• Restorative Dentistry and Endodontics
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• v.44 no.2
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• pp.16.1-16.12
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• 2019

Objectives: The upper molars generally have three roots; therefore, different combinations of fusion can occur, increasing the possibility of finding more complex root canal systems. The purpose of this study was to evaluate the prevalence and characterization of fused roots in first and second maxillary molars using cone-beam computed tomography (CBCT) in a Colombian population. Materials and Methods: A total of 1274 teeth were evaluated, of which 534 were maxillary first molars and 740 were maxillary second molars. Axial sections were made at the cervical, middle, and apical levels to determine the prevalence of root fusion and the types of fusion. Results: Overall, 43% of the molars (n = 551) presented some type of fused root. Root fusion was present in 23.4% of the maxillary first molars. The most frequent type of fused root was type 3 (distobuccal-palatal; DB-P) (58.9%). Root fusion was observed in 57.6% of the maxillary second molars, and the most prevalent type of fused root was type 6 (cone-shaped) (45.2%). Of the maxillary molars, 12.5% were classified as C-shaped. Conclusion: Within the limitations of this study, there was a high prevalence of fused roots in maxillary molars in the Colombian population, mainly in the maxillary second molars. In first molars, the most common type of fused root was type 3 (DB-P) and in second molars, the most common type was type 6 (cone-shaped). Additionally, molars with root fusion presented variation at different levels of the radicular portion, with implications for treatment quality.

• Restorative Dentistry and Endodontics
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• v.43 no.4
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• pp.44.1-44.9
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• 2018

Fusion and gemination are developmental anomalies of teeth that may require endodontic treatment. Fusion may cause various clinical problems related to esthetics, tooth spacing, and other periodontal complications. Additional diagnostic tools are required for the diagnosis and the treatment planning of fused tooth. The present case report describes a case of unilateral fusion of a supernumerary root to an upper permanent central incisor with large periapical lesion in which a conservative approach was used without extraction of supernumerary tooth and obturated with mineral trioxide aggregate to reach a favorable outcome.

• Restorative Dentistry and Endodontics
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• v.39 no.4
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• pp.319-323
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• 2014

In dentistry, the term 'fusion' is used to describe a developmental disorder of dental hard tissues. In the permanent dentition, fusion of a normal tooth and a supernumerary tooth usually involves the incisors or canines. However, a few cases of fusion involving premolars have also been reported to date. We present a rare case in which fusion of the maxillary left second premolar and a supernumerary tooth in a 13-year-old girl was diagnosed using cone beam computed tomography (CBCT, Alphard-3030, Asahi Roentgen Ind. Co., Ltd.). The tooth was bicuspidized after routine nonsurgical root canal treatment, and the separated teeth underwent appropriate restoration procedures. The second premolar and supernumerary tooth remained asymptomatic without any signs of inflammation after a follow-up period of 9 years. Identification of anatomical anomalies is important for treatment in cases involving fusion with supernumerary tooth, and therefore the microscopic examinations and CBCT are essential for the diagnosis. Fused teeth can be effectively managed by the comprehensive treatment which includes both endodontic and periodontal procedures.

• The korean journal of orthodontics
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• v.47 no.6
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• pp.384-393
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• 2017

Fusion of teeth is a developmental anomaly. It occurs at the stage of tooth formation, which determines the shape and size of the tooth crown, when one or more teeth fuse at the dentin level during the morphodifferentiation of the dental germs. Such teeth show macrodontia and may cause crowding, as well as esthetic and endodontic problems. In this article, we report a rare case of a maxillary central incisor fused to a supernumerary tooth showing labial and palatal talon cusps, which was orthodontically moved across the midpalatal suture. A 13-year-old Caucasian boy sought treatment for the unesthetic appearance of his maxillary central incisor and anterior crowding. He was rehabilitated successfully via a multidisciplinary approach involving orthodontic, nonsurgical endodontic, periodontal, and prosthodontic treatments. After a 26-month treatment period, the patient's macroesthetics and microesthetics were improved. The overall improvement of this macrodontic tooth and its surrounding tissues through multidisciplinary treatment was documented using cone-beam computed tomography.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.2
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• pp.136-143
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• 2004

