2.1. Diagnosis
On examination, the maxillary right (# 11) and left (# 21) central incisors had increased mesiodistal widths with slight notching presented in the incisal region extending through the labial cervical third. Both incisors were within the arch form with no evidence of any caries. The remaining teeth were of normal size and shape and the total number of teeth was normal (Figure1).
Radiographic evaluations (Figure 2) showed that #21 had a single root and a common pulp chamber while #11 had two distinct diverging roots and their pulp chambers were individualized. The diagnosis was made to be bilateral double teeth which # 21 was an incomplete gemination and # 11 was a fusion between the incisor and a supernumerary tooth.
Lateral cephologram analysis (Figure 3) showed skeletal class I and slight tendency to the vertical growth pattern. Dental cast (Figure 4) analysis showed severe space deficiency in both arches. (12 mm in upper arch and 11 mm in lower arch)