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Concrescence: can the teeth involved be moved or separated?

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Concrescence, a rare dental anomaly, fuses teeth due to cement layers. Early diagnosis is crucial for successful separation and orthodontic treatment, preventing complications during extraction or movement.

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Area of Science:

  • Dentistry
  • Oral Surgery
  • Orthodontics

Background:

  • Concrescence is a rare dental anomaly characterized by the fusion of cemental layers between adjacent teeth.
  • It often affects maxillary molars and can result from periodontal ligament atrophy and lack of functional stimulus.
  • This condition may present asymptomatically, complicating orthodontic treatment and surgical extraction.

Purpose of the Study:

  • To describe the characteristics of concrescence.
  • To outline the implications of concrescence in orthodontic treatment and surgical extraction.
  • To emphasize the importance of timely diagnosis and management strategies for concrescence.

Main Methods:

  • Review of literature on concrescence.
  • Analysis of clinical cases involving concrescence.
  • Discussion of diagnostic challenges and treatment modalities.

Main Results:

  • Concrescence typically occurs in maxillary molars and can impede orthodontic movement due to fused cementum.
  • Surgical extraction of fused teeth requires careful consideration, as forceful attempts can lead to complications.
  • Separation of concrescent teeth is possible but depends on the extent of fusion, surgical access, and clinical feasibility.

Conclusions:

  • Early and accurate diagnosis of concrescence is vital before initiating orthodontic treatment or surgical procedures.
  • Separation of fused teeth can be achieved, followed by a healing period, allowing for subsequent orthodontic movement.
  • Proper management involves surgical separation, repair of the extracted tooth with new cement, and a post-separation observation period to prevent re-fusion.