35 research outputs found
Multidisciplinary Approach to Fused Maxillary central Incisors: a Case Report
Introduction: The fusion of permanent teeth is a development anomaly of dental hard tissue. It may require a hard
multidisciplinary approach with orthodontics, endodontics, surgery and prosthetics to solve aesthetic and functional
problems.
Case presentation: A 20-year-old Caucasian man presented to our Department to solve a dental anomaly of his
upper central incisors. An oral investigation revealed the fusion of his maxillary central incisors and dyschromia of
right central incisor. Vitality pulp tests were negative for lateral upper incisors and left central incisor. Radiographic
examinations showed a fused tooth with two separate pulp chambers, two distinct roots and two separate root
canals. There were also periapical lesions of central incisors and right lateral incisor, so he underwent endodontic
treatment. Six months later, OPT examination revealed persistence of the periapical radiolucency, so endodontic
surgery was performed, which included exeresis of the lesion, an apicoectomy and retrograde obturation with a
reinforced zinc oxide-eugenol cement (SuperEBA) Complete healing of the lesion was obtained six months
postoperatively. Fused teeth crowns were separated and orthodontic appliances were put in place. When correct
teeth position was achieved (after nine months), the anterior teeth were prosthetically rehabilitated.
Conclusion: Many treatment options have been proposed in the literature to solve cases of dental fusion. The best
treatment plan depends on the nature of the anomaly, its location, the morphology of the pulp chamber
and root canal system, the subgingival extent of the separation line, and the patient compliance. Following
an analysis of radiographical and clinical data, it was possible to solve our patient’s dental anomaly with a
multidisciplinary approach
The platform switching approach to optimize split crest technique.
The split crest technique is a reliable procedure used simultaneously in the implant positioning. In the literature some authors describe a secondary bone resorption as postoperative complication. The authors show how platform switching can be able to avoid secondary resorption as complication of split crest technique