Sectioning of a double tooth aided by cone-beam computed tomography

Double teeth present challenges for their clinical management. Recent advances in imaging, particularly cone-beam computed tomography (CBCT), have aided clinicians in accurate diagnosis and management. Data from CBCT imaging can be used for three-dimensional reconstruction to further aid pre-surgical planning.

A 14-year-old Caucasian male presented with an aesthetically unacceptable double tooth in the 22 region. Clinical and radiographic examination and assessment included CBCT imaging and three-dimensional reconstruction.

Based on this information, together with a comprehensive assessment of the patient's motivation, a treatment plan consisting of extra-alveolar sectioning, re-implantation, endodontic therapy and composite resin restoration was carried out.

The patient failed to return for follow-up at 6 months post-treatment. However, he did return at 12 months, where clinical and radiographic examination was undertaken. At this point the tooth was clinically sound and bony infill was seen radiographically.

The information gained from the pre-surgical imaging with CBCT was useful in planning treatment in this case. However, this had to be combined with a careful assessment of the patient's motivation to ensure that the course of treatment embarked upon was likely to be successful whilst addressing the patient's concerns.