Managing multiple dental anomalies in the anterior region of the dental arch presents unique and complex challenges. This case report describes using a multidisciplinary approach to manage a child with not only a fused tooth with a supernumerary but also the presence of other supernumerary teeth in the same place. In this case, deviation from the standard management of a fused permanent anterior tooth, an anchor for aesthetics, by extracting it because of crown root complexity and allowing a supernumerary to erupt into its place made the difference in the successful outcome.
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