THE ANATOMY AND CLINICAL IMPLICATIONS OF FUSED TEETH: A SYSTEMATIC REVIEW
Main Article Content
Keywords
Double teeth, fusion, germination, dental anomalies, schizodontism, twinning teeth, shark teeth.
Abstract
Fused teeth are rare developmental dental anomalies that are mostly categorized along with gemination under the umbrella term “double teeth” due to their similar clinical appearance and thus are harder to diagnose.. This systematic review aimed to examine the available literature on the epidemiology, etiology, clinical presentation, diagnosis, treatment, prognosis and associated anomalies of fused teeth. A literature search was performed on PubMed, Google Scholar, Cureus
, and Google Search with respect to the PRISMA 2020 guidelines. Studies reporting clinical, radiographic, epidemiological, diagnostic, and treatment-related information on tooth fusion were reviewed. Given the heterogeneity of included studies, a qualitative narrative synthesis was performed.The literature review showed that fused teeth are rare developmental anomalies more common in primary dentition (milk teeth) than permanent dentition. (adult teeth), The literature reviewed indicated that fused teeth are uncommon developmental anomalies and they are seen more frequently in primary dentition than in permanent dentition.
Common clinical findings were enlarged crowns, developmental grooves, aesthetic concerns, malocclusion, and eruption disturbances. Diagnosis generally required both clinical and radiographic assessment, because the appearance of geminated and fused teeth usually was similar. The treatment plans varied according to the severity and morphology of the anomaly and ranged from periodic observation to restorative, endodontic, surgical and orthodontic treatments. In summary, fused teeth generally have a good prognosis when properly diagnosed and treated. Additional studies are needed to better understand etiology, prevalence, and longterm effects of condition
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13. Li, S., Li, Y., Sun, W. et al. Panoramic radiographic analysis of primary tooth fusion and associated permanent successor anomalies in 2989 Chinese children: a retrospective epidemiological study. BMC Oral Health 26, 1033 (2026). https://doi.org/10.1186/s12903-026-08283-w
14. Venkatesh A, Mitthra S, Prakash V, Prasad T. S. Gemination or Fusion ? – A case report. Biomed Pharmacol J 2016;9(3).
15. Badole GP, Shenoi PR, Parlikar A. Endodontic management of central incisor associated with large periapical lesion and fused supernumerary root: a conservative approach. Restor Dent Endod. 2018 Oct 26;43(4):e44. doi: 10.5395/rde.2018.43.e44. PMID: 30483468; PMCID: PMC6237732.
16. Tasa GL, Lukacs JR. The prevalence and expression of primary double teeth in western India. ASDC J Dent Child. 2001 May-Jun;68(3):196-200. PMID: 11693013.
17. El Backly RM, Kotry GS, Moussa H. Multidisciplinary management of a fused maxillary incisor: Case report with 5-year follow-up. Clin Case Rep. 2020 Dec 10;9(2):775-786. doi: 10.1002/ccr3.3629. PMID: 33598244; PMCID: PMC7869352.
18. Sammartino, G., Cerone, V., Gasparro, R. et al. Multidisciplinary approach to fused maxillary central incisors: a case report. J Med Case Reports 8, 398 (2014). https://doi.org/10.1186/1752-1947-8-398
19. Matthew J. Page, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71
20. Ramamurthy S, Satish R, Priya K. Surgical and orthodontic management of fused maxillary central and lateral incisors in early mixed dentition stage. Case Rep Dent. 2014;2014:109301. doi: 10.1155/2014/109301. Epub 2014 Oct 13. PMID: 25371828; PMCID: PMC4209776.
21. Türkaslan S, Gökçe HS, Dalkız M. Esthetic rehabilitation of bilateral geminated teeth: a case report. Eur J Dent. 2007 Jul;1(3):188-91. PMID: 19212565; PMCID: PMC2638247.
22. Pandya-Sharpe, A., & Puryer, J. (2021). A Geminated Mandibular Second Molar—A Case Report. Reports, 4(4), 31. https://doi.org/10.3390/reports4040031
23. Mohan RP, Verma S, Singh AK, Singh U. Double tooth in mandibular incisor region: a case report. BMJ Case Rep. 2013 Feb 20;2013:bcr2012008647. doi:10.1136/bcr-2013-008647. PMID: 23429027; PMCID: PMC3604312.
24. Agarwal R, Chaudhry K, Yeluri R, Munshi AK. Esthetic management of a primary double tooth using a silicone putty guide: a case report. J Calif Dent Assoc. 2013 Mar;41(3):203-6. PMID: 23600163.
25. Rao P, Veena K, Chatra L, Shenai P. Twin tooth on either side: a case report of bilateral gemination. Ann Med Health Sci Res. 2013 Apr;3(2):271-3. doi: 10.4103/2141-9248.113677. PMID: 23919204; PMCID: PMC3728877.
26. Chen, M., Bai, X., Wang, X. et al. Conservative management of double teeth in molar teeth with pulp or periapical disease: a report of five cases and literature review. BMC Oral Health 23, 738 (2023). https://doi.org/10.1186/s12903-023-03463-4
27. Hattab FN. Double talon cusps on supernumerary tooth fused to maxillary central incisor: Review of literature and report of case. J Clin Exp Dent. 2014 Oct 1;6(4):e400-7. doi: 10.4317/jced.51428. PMID: 25593664; PMCID: PMC4282909.
