A case report of incidental finding of concrescence teeth on a panoramic radiograph as a complication of impacted maxillary third molar
Abstract
Objectives: Concrescence is a rare dental developmental anomaly where two fully formed teeth are fused by cementum. It often occurs in the maxillary posterior region and may lead to tooth impaction. This case report presents an incidental radiographic finding of a concrescence related to maxillary third molar (M3) impaction.Case Report: A 72-year-old woman presented with a panoramic radiograph referral for mandibular denture placement with a clinical diagnosis of missing teeth in the right and left mandibular regions. On the panoramic radiograph, the impacted root of tooth 28 was seen, fused with the root of tooth 27.
Conclusion: Concrescence is a rare case of anomaly and can occur in an impacted M3 tooth, and Concrescence is suspected as the main cause of the tooth not being erupted/impacted.
Keywords: Concrescence, maxillary molar tooth impaction, panoramic radiography
References
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23. Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology. 4th ed. St. Louis: Saunders; 2015
24. Tapadiya V, Ramanojam S, Gelada K, Sethi S, Oswal N. Concerescence of erupted second molar and impacted third molar: a rare case report. IOSR J Dent Med Sci. 2017;16(4):74-6. https://doi.org/10.9790/0853-1604067476.
25. White SC, Pharoah MJ. Oral radiology: principles and interpretation. 7th ed. St. Louis: Elsevier Health Sciences; 2014. p. 582, 588.
26. Langthasa M, Das SJ, Khandelwal P. Concrescence: an enigma of root anomaly. Int J Curr Res. 2020;12(7):12705-7 https://doi.org/10.24941/ijcr.39195.07.2020
27. Dargue A. “Acquired” concrescence causing surgical complications – a report of two cases. Oral Surg. 2017;10(4):e92-e97. https://doi.org/10.1111/ors.12288
28. Meisha DE. Coincidence of Fusion and Concrescence in Mandibular Deciduous Incisors: A Case Report. J Contemp Dent Pract. 2019;20(12):1466-9. https://doi.org/10.5005/jp-journals-10024-2695
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30. Syed AZ, Alluri LC, Mallela D, Frazee T. Concrescence: Cone-Beam Computed Tomography Imaging Perspective. Case Rep Dent. 2016;2016:8597872. https://doi.org/10.1155/2016/8597872
2. Janakiraman EN, Alexander M, Sanjay P. Prospective analysis of frequency and contributing factors of nerve injuries following third-molar surgery. J Craniofac Surg. 2010;21(3):784-6. https://doi.org/10.1097/SCS.0b013e3181d7f29a [PMID: 20485048]
3. Matsuyama J, Kinoshita-Kawano S, Hayashi-Sakai S, Mitomi T, Sano-Asahito T. Severe impaction of the primary mandibular second molar accompanied by displacement of the permanent second premolar. Case Rep Dent. 2015;2015:582462. https://doi.org/10.1155/2015/582462. [PMID: 25810929; PMCID: PMC4355565.]
4. Abu-Hussein M, Nezar W. Prevalence of impacted mandibular third molars in population of Arab Israeli: a retrospective study. IOSR J Dent Med Sci. 2016 Jan;15(1):80-9. https://doi.org/10.9790/0853-15178089
5. Carvalho RWF, do Egito Vasconcelos BC. Assessment of factors associated with surgical difficulty during removal of impacted lower third molars. J Oral Maxillofac Surg. 2011 Nov;69(11):2714-21. https://doi.org/10.1016/j.joms.2011.02.097. [PMID: 21752507.]
6. Hashemipour MA, Tahmasbi-Arashlow M, Fahimi-Hanzaei F. Incidence of impacted mandibular and maxillary third molars: a radiographic study in a Southeast Iran population. Med Oral Patol Oral Cir Bucal. 2013 Jan 1;18(1):e140-5. https://doi.org/10.4317/medoral.18028. [PMID: 23229243; PMCID: PMC3548666.]
7. Kumar VR, Yadav P, Kahsu E, Girkar F, Chakraborty R. Prevalence and pattern of mandibular third molar impaction in Eritrean population: a retrospective study. J Contemp Dent Pract. 2017 Feb 1;18(2):100-6. https://doi.org/10.5005/jp-journals-10024-1998. [PMID: 28174361.]
8. Nagaraj T, Balraj L, Irugu K, Rajashekamurthy S, Sreelakshmi. Radiographic assessment of distribution of mandibular third molar impaction: a retrospective study. J Indian Acad Oral Med Radiol. 2016 Apr-Jun;28(2):145-9. https://doi.org/10.4103/0972-1363.191525.
9. Ajith SD, Shetty S, Hussain H, Nagaraj T, Srinath M. Management of multiple impacted teeth: a case report and review. J Int Oral Health. 2014 Jun;6(3):93-8. [PMID: 25083041; PMCID: PMC4109248.]
10. Szubert P, Jankowski M, Krajczyk M, Jankowska-Wikl J, Sokalski J. Analysis of predisposing factors for complications after surgical removal of mandibular wisdom teeth. Dent Forum. 2015;43(1):45-51
11. Sigron GR, Pourmand PP, Mache B, Stadlinger B, Locher MC. The most common complications after wisdom-tooth removal: part 1: a retrospective study of 1,199 cases in the mandible. Swiss Dent J. 2014;124(10):1042-56. https://doi.org/10.61872/sdj-2014-10-01 [PMID: 25342545.]
