• P-ISSN 2277-3525 E-ISSN 2582-7901

Journal of Multidisciplinary
Dental Research

Article

Journal of Multidisciplinary Dental Research

Volume: 10, Issue: 2, Pages: 60-64

Original Article

A Rare Case of Morphological Variation in Mandibular Dentition: Fusion and Two Rooted Premolars

Received Date:17 July 2023, Accepted Date:18 March 2024, Published Date:20 August 2024

Abstract

The differentiation process of dental lamina and morpho-differentiation of the tooth germ may be the cause of developmental abnormality in terms of number, size, and shape. Management of such anomalies can be more complicated, because they can result in aesthetic problems, malocclusion, and other significant clinical consequences. To present a rare case with developmental anomalies of fusion of the permanent right mandibular central and lateral incisor with unusual anatomy of mandibular first and second premolar with two roots and canals. A 8-year-old male patient reported to the department of Pediatric and Preventive Dentistry for routine dental check-up and after clinical examination a preliminary diagnosis of fusion was made i.r.t 41,42. CBCT examination revealed fusion of mandibular permanent central and lateral incisors and also the presence of two roots in the first and second premolars bilaterally. For fusion the aesthetic management of bifurcation of crown was the suggestion. The two root canals of premolars could be challenging if root canal treatment was required. Although asymptomatic, these dental anomalies of fusion can be of aesthetic concern and management of disengaging the fusion require skillful technique. The two root canals of premolars were caries free and as this variation has been observed in young age the preventive strategy for caries is strongly recommended.

