Endodontic therapy in antero-superior primary teeth with fusion and taurodontism. Report of two cases

Abstract

Introduction: Dental anomalies can be of number, size, shape and position. Fused teeth are a common anomaly in anterosuperior deciduous teeth, characterized by the union of two adjacent or supernumerary teeth. Taurodontism is an apical displacement of the pulp chamber with absence of constriction of the cemento-enamel junction and bi/trifurcation of the roots, rarely observed in anterosuperior teeth. Due to the low prevalence (0.5-8%), diagnosis and treatment can be challenging for the clinician. Objective: To describe the endodontic management of a case of fusion and a case of taurodontism in anterosuperior deciduous teeth. Report of two cases Case 1. A 3 year old patient presented in emergency with pain. On intraoral examination, fusion of the crowns of the upper central incisor with the lateral incisor and a supernumerary were observed. The periapical radiograph showed the presence of 3 fused crowns, two roots and 3 canals, a finding confirmed by CBCT. Case 2. A 3 year old patient came for consultation due to dental pain associated with the presence of caries in teeth E and F. The periapical radiography revealed a pulp chamber extended towards the apical with a bifurcation in the middle-apical third. In both cases pulpectomies were performed with manual instrumentation, irrigation with 2% chlorhexidine, obturation with iodoform paste, glass ionomer base and definitive restoration. Conclusion: The knowledge of the dental anomalies, accompanied by periapical radiographs and CBCT, allow an adequate diagnosis and treatment. In addition, they allow us to determine the possible presence of anomalies in permanent teeth.