Macrodontia is a dental anomaly pertaining to the increased size of a tooth or multiple teeth. Double teeth are dental abnormalities concerning tooth morphology and the term traditionally refers to geminated or fused teeth. These anomalies may manifest in both primary and permanent dentitions and usually become apparent in childhood. They may cause a variety of clinical sequelae, including orthodontic complications, such as crowding, ectopic eruption of adjacent teeth and periodontal concerns. Double teeth are also at a higher risk of developing caries. The aesthetic implications of these dental anomalies can affect the psychosocial development of a patient. This, together with the range of functional repercussions, can often need dental treatment to improve quality of life. The functional and aesthetic complexities that may arise in the affected patients can require endodontic, restorative, surgical and/or orthodontic input as part of the management strategy and execution. We present four clinical cases of paediatric patients where a range of management approaches were employed for both macrodontia and double teeth.
This paper provides a review of the literature regarding macrodontia and double teeth and the treatment options available.
We present a number of cases managed in our department employing a range of treatment approaches.
We advocate multidisciplinary input in the planning and management of macrodontia and double teeth in the permanent dentition.
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Chetty M, Beshtawi K, Roomaney I, Kabbashi S. MACRODONTIA: A brief overview and a case report of KBG syndrome. Radiol Case Rep 2021; 16: 1305-1310.
King N M, Tsai J S J, Wong H M. Morphological and numerical characteristics of the southern Chinese dentitions. Part I: anomalies in the permanent dentition. Open Anthropol J 2010; 3: 71-84.
Canoglu E, Canoglu H, Aktas A, Cehreli Z C. Isolated bilateral macrodontia of mandibular second premolars: A case report. Eur J Dent 2012; 6: 330-334.
Nandini D B, Deepak B S, Selvamani M, Puneeth H K. Diagnostic dilemma of a double tooth: a rare case report and review. Journal of clinical and diagnostic research. J Clin Diagn Res 2014; 8: 271-272.
Khanna S, Sandhu S V, Bansal H, Khanna V. Concrescence - A Report of Two Cases. Int J Dent Clinic 2011; 3: 75-76.
Gunduz K, Sumer M, Sumer A P, Gunhan O. Concrescence of a mandibular third molar and a supernumerary fourth molar: report of a rare case. Br Dent J 2006; 200: 141-142.
Sfasciotti G L, Marini R, Bossù M, Ierardo G, Annibali S. Fused upper central incisors: management of two clinical cases. Ann Stomatol (Roma) 2011; 2: 40-44.
Koszowski R, Waśkowska J, Kucharski G, Śmieszek-Wilczewska J. Double teeth: evaluation of 10-years of clinical material. Open Med 2014; 9: 254-263.
Chaudhry S I, Sprawson N J, Howe L, Nairn R I. Dental twinning. Br Dent J 1997; 182: 185-188.
Van der Vyver P J, Potgieter N, Moelich N, Vally Z. Macrodontia and Dens Invaginatus - Review of the literature and a case report. S Afr Dent J 2021; 76: 91-95.
Knežević A, Travan S, Tarle Z, Šutalo J, Janković B, Ciglar I. Double tooth. Coll Antropol 2002; 26: 667-672.
Brook A H. A unifying aetiological explanation for anomalies of human tooth number and size. Arch Oral Biol 1984; 29: 373-378.
Temilola D O, Folayan M O, Fatusi O et al. Theprevalence, pattern and clinical presentation of developmental dental hard-tissue anomalies in children with primary and mix dentition from Ile-Ife, Nigeria. BMC Oral Health 2014; 14: 125.
Harker A R, Walley S, Albadri S. Conservative Management of Macrodontia in the Mixed Dentition Stage - A Case Report. Dent Update 2015; 42: 960-964.
Thomas M B, Greenhalgh C M, Addy L. 'Double-veneers' - a novel approach to treating macrodontia. Dent Update 2008; 35: 479-484.
Yuen S W, Chan J C, Wei S H. Double primary teeth and their relationship with the permanent successors: a radiographic study of 376 cases. Paediatr Dent 1987; 9: 42-48.
Mangla N, Khinda V I S, Kallar S, Brar G S. Molarization of mandibular second premolar. Int J Clin Paediatr Dent 2014; 7: 137.
