Fusions and orthodontic treatment

The term double tooth is used to describe fused teeth, gemination, twinning and concrescence. Fused teeth can be the cause of a local malocclusion manifesting as crowding or spacing. The aetiology of dental fusion is unclear, with both genetic and environmental factors suggested. Treatment options for fused teeth include: accept and align, reduction in size, extraction and surgical hemi-section. Successful management of these cases may involve a multidisciplinary approach. The following is a description of a clinical case in which a fusion of the LL1 and LL2 presented in association with a complex malocclusion. The aetiology and management of fused teeth is discussed.