(TC55) Anterior Tooth Gemination and Esthetic Management

Abstract: Gemination is a rare dental anomaly, affecting 0.1% of permanent and 0.5% of primary teeth. It is a developmental aberration wherein one tooth germ attempts unsuccessfully to divide and form two teeth. The result is generally an oversized, sometimes bifid, clinical crown and a single or fused root. The overall tooth count remains normal, as the geminated tooth is counted as one. Anterior teeth are most commonly affected, followed by bicuspids, and the phenomenon is rarely seen in molars. Gemination should be differentiated from fusion, which, in contrast, occurs when two separate tooth germs fuse during later stages of development to form one large tooth, resulting in one fewer tooth in the arch. A geminated tooth can present as an esthetic challenge. The purpose of this table clinic is to present the treatment of a geminated maxillary right central incisor in a 12-year-old male patient. As esthetics was the main concern, endodontic and orthodontic treatments were coordinated to arrive at the best esthetic results. Prophylactic root canal treatment with buildup was performed on the distal portion of the tooth, followed by the hemisection of the mesial half of the clinical crown and the root. A bone graft and membrane were placed in the edentulous site. Orthodontic treatment to close the diastema between the two maxillary central incisors is currently underway. This case report demonstrates a successful coordinated effort across two dental specialties to achieve health, esthetics, and function for a young patient while retaining his natural tooth.