Onçag Ozant, Candan Umit, Arikan Fatih
Ege University, Faculty of Dentistry, Department of Pedodontics, Bornova-lzmir, Turkey.
Int Dent J. 2005 Aug;55(4):213-6. doi: 10.1111/j.1875-595x.2005.tb00318.x.
The term fusion is used to define a developmental anomaly characterised by the union of two adjacent teeth. In the case reported here, clinical and radiographic examinations suggested a unilateral fusion between the mandibular left permanent incisor and a super-numerary tooth. Radiographs showed that the fused teeth had two distinct pulp chambers and canals. A diagnosis of chronic periapical abscess of the supernumerary tooth was made. Before root canal therapy, a periodontal surgical procedure was performed to section the central incisor and its fused supernumerary. Also, odontoplasty was performed on the roots, to establish an anatomy consistent with a normal central incisor. Later, the chronic apical abscess on the supernumerary tooth was instrumented chemo-mechanically, root canal filling was performed and an anterior composite resin restoration was placed. The patient was evaluated for one year after root canal therapy. The tooth was asymptomatic, not exhibiting any pathological root resorption or alveolar resorption, and the anterior composite restoration was intact. Instead of extracting the supernumerary tooth, the application of endodontic, periodontal, and restorative procedures proved to be an alternative treatment.
融合一词用于定义一种发育异常，其特征为两颗相邻牙齿结合在一起。在本文报道的病例中，临床和影像学检查提示下颌左侧恒切牙与一颗多生牙之间存在单侧融合。X线片显示融合牙有两个不同的牙髓腔和根管。诊断为多生牙慢性根尖周脓肿。在根管治疗前，进行了牙周外科手术，将中切牙及其融合的多生牙分开。此外，对牙根进行了牙体成形术，以建立与正常中切牙一致的解剖结构。随后，对多生牙的慢性根尖脓肿进行了化学机械预备、根管充填，并进行了前牙复合树脂修复。根管治疗后对患者进行了一年的评估。该牙无症状，未出现任何病理性牙根吸收或牙槽骨吸收，前牙复合树脂修复体完好无损。事实证明，采用牙髓治疗、牙周治疗和修复治疗程序而非拔除多生牙是一种替代治疗方法。