28. Akitomo, Tatsuya, Satoru Kusaka, Momoko Usuda, Mariko Kametani, Ami Kaneki, Taku Nishimura, Masashi Ogawa, Chieko Mitsuhata, and Ryota Nomura. 2024. "Fusion of a Tooth with a Supernumerary Tooth: A Case Report and Literature Review of 35 Cases" Children 11, no. 1: 6. https://doi. org/10.3390/children11010006
29. Demircioglu Guler, Derya, Sen Tunc, Emine, Arici, Nursel, Ozkan, Nilüfer, Multi disciplinary Management of a Fused Tooth: A Case Report, Case Reports in Dentistry, 2013, 634052, 5 pages, 2013. https: //doi.org/10.1155/2013/634052
30. Kamath JS, Hegde S, Ajila V. Dental fusion: A report of 2 cases [Internet]. IP Int J Maxillofac Imaging. 2018 [cited 2026 Jun 20];4(3):99-101. Available from: https://doi.org/10.18231/2581-3838.2018.0025
31. Liang, RZ., Wu, JT., Wu, YN. et al. Bilateral maxillary fused second and third molars: a rare occurrence. Int J Oral Sci 4, 231–234 (2012). https://doi.org/10.1038/ijos.2012.62
32. Velasco LF, de Araujo FB, Ferreira ES, Velasco LE. Esthetic and functional treatment of a fused permanent tooth: a case report. Quintessence Int. 1997 Oct;28(10):677-80. PMID: 9477888.
33. Cetinbas T, Halil S, Akcam MO, Sari S, Cetiner S. Hemisection of a fused tooth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Oct;104(4):e120-4. doi: 10.1016/j.tripleo.2007.03.029. Epub 2007 Jul 25. PMID: 17656128.
34. Mochizuki K, Yonezu T, Yakushiji M, Machida Y. The fusion of three primary incisors: report of case. ASDC J Dent Child. 1999 Nov-Dec;66(6):421-5, 367. PMID: 10656127.
35. Sultan N. Incidental finding of two rare developmental anomalies: Fusion and dilaceration: A case report and literature review. J Nat Sci Biol Med. 2015 Aug;6(Suppl 1):S163-6. doi: 10.4103/0976-9668.166129. PMID: 26604610; PMCID: PMC4630754.
36. Goswami M, Lohia S. Exploring Dental Fusion in Primary Dentition: A Pediatric Dental Perspective. Cureus. 2024 Sep 2;16(9):e68469. doi: 10.7759/cureus.68469. PMID: 39360086; PMCID: PMC11446408.
37. McKinney R, Brizuela M, Olmo H. Developmental Disturbances of the Teeth, Anomalies of Shape and Size. [Updated 2025 Feb 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-
38. Rajendran R, Sivapathasundharam B. Developmental disturbances of oral and paraoral structures. In: Rajendran R, Sivapathasundharam B, editors. Shafer's Textbook of Oral Pathology. 8th ed. New Delhi: Elsevier; 2016.
39. Brook AH. Multilevel complex interactions between genetic, epigenetic and environmental factors in the aetiology of anomalies of dental development. Arch Oral Biol. 2009 Dec;54 Suppl 1(Suppl 1):S3-17. doi: 10.1016/j.archoralbio.2009.09.005. Epub 2009 Nov 13. PMID: 19913215; PMCID: PMC2981858.
40. Developmental Anomalies of Tooth Shape: A Review of Clinical Presentation, Diagnosis, and Management. (2026). European Journal of Dental and Oral Health, 7(3), 1-5. https://doi.org/10.24018/ejdent.2026.7.3.70336
41. Tuna EB, Koruyucu M, Seymen F, Gencay K, Ozgen M. Fused teeth: a review of the treatment options. J Dent Child (Chic). 2009;76:109-116.
42. Ben Salem M, Chouchene F, Masmoudi F, Baaziz A, Maatouk F, Ghedira H. Fusion or Gemination? Diagnosis and Management in Primary Teeth: A Report of Two Cases. Case Rep Dent. 2021 Jun 1;2021:6661776. doi: 10.1155/2021/6661776. PMID: 34123435; PMCID: PMC8189771
43. Shrivastava S, Tijare M, Singh S. Fusion/double teeth. J Indian Acad Oral Med Radiol. 2011;23:S468-70. doi:10.5005/jp-journals-10011-1200.
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Dec 09, 2020
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Dr.N.Inbanesan. (2020). THE ANATOMY AND CLINICAL IMPLICATIONS OF FUSED TEETH: A SYSTEMATIC REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 27(4), 371-384. https://doi.org/10.69980/r4zv7d57
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Author Biography
Dr.N.Inbanesan
Reader in Department of OMFS Karpaga vinayaga Institute of Dental sciences, Tamilnadu, India,
How to Cite
Dr.N.Inbanesan. (2020). THE ANATOMY AND CLINICAL IMPLICATIONS OF FUSED TEETH: A SYSTEMATIC REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 27(4), 371-384. https://doi.org/10.69980/r4zv7d57
