The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 20 , ISSUE 12 ( December, 2019 ) > List of Articles


Coincidence of Fusion and Concrescence in Mandibular Deciduous Incisors: A Case Report

Dalia E Meisha

Keywords : Concrescence, Deciduous, Dental anomaly, Fusion, Primary incisors

Citation Information : Meisha DE. Coincidence of Fusion and Concrescence in Mandibular Deciduous Incisors: A Case Report. J Contemp Dent Pract 2019; 20 (12):1466-1469.

DOI: 10.5005/jp-journals-10024-2695

License: CC BY-NC 4.0

Published Online: 01-04-2016

Copyright Statement:  Copyright © 2019; The Author(s).


Aim: The aim of this paper is to report a rare case in which two dental anomalies in primary dentition coexisted—fusion and concrescence in a 4-year-old boy. This highlights the significance of the accurate early diagnosis of these dental anomalies. Background: Odontogenic anomalies are frequently encountered in dental practice. These anomalies can occur due to abnormalities during the differentiation stage and lead to abnormalities in the hard tissue formation. Dental anomalies in number and form include fusion, gemination, and concrescence. Case description: Primary dentition with fusion between the right central and lateral primary incisors with increased mesiodistal width. Concrescence between the left central and lateral primary incisors with a groove through the incisal edge. Clinical observation along with radiographic evaluation using intraoral periapical (IOPA) radiographs and orthopantomogram (OPG) were used to arrive at a diagnosis. Conclusion: Early diagnosis of concrescence will reduce the risk of possible complications associated with any need of extraction later on. Monitoring the patient and long-term follow-up is required to manage the case with coexisting anomalies of true fusion and acquired concrescence. Clinical significance: A thorough history taking and clinical and radiographic evaluation of fusion and concrescence at an early stage result in an accurate diagnosis. A careful monitoring plan is a key to reduce the risk of possible complications later on.

