# The large bilateral gemination of permanent maxillary central incisors: A rare developmental dental anomaly case report

## TL;DR

This case report describes a rare dental anomaly where a boy's maxillary central incisors abnormally fused, requiring specialized diagnosis and treatment.

## Contribution

The novelty lies in presenting a detailed case of bilateral gemination with CBCT imaging insights and multidisciplinary management strategies.

## Key findings

- CBCT imaging revealed divergent root canal anatomy in the affected incisors.
- The anomaly caused palatal displacement of adjacent teeth and increased caries risk.
- Multidisciplinary management including enameloplasty and orthodontics was recommended.

## Abstract

Bilateral gemination of permanent maxillary central incisors is a rare developmental dental anomaly, with a prevalence of approximately 0.04% in permanent dentition. This case report describes a 12-year-old boy presenting with enlarged central incisors, featuring incisal notches and causing palatal displacement of adjacent lateral incisors due to space encroachment. Cone-beam computed tomography (CBCT) revealed 2 distinct root canals with divergent apices in the right incisor and a single bean-shaped canal in the left, with no periapical pathology. These findings highlight CBCT’s critical role in mapping complex pulpal anatomy for accurate diagnosis. The condition predisposes teeth to plaque retention, increasing risks of caries and gingival inflammation. Management requires a multidisciplinary approach, including conservative enameloplasty, restorative procedures, or orthodontic intervention to address aesthetic and functional challenges. Further research is needed to refine treatment protocols and explore the etiology of such anomalies.