Conte M, Lombardi P, Linfant J. A supernumerary tooth fused to the distal surface of a mandibular third molar. J N J Dent Assoc. 2002; 73:8-9
Littner MM, Gordon M, Engelberg ME, Kaffe I. Fusion of a supernumerary tooth to third mandibular molar. Refuat Hashinayim. 1984; 2:16-18
Morris DO. Fusion of mandibular third and supernumerary fourth molars. Dent Update. 1992; 19:177-178
Chi AC, Neville BW, Damm DD, Allen C. Oral and Maxillofacial Pathology.: Elsevier Health Sciences; 2017
Ruprecht A, Batniji S, el-Neweihi E. Double teeth: the incidence of gemination and fusion. J Pedod. 1985; 9:332-337
Gera N, Tripathi S, Naik NS, Astekar M. Triplication in permanent teeth: a rare case report. J Oral Maxillofac Pathol. 2017; 21:145-148 https://doi.org/10.4103/jomfp.JOMFP_155_16
Labanca M, Azzola F, Vinci R, Rodella LF. Piezoelectric surgery: twenty years of use. Br J Oral Maxillofac Surg. 2008; 46:265-269 https://doi.org/10.1016/j.bjoms.2007.12.007
Abella F, de Ribot J, Doria G Applications of piezoelectric surgery in endodontic surgery: a literature review. J Endod. 2014; 40:325-332 https://doi.org/10.1016/j.joen.2013.11.014
Bhati B, Kukreja P, Kumar S Piezosurgery versus rotatory osteotomy in mandibular impacted third molar extraction. Ann Maxillofac Surg. 2017; 7:5-10 https://doi.org/10.4103/ams.ams_38_16
Sivolella S, Berengo M, Bressan E Osteotomy for lower third molar germectomy: randomized prospective crossover clinical study comparing piezosurgery and conventional rotatory osteotomy. J Oral Maxillofac Surg. 2011; 69:e15-23 https://doi.org/10.1016/j.joms.2010.12.036
Fusion of an Impacted Third and Supernumerary Fourth Molar Tooth with Concrescence of the Second Molar Julian Leow Kohmal Solanki Mahesh Kumar Dental Update 2024 50:9, 707-709.
Authors
JulianLeow
BDS, MFDS RCPS (Glasg), PGCert (MedEd)
Oral and Maxillofacial Surgery Senior House Officer
We report the case of a symptomatic 41-year-old female presenting with fusion of an impacted third (LL8) and fourth (LL9) mandibular molar tooth with concrescence of the second molar tooth (LL7). Cone-beam computed tomography showed direct contact with the inferior dental nerve (IDN) and lingual aspect of the double tooth. The patient underwent surgical removal of the LL8–LL9 using piezoelectric surgery. We present the first case of successfully using pre-operative CBCT in the planning of surgery and piezoelectric surgery to separate an impacted fused LL8–LL9 from a concrescent LL7 without causing trauma to the LL7 or intimately positioned IDN.
CPD/Clinical Relevance: An impacted fused mandibular third and supernumerary fourth molar with concrescence of the second molar requires very careful management.
Article
There are numerous developmental abnormalities in the shape of teeth. Connate or double teeth with dentine and/or pulp union may either be a result of the conjoining of two adjacent tooth buds, usually with two separate root canal systems (fusion) or the partial division of a single tooth bud into two, usually with a single root canal (gemination). Concrescence is the joining of two teeth by cementum only, with non-contiguous dentine. Whereas fusion and gemination are congenital abnormalities, concrescence may either occur at the developmental stage or as a post-eruption abnormality caused by inflammation.
We report the case of a symptomatic 41-year-old female presenting with fusion of an impacted third and fourth mandibular molar tooth with concrescence of the distal root of the second molar tooth (LL7). Although fusion of mandibular third (LL8) and fourth molar (LL9) teeth has been previously reported in the literature,1,2,3 to the best of our knowledge, this is the first report of a fused third and fourth molar, complicated not only by concrescence to the distal root of the second molar, but also by impaction and direct relation to the left inferior dental nerve (IDN). We share our experience of pre-operative cone beam computed tomography (CBCT) to aid surgical treatment planning as well as the novel use of piezoelectric surgery to divide the concrescent distal root of the LL7 from the mesial aspect of the double tooth.
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
