Abstract
Background: Double tooth is considered as a rare dental anomaly. However, double tooth and supernumerary teeth are the second most common anomalies. The term double tooth represents either gemination or fusion. Gemination can either be unilateral or bilateral. The prevalence of unilateral gemination is 0.5% in deciduous dentition and 0.1% in permanent dentition. In contrast, the prevalence of bilateral gemination is 0.02% in both permanent and deciduous dentition, making it an extremely rare anomaly.
Case Presentation: This paper reports a case of a 22-year-old man presented to the Oral and Maxillofacial Surgery Clinic at Dental College and Hospital of Taibah University with a complaint of pain related to impacted tooth #28 according to the FDI two-digit tooth numbering system. Ortho-panto-graph showed that the tooth is totally covered by bone and is impacted with gemination and extra supernumerary tooth.
Conclusion: Proper diagnosis should be achieved through clinical and radiographical examination to avoid any complications. Different treatment modalities, including conservative, endodontics, prosthodontics, periodontics, or even orthodontic treatment, can be applied to treat gemination. Moreover, supernumerary teeth are similar to geminated teeth and can be diagnosed through clinical and radiographic examinations to avoid complications. Such cases cannot be detected through a routine dental examination unless the patient feels pain related to the area. Hence, proper investigations should be performed to avoid any further complications.

Key words: Gemination, supernumerary, double tooth, surgical extraction, case reports