P32 - Endodontic treatment of a geminated canine - case report

Background Dental gemination is a designation used to identify a disturbance occurred during odontogenesis that causes changes in the shape of the tooth. It is recognized as a failed attempt by a single tooth germ to divide by invagination, resulting in a single wide tooth with a bifd crown. It is a rare condition that occurs with greater prevalence in the primary dentition and afects mostly incisor teeth. Its etiology is not clearly understood, although there is evidence that it may be related to genetic factors, trauma and with some syndromes. Despite being generally asymptomatic, it can manifest clinical alterations like malocclusion, impaction of adjacent teeth and even greater susceptibility to caries and periodontal destruction. Case report A 22-year-old female patient with Fahr’s Syndrome was referred to the endodontic appointment at the Clinica Dentária Universitária of Universidade Católica Portuguesa in Viseu, presenting tooth 23 with symptoms compatible with a state of irreversible pulpitis. Periapical radiographs and CBCT confrmed the diagnosis of geminated tooth with irreversible pulpitis. Endodontic treatment was performed using an operative microscope. The preparation was performed with ProTaperTM Gold F5 using 2.5% sodium hypochlorite irrigation. In the obturation, two techniques were used, continuous wave compaction in the apical third and gutta-percha injection with vertical compaction in the remain canal. The crown was restored with a direct composite. After six months, the tooth maintained the function and there was no symptomatology. The radiograph was normal, predicting a good evolution. Informed consent was obtained for publication. Conclusion Dental gemination is an anomaly diagnosed through clinical and radiological criteria. A careful clinical and radiographic examination, as well as the use of an operative microscope, increases the probability of success and improves the prognosis of endodontic treatment. The recognition and adequate treatment of this anomaly allowed to restore the patient’s function and aesthetics.