SCENARIO IN ENGLISH

A 14 y.o male visit dental clinic accompanied with his father due to his
lower right front tooth tha is bigger than the others. Clinical examination
revealed a presence of unusually large tooh in the right lower incisor
canine region. Radiographic examination of mandibular right side
revealed that the tooth has 2 root and root canal.
STEP 1:
1. Diagnosis?
2. Etiology?
3. Differential Diagnosis
4. Risk factor from diagnosis
5. Pathophysiology?
6. Preventif?
7. Treatment?
STEP 2 :
1. Diagnosis
The diagnosis is fusion teeth. Fusion teeh like the tooth has 2 root
and only 1 crown, and it look like the fusion of 2 kind of tooth and
commonly happen anterior teeth. Also common happen desidui
teeth. It can diagnostic by counting teeth(less than normal).
Fusion is 2 tooth become 1, has 2 root and 1 crown.
Fusion can also occur supernumery tooth, resulting a normal count
of tooth. Diagnosis exam, it radiologycal and clinical exam by
counting the number crown of teeth. And the last we can see
CTscan. desidui teeth 0.5-2.5% and permanent teeth 0.1%
Fusion teeth can be happen in the first stage in odontogenesis.
Before calcification stage.
The teeth look bigger than other, like macrodontia.
2. Etiology
It can cause by genetic factor and physic fact about what the boy
doing everyday. Pressure and physical force, causing contact when
tooth formation.
1. The presence of such contact will cause periodontal tissues
necrosis.
2. persistent interdental lamina from 2 dental seeds
3.trauma and environmental fact, like alcohol, hipervitamin A from
the pregnan mother
4.is non clearly, but it can be happen by what my friend said
5.genetic fact is mean autosomal dominant

3. Differential diagnosis
Germination. When 1 tooth buds tries to divide into two teeth.
Because the teeth has 2 crown but the root still 1,Occur in primery
teeth. Commonly seen in incisal area. The patient, has germination
in her primary tooth it doesn’t meanthe permanent teeth will be the
same. Common in the upper teeth(maxilla area), but the fusion
most common in the lower teeth(mandibular area). It can happen in
desidui or permanent.
Macrodontia, size of tooth bigger than norm size. Has 2 type, true
macrodontia all teeth in gigantism, false macrodontia in multiple
teeth and usually in insicivus and caninus.
Concrensense, fusion of sementum beetwen 2 teeth. Cause of
trauma or dislocation on tooth seeds while root formation.
Different beetwen fusion and germination, is the number of
tooth element. On fusion, usually the number of teeth is reduce by
1 tooth due to fusion occur due to union of two teeth and seed
forming a tooth with a large crown.
4. The effect from diagnosis
karries and periodontal disease, maloklusi, and then the
eruption is abnormal(delay eruption of permanent tooth is by
delay of root resorption and exfuliation of desidui tooth). The
function of mastication system decrease. Commonly effect,
hypodontia of permanent tooth bud, when the fusion involve the
lateral incisal and canine desidui mandibular. Psicologycal,
decrease esthetic

5. Pathophysiology?
Happen when on cap stage. When the tooth bud is lost, it can fuse
become one the tooth bud. When fusion begins before calcification
stage it called completely fusion and in completely fusion occur at
later stage or after calcification stage. Actually, in cap stage,
interdental lamina doesn’t develop.

6. Prevent the diagnosis?

1.Reducing some traumatic activities.
2.From the mother, give good nutrion when she pregnant.

7. Treatment?
Restoration with compomer according to the shape of the teeth.
Because, can be defend teeth until the permanent tooth has
eruption. Surgical separation or hamisaction is recommended if
the tooth has 2 separate roots. After that, orthodontic clousure of
the space and reshaping of the teeth. Involve in diagnosis, such as
the specialist of mouth structure (periodontic), orthodontic and
conservation. Like patching the crown of teeth to preven karies
problem.
STEP 3 : CONCLUSION