The purpose of this study was to investigate the relationship between morphology and position of deciduous double teeth, and the occurrence of other dental anomalies in the same subject. Four morphological types were indentified according to Ailing's classification: type I, bifid crown-single root; type II, large crown-large root; type III, two fused crowns-single root; type IV, two fused crowns-two fused roots. Fifty-four double teeth were found in a total of 1,803 children, who had visited Wonkwang university hospital for dental treatment from January 1, 2003 to September 30, 2003. All of these children were examined clinically and intra-oral radiographs were taken. The results were as follows; 1. 49 children(2.7%) had more than one double teeth, 5 of these children had two double teeth on the bilateral side. And one child showed triple teeth which has three crowns and three roots. 2. Double teeth were predominantly situated in the anterior region, with a preference for the mandible. The ratio of cases involving central incisor and lateral incisor was higher than other cases. 3. There were 25 cases(46.2%) of missing successors among 54 cases of the double teeth. And, prevalence of the missing teeth was highest in the cases involving maxillary central incisor and lateral incisor. 4. In the case of type II(large crown-large root) had more missing successors.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.6
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• pp.633-640
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• 2001

Statement of problem. Relatively low success rate of root analogue implant system was supposed to be due to the time duration between extraction and implant installation. The use of three-dimensional computer tomography and the reconstruction of objects using rapid prototyping methods would be helpful to shorten this time. Purpose. This aim of this study was to evaluate the application possibility of the 3-dimensional computer tomography and the rapid prototyping to root analogue implants. Material and methods. Ten single rooted teeth were prepared. Width and height of the teeth were measured by the marking points. This was followed by CT scanning, data conversion and rapid prototyping model fabrication. 2 methods were used; fused deposition modelling and stereolithography. Same width and height of this models were measured and compared to the original tooth. Results. Fused deposition modelling showed an enlarged width and reduced height. The stereolithography showed more exact data compared with the fused deposition modelling. Smaller standard deviation were recorded in the stereolithographic method. Overall width error from tooth to rapid prototyping was 7.15% in fused deposition modelling and 0.2% in stereolithography. Overall height showed the tendency of reducing dimensions. Conclusion. From the results of this study, stereolithography seems to be very predictable method of fabricating root analogue implant.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.2
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• pp.429-449
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• 1996

An objective definition of the anomaly is not avaliable and most investigators define the term differently or fail to describe their criterion. Because dental anomaly may lead to many complications, early detection and diagnosis of dental anomalies are essential steps in the evaluation of the child patient and in treatment planning. These procedures require detailed medical and dental histories, through clinical examination and the use of radiographs. So, this study was designed to find out the prevalence of dental anomalies. The clinical and roentgenographic examination was undertaken for 8,054 children at age from 0 to 15 years and statistical analysis was done. The results were as follows : 1. Among the examined subjects, 2,134 subjects(26.5%) showed dental anomalies. The prevalence of individual dental anomalies were as follows : supernumerary teeth 15.6%, congenitally missing teeth 6.6%, fusion 2.2%, odontoma 0.35%, microdontia 1.2%, macrodontia 0.05%, gemination 0.22%, talon cusp 0.36%, dens evaginatus 0.24%, dens invaginatus 0.15%, dilaceration 0.27%, taurodontism 0.09%, abnormal tooth position 1.7%, natal & neonatal teeth 0.92%, amelogenesis imperfecta 0.01%. 2. Significant correlations between the groups with individual dental anomalies were as follows : between group I and other groups, there was negative correlation, especially group I and group II. And the correlation coefficient between male and female showed differences. 3. For the supernumerary teeth group, the prevalence of male was higher than female(p<0.001). While for the congenitally missing teeth, macrodontia, microdontia, abnormal tooth position group, the prevalence of female was greater than male(p<0.001). 4. For the congenitally missing teeth group, the mandibular primary lateral incisor showed the highest incidence in primary dentiton, while mandibular lateral incisor in permanent dentition. In the mandible(72.5%), this site showed higher prevalence than in maxilla. In the case with deciduous congenitally missing teeth, the prevalence of successive permanent congenitally missing teeth was about 33.9%, the incidence was highest in mandibular lateral incisors. 5. Most supernumerary teeth existed on middle area and showed inverted position and unerupted state. In addition, supernumerary teeth showed higher incidence on maxilla (99.3%). 6. In the case with deciduous fused teeth, the prevalence of successive permanent congenitally missing teeth was 39.9%, while that of successive permanent fused teeth was 2.7%. And the highest rate of the prevalence (40.3%) appeared in fusion of mandibular deciduous lateral incisor and canine. 7. In the case of odontoma, the prevalence was higher in maxilla(78.6%) and anterior region(82.7%) than mandible and posterior region.

