is recommended [11].…”

“…This treatment modality can be considered when deep caries lesions, exacerbating tooth mobility or root resorption, are diagnosed. When extraction is performed, space maintenance should be provided when necessary [11]. Regarding periodontal issues, strict oral hygiene is required.…”

“…Currently, three treatment options are suggested for PDT, involving preventive measures, a restorative approach after caries excavation, or a surgical procedure (extraction) [11].…”

Management of a Rare Case of Geminated and Fused Central Incisors in the Same Maxillary Dental Arch

“…Gemination is a malformation of a single tooth during its development to form a completely or partially separated crown with a single root [1]. The union of two or more teeth that normally develops separately is referred as fusion [2]. Gemination exhibits a normal number of teeth, whilst fusion presents a reduced number within the dental arch [3].…”