  1. Neville BW, Damm DD, Allen CM, et al. Oral and maxillofacial pathology, 4th ed., St. Louis, MO: Saunders Elsevier; 2016.
  2. Sivolella S, Bressan E, Mirabal V, et al. Extraoral endodontic treatment, odontotomy and intentional replantation of a double maxillary lateral permanent incisor: case report and 6-year follow-up. Int Endod J 2008;41(6):538–546. DOI: 10.1111/j.1365-2591.2008.01391.x.
  3. Yuen SW, Chan JC, Wei SH. Double primary teeth and their relationship with the permanent successors: a radiographic study of 376 cases. Pediatr Dent 1987;9(1):42–48.
  4. Brook AH, Winter GB. Double teeth. A retrospective study of “geminated” and “fused” teeth in children. Br Dent J 1970;129(3): 123–130. DOI: 10.1038/sj.bdj.4802533.
  5. Chaudhry SI, Sprawson NJ, Howe L, et al. Dental twinning. Br Dent J 1997;182(5):185–188. DOI: 10.1038/sj.bdj.4809339.
  6. Lowell RJ, Solomon AL. Fused teeth. J Am Dent Assoc 1964;68:762. DOI: 10.14219/jada.archive.1964.0159.
  7. White S, Pharoah MJ. Oral radiology: principles and interpretation, 7th ed., St. Louis, MO: Mosby Elsevier; 2014.
  8. Magnússon TE. Hypodontia, hyperodontia, and double formation of primary teeth in Iceland an epidemiological study. Acta Odontol Scand 1984;42(3):137–139. DOI: 10.3109/00016358408993864.
  9. Tasa GL, Lukacs JR. The prevalence and expression of primary double teeth in western India. J Dent Child 2001;68(3):196–200.
  10. Mukhopadhyay S, Mitra S. Anomalies in primary dentition: their distribution and correlation with permanent dentition. J Nat Sci Biol Med 2014;5(1):139–143. DOI: 10.4103/0976-9668.127313.
  11. Cheng RB, Chen X, Liu SJ. An epidemiological survey on fusion of deciduous teeth of 4286 kindergarten children in Shenyang city. Shanhai Kou Qiang Yi Xue 2003;12(6):424–426.
  12. Wu CW, Lin YT, Lin YT. Double primary teeth in children under 17 years old and their correlation with permanent successors. Chang Gung Med J 2010;33(2):188–193.
  13. McKibben DR, Brearley LJ. Radiographic determination of the prevalence of selected dental anomalies in children. ASDC J Dent Child 1971;38(6):390–398.
  14. Ruprecht A, Batniji S, El-Neweihi E. Double teeth: the incidence of gemination and fusion. J Pedod 1985;9(4):332–337.
  15. Salem G. Prevalence of selected dental anomalies in Saudi children from Gizan region. Community Dent Oral Epidemiol 1989;17(3): 162–163. DOI: 10.1111/j.1600-0528.1989.tb00014.x.
  16. Bruce C, Manning-Cox G, Stanback-Fryer C, et al. A radiographic survey of dental anomalies in black pediatric patients. NDA J 1994;45(1):6–13.
  17. Bäckman B, Wahlin YB. Variations in number and morphology of permanent teeth in 7-year-old Swedish children. Int J Paediatr Dent 2001;11(1):11–17. DOI: 10.1046/j.1365-263x.2001.00205.x.
  18. Hamasha AAH, Al-Khateeb T. Prevalence of fused and geminated teeth in Jordanian adults. Quintessence Int 2004;35(7):556–559.
  19. Aguiló L, Gandia JL, Cibrian R, et al. Primary double teeth. A retrospective clinical study of their morphological characteristics and associated anomalies. Int J Paediatr Dent 1999;9(3):175–183. DOI: 10.1046/j.1365-263x.1999.00131.x.
  20. American Association of Endodontists. Glossary of Endodontic Terms 9th ed., 2015. Available from: 4th Sep 2019).
  21. Shafer W, Hine M, Levy B. Shafer's textbook of oral pathology, 7th ed., Gurgaon, New Delhi: Elsevier India; 2014.
  22. Zakirulla M, Rakesh N. Concrescence in primary dentition: a case report. Int J Clin Dent Sci 2011;2(2):19–21.
  23. Sachdeva GS, Malhotra D, Sachdeva LT, et al. Endodontic management of mandibular central incisor fused to a supernumerary tooth associated with a talon cusp: a case report. Int Endod J 2012;45(6):590–596. DOI: 10.1111/j.1365-2591.2012.02029.x.
  24. Tsurumachi T, Kuno T. Endodontic and orthodontic treatment of a cross-bite fused maxillary lateral incisor. Int Endod J 2003;36(2): 135–142. DOI: 10.1046/j.1365-2591.2003.00635.x.
  25. Karacay S, Guven G, Koymen R. Management of a fused central incisor in association with a macrodont lateral incisor: a case report. Pediatr Dent 2006;28(4):336–340.
  26. Rani AK, Metgud S, Yakub SS, et al. Endodontic and esthetic management of maxillary lateral incisor fused to a supernumerary tooth associated with a talon cusp by using spiral computed tomography as a diagnostic aid: a case report. J Endod 2010;36(2): 345–349. DOI: 10.1016/j.joen.2009.07.014.
  27. Stanford ND, Hosni S, Morris T. Orthodontic management of a dental concrescence: a case report. J Orthod 2017;44(3):209–215. DOI: 10.1080/14653125.2017.1357877.
  28. Mehta V. Bilateral fusion in mandibular primary anterior teeth: report of a rare case with a brief review of literature. Dent Open J 2017;4(1):10–12.
  29. Shrivastava S, Tijare M, Singh S. Fusion/double teeth. J Indian Acad Oral Med Radiol 2011;23(3):S468–S470. DOI: 10.5005/jp-journals-10011-1200.
  30. Singh A, Bhatia HP, Sharma N. Coexistence of fusion and concrescence of primary teeth: in a child with Down syndrome. Spec Care Dent 2017;3:147–149. DOI: 10.1111/scd.12218.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.