Abstract: Enamel pearl, fused teeth, and supernumerary teeth are common dental dysplasia in clinic. The fusion of permanent tooth with supernumerary tooth is few reported. And the fusion of permanent tooth with supernumerary tooth combined with enamel pearl is extremely rare. This article reports a case of inflammation caused by buccal enamel pearl, and lingual fused supernumerary tooth in the right mandibular second molar, which was misdiagnosed as pericoronitis of wisdom teeth, and provides clinical analysis after literature review.

Key words: enamel pearl, fused teeth, supernumerary teeth, pericoronitis