Simultaneous Occurrence of Dens Invaginatus and Fusion

Although Dens invaginatus and fusion are well-known and well established dental anomalies, they are rarely seen in supernumerary teeth. In this article, simultaneous occurrence of Dens invaginatus and fusion between maxillary lateral incisor and a supernumerary tooth is described. Dens invaginatus is clinically significant due to the possibility of the pulpal involvement; pulpitis, necrotic pulps and chronic periapical lesions are often associated with this anomaly without clinical symptoms. Fusion has a negative impact on the aesthetics, especially when it occurs in maxillary anterior teeth. It is difficult to clinically make differential diagnosis between fused teeth and geminated teeth, especially when these anomalies take place together with hypodontia or supernumerary tooth. It has been found that sequel of such teeth may result in delayed eruption, ectopic eruption or even impaction of permanent teeth; hence proper diagnosis by clinical and radiographic methods and intervention at appropriate time is of paramount importance. The accurate knowledge of variations in morphology of tooth and pulp cavity greatly assists the dentist in planning successful treatment options