Fused primary supernumerary tooth associated with maxillary primary and permanent lateral incisors.

To cite: Vashisth P, Dwivedi S, Arora R, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/ bcr-2013-008797 DESCRIPTION A 4-year-old boy was brought to the Department of Pedodontics and Preventive Dentistry with major tooth decay. An intraoral examination revealed the presence of a complete primary dentition, fair oral hygiene and the presence of double teeth in relation to the right maxillary lateral incisor (figure 1). The patient had 21 teeth. Radiographic examination revealed that the lateral incisor and the accessory tooth had pulp chambers individualised with a normal size. The orthopantomograph (OPG) allowed the observation of permanent dentition showing the presence of hyperdontia in permanent dentition in maxillary right side (figure 2). The extra tooth bud was present in relation to the lateral incisor and the two tooth buds were fused to each other in a single dental follicle. Root canal therapy was performed in the lateral incisor and the accessory tooth followed by glass ionomer cement (GIC) restoration (figures 3 and 4). Gemination and fusion can appear similar and may be differentiated by assessing the number of teeth in the dentition. Some authors have suggested that gemination demonstrates a single root canal. In few cases it has been noted that separate canals are present in fusion, but this does not hold true in all cases. Supernumerary teeth are reported to be associated with few syndromes namely cleft lip and palate, Cleidocranial dysostosis, Gardner’s syndrome and Chondroectodermal dysplasia.