Non-invasive endodontic management of fused mandibular second molar and a paramolar, using cone beam computed tomography as an adjunctive diagnostic aid: A case report

Tooth fusion is a developmental anomaly characterized by the union between the dentin and/or enamel of at least two separately developing teeth. Fusion is a rare occurrence, with overall prevalence to be approximately 0.5% in deciduous teeth and 0.1% in permanent dentition. The significance of this particular case was that the unilateral fusion occurred in a permanent mandibular second molar with a paramolar and successful endodontic management was done. The rarity with which this entity appears, along with its complex characteristics, often makes it difficult to treat. In this case, a new advanced three-dimensional imaging Cone Beam Computed Tomography (CBCT) was used as an adjunctive diagnostic aid to differentiate between fusion occurred before or after root formation and help to reach the correct diagnosis.