Endodontic and Orthodontic Management of a Fused Mandibular Incisor and Supernumerary: A Case Report.

Dental fusion is a rare anomaly that can present unique challenges with clinical treatment. This report outlines a case of an 11-year-old who presented with fusion of a mandibular lateral incisor with a supernumerary. At presentation, the teeth were fully mature and normally responsive to pulp sensibility testing. Assessment with CBCT confirmed that the majority of the root canal system and pulp chambers were separate, with a single point of communication between both tooth units in the mid-crown. Removal of one of the teeth was requested to facilitate the patient's orthodontic treatment plan, and this was carried out with hemi-sectioning of the teeth, followed by vital pulp therapy of the exposed root canal systems of both teeth. At subsequent review, the tooth with the largest pulpal exposure was chosen for extraction, and the remaining tooth was recontoured for aesthetics. The teeth were subsequently aligned orthodontically. The patient was reviewed at 2.5 years, 3.5 years, and 9.5 years and was asymptomatic, with continued pulpal responsiveness and radiographically normal tissues.