Geminated Maxillary Incisors: The Success of an Orthodontic Conservative Approach: 15 Years Follow‐Up Study

Abstract

Tooth gemination is often presented clinically and radiologically as merged crowns or “megadonts” with or without a longitudinal fissure, single root, and a single pulp chamber. The increased mesiodistal width of these teeth results in poor anterior aesthetics, anterior crowding, and incisor rotation. Our aim is to present a conservative non‐extraction orthodontic approach that provides both good aesthetics and long‐term stability. It aims to achieve extra space to incorporate the megadonts into the dental arch and to exceed “super” class I dental relationships. Accordingly, this study shows that geminated teeth were successfully retained by means of conservative non‐extrac-tion orthodontic mechanotherapy and without premolar extractions or enamel reduction. It demonstrated stability during a long‐term 15‐year follow‐up, in addition to high patient satisfaction, good aesthetics, and periodontal health. The solution protocol is definitive and achieved the aesthetic, psychological, and functional objectives at a feasible cost. Thus, this treatment has proven to be preferable to other alternative surgical prosthodontic and endodontic approaches in terms of its long‐term stability, and by providing a solution that does not necessitate further multidisciplinary interventions. Dental practitioners in the fields of pediatric dentistry, endodontics and prosthodon-tics should be well aware of this option.