CDEN0110

12 I I case report _ hemisection _A 14-year-old girl greeted us in the treat- ment room with a friendly smile. Her aesthe- tically unpleasing tooth #21 was immediately apparent. It appeared twisted and too wide. The mother’s comment highlighted the severity of the situation: “My daughter generally does not smile like that. She is embarrassed and avoids smiling.” _Case report The patient presented with two deformed teeth in the region of tooth #21 that were fused together, a deformity that occurs in 0.01 % of the population. The central and lateral incisors in the maxilla are most frequently affected. One can distinguish between the fusion of the tooth surface and the whole tooth with a joint pulp chamber (partial versus complete fusion). Fu- sions in milk teeth are more frequent than those in permanent dentition are. Fusions in milk teeth are not determinants of fusion in the permanent dentition. The following treatment was planned for the patient: 1. X-ray diagnosis to determine whether the fusion was partial or complete; 2. hemisection of the teeth along the root sep- aration line; 3. direct capping with calcium hydroxide, if nec- essary, to retain the vitality of tooth #21; 4. temporary crowns; and 5. orthodontic integration of the tooth into the dental arch. _Summary The fusion of two teeth occurs in the nascent period of the teeth. There are various courses of action in therapy that address either partial (only the tooth enamel) or complete (with joint pulp) fusion. Since the young patient had two separate pulp chambers, the vital tooth #21 could be retained. Should pulp opening occur during hemisection with complete fusion, an immedi- ate application of a hydrogen peroxide pellet would be recommend. After a short integration period, calcium-hydroxide paste (e.g. Kerr Life, Kerr) should be applied to the pulp wound. Thisinitialtherapy—directcapping—isverylikely to help keep the part of the tooth to be retained vital. A temporary crown, as shown in this case, completed the treatment. After a rest period of at least three months and monthly vitality tests, long-term tooth retention can be expected. Orthodonticsfollowingthehemisectionshould notbeperformeduntilasixweekshealingperiod has elapsed._ cosmeticdentistry 1_2010 Hemisection of a front tooth Authors_ Dr Steffen Hohl, Germany & Dr Anne Sofie Brandt Petersen, Denmark Fig. 1 Fig. 2 DrSteffenHohl Estetalstraße1 21614Buxtehude Germany Website:www.dr-hohl.de DrAnneSofieBrandtPetersen Kogade4 6270Tonder Denmark Website:www.dentist.dk cosmeticdentistry _contact