12. Sella Tunis T, Sarne O, Hershkovitz I, Finkelstein T, Pavlidi AM, Shapira Y, Davidovitch M, Shpack N. Dental anomalies' characteristics. Diagnostics (Basel). 2021 Jun 25;11(7):1161. https://doi.org/10.3390/diagnostics11071161. [PMID: 34202064; PMCID: PMC8304734.]
13. Fekonja A. Prevalence of dental developmental anomalies of permanent teeth in children and their influence on esthetics. J Esthet Restor Dent. 2017 Jul;29(4):276-83. https://doi.org/10.1111/jerd.12302. [PMID: 28509361.]
14. Jahanimoghadam F. Dental anomalies: an update. Adv Hum Biol. 2016;6(3):112. https://doi.org/10.4103/2321-8568.195316
15. Mohapatra A, Prabhakar AR, Raju OS. An unusual triplication of primary teeth – a rare case report. Quintessence Int. 2010 Nov-Dec;41(10):815-20. [PMID: 20927417.]
16. Kapdan A, Kustarci A, Buldur B, Arslan D, Kapdan A. Dental anomalies in the primary dentition of Turkish children. Eur J Dent. 2012 Apr;6(2):178-83. https://doi.org/10.1055/s-0039-1698948. [PMID: 22509107; PMCID: PMC3317294.]
17. Shilpa G, Gokhale N, Mallineni SK, Nuvvula S. Prevalence of dental anomalies in deciduous dentition and its association with succedaneous dentition: a cross-sectional study of 4180 South Indian children. J Indian Soc Pedod Prev Dent. 2017 Jan-Mar;35(1):56-62. https://doi.org/10.4103/0970-4388.199228. [PMID: 28217542.]
18. Mohan B. Hypercementosis and concrescence of maxillary second molar with third molar: a case report and review of literature. Oral Health Dent Manag. 2014 Jun;13(2):558-61. [PMID: 24984682.]
19. Consolaro A, Hadaya O, Miranda DAO, Consolaro RB. Concrescence: can the teeth involved be moved or separated?. Dental Press J Orthod. 2020 Jan-Feb;25(1):20-5. https://doi.org/10.1590/2177-6709.25.1.020-026.oim. [PMID: 32215473; PMCID: PMC7077949.]
20. Meisha DE. Coincidence of fusion and concrescence in mandibular deciduous incisors: a case report. J Contemp Dent Pract. 2019 Dec 1;20(12):1466-1469. https://doi.org/10.5005/jp-journals-10024-2695. [PMID: 32381851].
21. Puttaswamy S, Prasad D, Shameer MCP. Concrescence of teeth: cemented union between the permanent central incisors and associated gingival biotype: a case report. IOSR J Dent Med Sci. 2018;17(6):19-21. https://doi.org/10.9790/0853-1706121921.
22. Palermo D, Davies-House A. Unusual finding of concrescence. BMJ Case Rep. 2016 Mar 23;2016:bcr2016244597. https://doi.org/10.1136/bcr-2016-214597. [PMID: 27009135; PMCID: PMC4823527]
23. Neville BW, Damm DD, Allen CM, Chi AC. Oral and maxillofacial pathology. 4th ed. St. Louis: Saunders; 2015
24. Tapadiya V, Ramanojam S, Gelada K, Sethi S, Oswal N. Concerescence of erupted second molar and impacted third molar: a rare case report. IOSR J Dent Med Sci. 2017;16(4):74-6. https://doi.org/10.9790/0853-1604067476.
25. White SC, Pharoah MJ. Oral radiology: principles and interpretation. 7th ed. St. Louis: Elsevier Health Sciences; 2014. p. 582, 588.
26. Langthasa M, Das SJ, Khandelwal P. Concrescence: an enigma of root anomaly. Int J Curr Res. 2020;12(7):12705-7 https://doi.org/10.24941/ijcr.39195.07.2020
27. Dargue A. “Acquired” concrescence causing surgical complications – a report of two cases. Oral Surg. 2017;10(4):e92-e97. https://doi.org/10.1111/ors.12288
28. Meisha DE. Coincidence of Fusion and Concrescence in Mandibular Deciduous Incisors: A Case Report. J Contemp Dent Pract. 2019;20(12):1466-9. https://doi.org/10.5005/jp-journals-10024-2695
29. Ghom AG, Ghom SA. Textbook of Oral Radiology. 2nd ed. Elsevier; 2016. p.570-1.
30. Syed AZ, Alluri LC, Mallela D, Frazee T. Concrescence: Cone-Beam Computed Tomography Imaging Perspective. Case Rep Dent. 2016;2016:8597872. https://doi.org/10.1155/2016/8597872
Published
2025-08-31
How to Cite
AGUSTIN, Sylvia et al.
A case report of incidental finding of concrescence teeth on a panoramic radiograph as a complication of impacted maxillary third molar.
Jurnal Radiologi Dentomaksilofasial Indonesia (JRDI), [S.l.], v. 9, n. 2, p. 87-90, aug. 2025.
ISSN 2686-1321.
Available at: <http://jurnal.pdgi.or.id/index.php/jrdi/article/view/1174>. Date accessed: 29 nov. 2025.
doi: https://doi.org/10.32793/jrdi.v9i2.1174.
Section
Case Report
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
