Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8367
Peer-review started: March 17, 2022
First decision: May 12, 2022
Revised: May 20, 2022
Accepted: July 11, 2022
Article in press: July 11, 2022
Published online: August 16, 2022
Fused teeth usually involve several complications, such as the development of caries in the groove between fused crowns, tooth impaction, diastemas, aesthetic and periodontal problems, and pulpal pathosis, due to the complex anatomical structure of fused teeth. A thorough diagnosis is paramount to forming an acc
This report details the diagnosis and endodontic treatment of a rare case involving a fused maxillary second molar and two paramolars with apical periodontitis. The patient experienced pain upon biting and cold sensitivity in the area of the maxillary left molar. No caries or other defects were identified in these teeth, and a normal response to a pulp electric viability test was observed. With the aid of CBCT and digital model technology, we initially suspected that the infection originated from the isthmus between the maxillary second molar and two paramolars. Therefore, we only treated the isthmus by an endodontic approach and did not destroy the original tooth structure; furthermore, the vital pulp was retained, and good treatment outcomes were observed at the 24-month follow-up.
This finding may provide new insights and perspectives on the diagnosis and treatment of fused teeth.
Core Tip: Fused teeth usually involve several complications due to their complex anatomical structure. A thorough diagnosis is of vital importance. With the aid of cone-beam computed tomography (CBCT) and digital model technology, accurate 3-dimensional images of teeth can be obtained; thus, CBCT provides a minimally invasive approach to acquiring detailed diagnostic information. In this report, we utilized CBCT data to generate a digital model of a fused tooth and only treated the infected isthmus by an endodontic approach. Good treatment outcomes were observed at the 24-month follow-up. This finding provides new perspectives on the diagnosis and treatment of fused teeth.