A Rare Case of Morphological Variation in Mandibular Dentition: Fusion and Two Rooted Premolars

The differentiation process of dental lamina and morpho-differentiation of the tooth germ may be the cause of developmental abnormality in terms of number, size, and shape. Management of such anomalies can be more complicated, because they can result in aesthetic problems, malocclusion, and other significant clinical consequences. To present a rare case with developmental anomalies of fusion of the permanent right mandibular central and lateral incisor with unusual anatomy of mandibular first and second premolar with two roots and canals. A 8-year-old male patient reported to the department of Pediatric and Preventive Dentistry for routine dental check-up and after clinical examination a preliminary diagnosis of fusion was made i.r.t 41,42. CBCT examination revealed fusion of mandibular permanent central and lateral incisors and also the presence of two roots in the first and second premolars bilaterally. For fusion the aesthetic management of bifurcation of crown was the suggestion. The two root canals of premolars could be challenging if root canal treatment was required. Although asymptomatic, these dental anomalies of fusion can be of aesthetic concern and management of disengaging the fusion require skillful technique. The two root canals of premolars were caries free and as this variation has been observed in young age the preventive strategy for caries is strongly recommended. Keywords: Root Morphology, Fusion, Dental anamoly, Permanent dentition