Conservative management of a fused maxillary molar and supernumerary premolar using CBCT: A case report with 2-year follow-up

Hasan Said Sener¹ image, Alparslan Mustafa Celer2 image, Emin Caner Tumen3 image

Highlights

Cone-beam computed tomography enabled precise three-dimensional assessment of a rare posterior dental fusion involving a maxillary molar and a supernumerary premolar.

Indirect pulp capping with BiodentineTM allowed preservation of pulp vitality and avoidance of complex endodontic or surgical intervention.

Conservative management resulted in stable clinical and radiographic outcomes with no pathology during a 2-year follow-up period.

Abstract

Fusion is a rare developmental anomaly in the permanent dentition, particularly in the posterior region, and presents diagnostic and therapeutic challenges due to complex root canal anatomy. This case report aimed to evaluate the anatomy of a fused maxillary molar and a supernumerary premolar using cone-beam computed tomography (CBCT) and to manage the associated carious lesion conservatively. A 14-year-old female patient presented with pain in the right posterior maxillary region. Intraoral examination revealed fusion between the maxillary first molar and a supernumerary premolar. CBCT imaging demonstrated a complex root canal morphology. The teeth were isolated using a rubber dam, and two separate access cavities were prepared. Indirect pulp capping was performed using Biodentine™. The carious lesion was removed and restored with composite resin. The patient remained asymptomatic, and no periapical pathology was detected during the 2-year follow-up period. CBCT is an essential tool for the accurate diagnosis of fused teeth, and conservative treatment approaches can lead to favorable clinical outcomes in appropriately selected cases, particularly in pediatric patients.

Keywords: Biodentine; Cone-Beam Computed Tomography; Dental Fusion; Indirect Pulp Capping

Author Affiliations

  1. Res. Assist., Department of Pediatric Dentistry, Faculty of Dentistry, Dicle University,  Türkiye (Correspondence:dtsaidsener@gmail.com)
  2. Assist. Prof.., Department of Pediatric Dentistry, Faculty of Dentistry, Hatay Mustafa Kemal University, Türkiye
  3. Prof., Department of Pediatric Dentistry, Faculty of Dentistry, Dicle University, Türkiye
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Article Info

Contemp Pediatr Dent 2025:6(3):254-262

Received: 03 August 2025

Accepted: 05 December 2025

Online First: 28 December 2025

DOI: 10.51463/cpd.2025.43

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					Hasan Said Sener, Alparslan Mustafa Celer, Emin Caner Tumen. Conservative management of a fused maxillary molar and supernumerary premolar using CBCT: A case report with 2-year follow-up. Contemp Pediatr Dent 2025:6(3):254-262

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