This case report describes the diagnosis and treatment of a non-syndromic unilateral geminated second premolar complicated by hypodontia of three second premolars. Gemination is defined as a developmental disturbance of the shape of teeth and is usually recognized as a partial cleavage of a single tooth germ resulting in one root and one pulp space with two partially or totally separated crowns. Hypodontia is defined as the developmental absence of one or more teeth, excluding the third molars. Geminations of maxillary second premolars are rarely reported. These dental anomalies can cause local malocclusion manifesting as crowding or spacing.
CPD/Clinical Relevance: Diagnosis of dental anomalies such as gemination can be difficult. This paper discusses the diagnosis and management of one such case which involved CBCT.
Article
Gemination is defined as a developmental disturbance of the shape of teeth and is usually recognized as a partial cleavage of a single tooth germ resulting in one root and one pulp space with two partially or totally separated crowns.1 Although it occurs in both dentitions, it has a higher occurrence in the primary dentition, especially in the anterior maxillary region. Unilateral gemination has a prevalence rate of 0.5% and 0.1% in deciduous and permanent dentition, respectively.2 Fusion normally results in one less tooth in the arch, however, an exception to this is the fusion between a supernumerary tooth and a tooth of the normal dental series. Management options of geminated teeth include accepting and monitoring, complex endodontics, or extraction.
Hypodontia is defined as the developmental absence of one or more teeth, excluding the third molars.3 The prevalence of hypodontia in the permanent dentition is estimated to be 6·4% in the UK.4 The aetiology of the condition is multifactorial and can be divided into genetic factors, environmental factors and/or systemic factors.5,6 The most commonly affected teeth are mandibular second premolars, followed by maxillary lateral incisors, maxillary second premolars and mandibular incisors.7,8
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