• Proceedings of the KACD Conference
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• 2001.05a
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• pp.247-251
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• 2001

;A dental developmental anomaly is defined as an isolated aberration in tooth form, caused by a disturbance or abnormality which occurred during tooth development. There are numerous types of dental anomalies, and a considerable variation in the extent of the defects occurs with each type. Teeth with these anomalies pose unique challenges. Since the defects are not always apparent clinically, they can confuse diagnosticians investigating the etiology of pulpal pathosis. When endodontic treatment is required, the defects often hinder access cavity preparation and canal instrumentation. Treatment planning also becomes more challenging, since the defects can create complicated periodontal problems, and the malformed teeth can be difficult to restore, particularly those weakened by endodontic therapy. Fusion is defined as the joining of two developing tooth germs resulting in a single large tooth structure. The incidence of fusion is < 1% in the Caucasian population, and it is believed that physical force or pressure produces contact of the developing teeth. Clinically and radiographically, a fused tooth usually appears as one large crown with at least partially separated roots and root canals. There may be a vertical groove in the tooth crown delineating the originally separate crowns. Dens invaginatus is a deep surface invagination of the crown or root that is lined by enamel. Teeth in both maxillary and mandibular arches may be affected, but the permanent maxillary lateral incisor is the tooth most commonly involved. Studies have revealed an incidence ranging from 0.25% to as high as 10%. The invagination ranges from a slight pitting to an anomaly occupying most of the crown and root. The invagination frequently communicates with the oral cavity, allowing the entry of irritants and microorganism either directly into pulpal tissues or into an area that is deparated from pulpal tissues by only a thin layer of enamel and dentin. This continuous ingress of irritants and the subsequent inflammation usually lead to necrosis of the adjacent pulp tissue and then to periapical or periodontal abscesses. If the invagination extends from the crown to the periradicular tissue and has no communication with the root canal system, the pulp may remain vital. Recommended treatment of fused tooth and dens invaginatus has been reported in the endodontic literature. This case report describes the endodontic treatment of a maxillary laterl incisors having fused crown and dens invaginatus.natus.

• The Journal of Advanced Prosthodontics
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• v.3 no.4
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• pp.186-189
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• 2011

PURPOSE. Porcelain fused to metal (PFM) crowns provide the best treatment option for teeth that have a large or defective restoration. More than 20% of teeth with PFM crowns or bridges require non-surgical root canal treatment (NSRCT). This may be due to the effect of restorative procedures and the possible leakage of bacteria and or their by-products, which leads to the demise of the tooth pulp. Thus, this study was planned to compare the ability of the restorative materials to seal perforated PFM specimens. MATERIALS AND METHODS. The study evaluates the ability of amalgam, composite or compomer restorative materials to close perforated PFM specimen's in-vitro. Ninety PFM specimens were constructed using Ni-Cr alloys and feldspathic porcelain, and then they were divided into 3 groups: amalgam (A), composite + Exite adhesive bond (B) and compomer + Syntac adhesive bond (C). All the PFM samples were embedded in an acrylic block to provide complete sealing of the hole from the bottom side. After the aging period, each group was further divided into 3 equal subgroups according to the thermocycling period (one week for 70 cycles, one month for 300 cycles and three months for 900 cycles). Each subgroup was put into containers containing dye (Pelikan INK), one maintained at $5^{\circ}C$ and the other at $55^{\circ}C$, each cycle for 30 sec time. The data obtained was analyzed by SPSS, 2006 using one way ANOVA test and student t-test and significant difference level at (P<.01). RESULTS. The depth of dye penetration was measured at the interfaces of PFM and filling materials using Co-ordinate Vernier Microscope. The lowest levels of the dye penetration for the three groups, as well as subgroups were during the first week. The values of dye leakage had significantly increased by time intervals in subgroups A and C. CONCLUSION. It was seen that amalgam showed higher leakage than composite while compomer showed the lowest level of leakage.

• The korean journal of orthodontics
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• v.45 no.5
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• pp.217-225
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• 2015

Objective: Three-dimensional (3D) printing is a recent technological development that may play a significant role in orthodontic diagnosis and treatment. It can be used to fabricate skull models or study models, as well as to make replica teeth in autotransplantation or tooth impaction cases. The aim of this study was to evaluate the accuracy of fabrication of replica teeth made by two types of 3D printing technologies. Methods: Fifty extracted molar teeth were selected as samples. They were scanned to generate high-resolution 3D surface model stereolithography files. These files were converted into physical models using two types of 3D printing technologies: Fused deposition modeling (FDM) and PolyJet technology. All replica teeth were scanned and 3D images generated. Computer software compared the replica teeth to the original teeth with linear measurements, volumetric measurements, and mean deviation measurements with best-fit alignment. Paired t-tests were used to statistically analyze the measurements. Results: Most measurements of teeth formed using FDM tended to be slightly smaller, while those of the PolyJet replicas tended to be slightly larger, than those of the extracted teeth. Mean deviation measurements with best-fit alignment of FDM and PolyJet group were 0.047 mm and 0.038 mm, respectively. Although there were statistically significant differences, they were regarded as clinically insignificant. Conclusions: This study confirms that FDM and PolyJet technologies are accurate enough to be usable in orthodontic diagnosis and treatment.