Keywords: Root Morphology, Fusion, Dental anamoly, Permanent dentition

References

  1. More CB, Tailor MN. Tooth fusion, a rare dental anomaly: analysis of six cases. International Journal of Oral & Maxillofacial Pathology. 2013;4(1):50–53. Available from: http://dx.doi.org/10.13140/2.1.3714.1128
  2. Duncan WK, Helpin ML. Bilateral fusion and gemination: a literature analysis and case report,” Oral Surgery, Oral Medicine. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology. 1987;64(1):82–87. Available from: https://doi.org/10.1016/0030-4220(87)90121-6
  3. Mukhopadhyay S, Mitra S. Anomalies in primary dentition: Their distribution and correlation with permanent dentition. Journal of Natural Science, Biology and Medicine. 2014;5(1):139–143. Available from: https://doi.org/10.4103%2F0976-9668.127313
  4. Guven EP. Root Canal Morphology and Anatomy . In: ZA, Bourzgui F., eds. Human Teeth - Key Skills and Clinical Illustrations. IntechOpen. 2019.
  5. Slowey RR. Root canal anatomy. road map to successful endodontics. Dental Clinics of North America. 1979;23(4):555–573. Available from: https://pubmed.ncbi.nlm.nih.gov/294389/
  6. Sonarkar S, Purba R, Badole G, Makade C. Unusual root canal morphology of mandibular second premolar: A case series and review. Journal of Dental Research and Review. 2017;4:107–113. Available from: http://dx.doi.org/10.4103/jdrr.jdrr_64_17
  7. Karobari MI, Parveen A, Mirza MB, Makandar SD, Ghani NRNA, Noorani TY, et al. Root and Root Canal Morphology Classification Systems. International Journal of Dentistry. 2021;2021:1–6. Available from: https://doi.org/10.1155%2F2021%2F6682189
  8. Açıkel H, İbiş S, Tunç EŞ. Şen Tunç E. Primary Fused Teeth and Findings in Permanent Dentition. Medical Principles and Practice. 2018;27(2):129–132. Available from: https://doi.org/10.1159/000487322
  9. Peyrano A, Zmener O. Endodontic management of mandibular lateral incisor fused with supernumerary tooth. Endodontics and dental traumatology. 1995;11(4):196–198. Available from: https://doi.org/10.1111/j.1600-9657.1995.tb00487.x
  10. Shapira J, Kochavi D, Harary D, Chosack A. A two-step separation technique for fused teeth: clinical report. Pediatric Dentistry. 1983;5(4):270–272. Available from: https://www.aapd.org/globalassets/media/publications/archives/shapira-05-04.pdf
  11. Tannenbaum KA, Alling EE. Anomalous tooth development: Case report of gemination and twinning. Oral Surgery, Oral Medicine, Oral Pathology. 1963;16(7):883–887. Available from: https://doi.org/10.1016/0030-4220(63)90326-8
  12. Chalakkal P, Thomas AM. Bilateral fusion of mandibular primary teeth. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2009;27(2):108–110. Available from: http://dx.doi.org/10.4103/0970-4388.55336
  13. Walton RE. Principles and Practice of Endodontics. (3). (pp. 1-600) 2002.
  14. Bansal D, Mahajan M. Morphological variations in the root canal system of mandibular premolars in the population of Uttarakhand. International Journal of Applied Dental Sciences. 2016;2(4):68–71. Available from: https://www.oraljournal.com/pdf/2016/vol2issue4/PartB/2-4-14.pdf
  15. Thanaruengrong P, Kulvitit S, Navachinda M, Charoenlarp P. Prevalence of complex root canal morphology in the mandibular first and second premolars in Thai population: CBCT analysis. BMC Oral Health. 2021;21:1–12. Available from: https://doi.org/10.1186/s12903-021-01822-7
  16. Bulut DG, Kose E, Ozcan G, Sekerci AE, Canger EM, Sisman Y. Evaluation of root morphology and root canal configuration of premolars in the Turkish individuals using cone beam computed tomography. European Journal of Dentistry. 2015;9(4):551–557. Available from: https://doi.org/10.4103/1305-7456.172624
  17. Arroyo-Bote S. Use of cbct in the endodontic management of a second mandibular premolar with three roots: Clinical case. Journal of Clinical and Experimental Dentistry. 2022;14(1):107–113. Available from: http://www.medicinaoral.com/medoralfree01/aop/58612.pdf
  18. Georgiev K, Pecheva A. Deviant morphology of the root canal system in mandibular premolars: clinical cases. Folia Medica. 2022;64(1):176–180. Available from: https://dx.doi.org/10.3897/folmed.64.e58877
  19. Alfawaz H, Alqedairi A, Al-Dahman YH, Al-Jebaly AS, FAA, Alsubait S, et al. Evaluation of root canal morphology of mandibular premolars in a Saudi population using cone beam computed tomography: A retrospective study. Saudi Dental Journal. 2019;31(1):137–142. Available from: https://doi.org/10.1016/j.sdentj.2018.10.005
  20. Scott GR, Turner CG. The Anthropology of Modern Human Teeth (2). Cambridge, USA. Cambridge University Press. 2018.
  21. Kararia N, Chaudhary A, Kararia V. Mandibular left first premolar with two roots: A morphological oddity. Contemporary Clinical Dentistry. 2012;3(2):234–236. Available from: https://dx.doi.org/10.4103/0976-237x.96840
  22. Schuurs AH, Loveren Cv. Double teeth: Review of the literature. ASDC journal of dentistry for children. 2000;67(5):313–325. Available from: https://pubmed.ncbi.nlm.nih.gov/11068663/
  23. Buenviaje TM, Rapp R. Dental anomalies in children: A clinical and radiographic survey. ASDC journal of dentistry for children. 1984;51(1):42–46. Available from: https://pubmed.ncbi.nlm.nih.gov/6583219/
  24. Salem G. Prevalence of selected dental anomalies in Saudi children from Gizan region. Community Dentistry and Oral Epidemiology. 1989;17(3):162–163. Available from: https://dx.doi.org/10.1111/j.1600-0528.1989.tb00014.x
  25. Kakkar P, Singh A. Mandibular first premolar with three roots: a case report. Iranian Endodontic Journal. 2012;7(4):207–210. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487526/
  26. Jain H, Ballal NV. Endodontic Management of Aberrant Root Canal Anatomy in Premolars - A Report of Two Cases. Journal of Dental Problems and Solutions. 2016;3(1):008–011. Available from: https://dx.doi.org/10.17352/2394-8418.000025

COPYRIGHT

© 2024 Published by International Dental Educationists’ Association (IDEA). This is an open-access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/

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