Conservative Management of Fused and Geminated Permanent Anterior Teeth

The purpose of this case report is to present an eight-year-old patient with a permanent right central incisor that was fused with a supernumerary tooth as well as a geminated permanent left central incisor, and to describe the surgical-orthodontic-restorative management of the resultant malocclusion in the developing dentition. The fused teeth were split, mesiodistal widths of both central incisors were reduced, and the incisors were orthodontically aligned into an ideal occlusion. Both maxillary central incisors maintained vitality and normal masticatory function. We also discuss the physiological basis of the treatment plan, the clinical considerations, and how problems associated with double teeth can be managed conservatively with minimally invasive treatments for an esthetically pleasing result.