Gupta S, Singla S, Marwah N, Dutta S, Goel M. Synodontia between permanent maxillary lateral incisor and a supernumerary tooth: surgical treatment perspective. J Oral Health Comm Dent 2007; 1: 52-55.
Groper J N. Macrodontia of a single tooth: review of literature and report of case. J Am Dent Assoc 1987; 114: 69.
Pereira L, de Almeida Assunção P, de Almeida Salazar S L et al. Uncommon true isolated macrodontia of a maxillary tooth. J Contemp Dent Practice 2014; 15: 116-118.
Rostomyan L, Daly A F, Beckers A. Pituitary gigantism: Causes and clinical characteristics. Ann Endocrinol (Paris) 2015; 76: 643-649.
Wilcox G. Insulin and insulin resistance. Clin Biochem Rev 2005; 26: 19-39.
Solanki M, Patil S S, Baweja D K, Noorani H, Shivaprakash P K. Talon cusps, macrodontia, and aberrant tooth morphology in Berardinelli-Seip syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; DOI: 10.1016/j.tripleo.2007.07.022.
Shanmugasundaram K, Vedam V K V, Ganapathy S, Sathish S, Satti P. Congenital Hemifacial Hyperplasia: Clinical Presentation and Literature Review. Case Rep Dent 2016; DOI: 10.1155/2016/5260645.
Morel Swols D, Foster J 2nd, Tekin M. KBG syndrome. Orphanet J Rare Dis 2017; 12: 183.
Nakajima J, Nakayama H, Higuchi K, Takano Y, Sato Y. A variant of the ekman-westborg-julin trait. A case report and review of the literature. J Oral Maxillofac Surg Med Pathol 2016; 28: 30-35.
Mrinalini M, Chetan C. True generalized macrodontia in a case of Rabson-Mendenhall syndrome. J Oral Maxillofac Surg Med Pathol 2015; 27: 357-360.
Bloch-Zupan A, Goodman J R. Otodental syndrome. Orphanet J Rare Dis 2006; 1: 5.
Mainali A, Denny C, Sumanth K N, Ongole R. Non syndromic generalised macrodontia. J Nepal Dent Assoc 2010; 11: 150-153.
Tüttelmann F, Gromoll J. Novel genetic aspects of Klinefelter's syndrome. Mol Hum Reprod 2010; 16: 386-395.
Scheidt L, Sanabe M E, Diniz M B. Oral, physical, and behavioural aspects of patient with chromosome 47, XYY syndrome. J Indian Soc Pedod Prev Dent 2015; 33: 347-350.
Mutluay M, Sönmez I S, Arikan V. A Rare Case of "Double Teeth" in Permanent Dentition. Turkiye Klinikleri J Dent Sci 2017; 23: 216-220.
Shah P, Chander J M L, Noar J, Ashley P F. Management of 'double teeth' in children and adolescents. Int J Paediatr Dent 2012; 22: 419-426.
Melo M, Ata-Ali F, Huertas J, Cobo T, Shibli J A, Galindo-Moreno P, Ata-Ali J. Revisiting the Maxillary Teeth in 384 Subjects Reveals A Deviation From the Classical Aesthetic Dimensions. Sci Rep 2019; 9: 730.
Chu S J. Range and mean distribution frequency of individual tooth width of the maxillary anterior dentition. Pract Proced Aesthet Dent 2007; 19: 209-215.
Tayefeh Davalloo R. Case Report: Conservative management of macrodontia. J Dentomaxillofac Radiol Pathol Surg 2019; 8: 27-31.
Almoammar K A, Aldrees A M, Bawazir O A, Alqutub M N. Autotransplantation as a Treatment Modality of Macrodontia: A Case Report. Oral Health Dent Manag 2014; 13: 1081-1085.
Steinbock N, Wigler R, Kaufman A Y, Lin S, Abu-El Naaj I, Aizenbud D. Fusion of central incisors with supernumerary teeth: a 10-year follow-up of multidisciplinary treatment. J Endod 2014; 40: 1020-1024.
The authors declare that they have no conflicts of interest.
Written consent was obtained from the patient's parent for use of clinical images in Case 4.
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Mamdani, S., Pathak, D., Harrison, M. et al. Macrodontia and double teeth: a review and case series. Br Dent J 234, 315–321 (2023). https://doi.org/10.1038/s41415-023-5571-9