scholarly journals Management of Inflammatory Root Resorption of Maxillary Central Incisors following Traumatic Avulsion

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Seyed Mohsen Sadeghi ◽  
Samaneh Moradi ◽  
Samaneh Soltani

Background. Avulsion is among the most severe types of dental trauma, which often occurs at young ages and can compromise the long-term prognosis of the traumatized tooth. Case Report. Herein, we report replantation of two avulsed teeth. Our patient was an 11-year-old boy with two avulsed maxillary central incisors due to a bicycle fall 2 months earlier. The patient was referred to us after rigid splinting of his teeth by a surgeon. Long-term calcium hydroxide (CH) therapy was performed for the patient, and after healing of periodontal ligament (PDL), apexification was performed for both teeth followed by root canal therapy. During the 2-year follow-up, both teeth were functional and had no radiographic or clinical evidence of resorption or ankylosis. Conclusion. The reported case highlights the favorably high tissue healing potential following severe dental trauma, given that appropriate treatment is performed. Correct endodontic management can guarantee the long-term prognosis of teeth following severe dental trauma.

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Ines Kallel ◽  
Nabiha Douki ◽  
Syrine Amaidi ◽  
Faten Ben Amor

Objective. The aim of this work was to study the incidence of complications of dental traumatisms and look for associations between factors related to trauma and the occurrence of complications. Materials and Methods. It is a longitudinal retrospective study on a sample of 125 traumatized teeth. The sample is taken from patients consulting the dentistry service at the hospital Sahloul Sousse between 2014 and 2017. Criteria for including a patient were presence of a permanent incisor affected by a subluxation, intrusion, lateral luxation, extrusion, or avulsion injuries associated or not with concomitant dentoalveolar injuries. Data were collected using a questionnaire. The information about etiology of trauma, delay of consultation, orientation of the patient, kind of injury, and emergency treatment and complications were obtained from the patients’ records. Results. The incidence of complications was 8%: external root resorption was present in 70% of cases, surface resorption was observed in 10% of cases, and replacement resorption in 10%, ankylosis in 10%. About pulpal complications, pulp necrosis was found after 4 weeks of follow-up, as well as the internal root resorption after one year. The most common cause of the trauma was the fall (40%). The majority of patients came for emergency consultation within “1 to 3 days,” and the coronary fracture without pulp exposure was the first diagnosis (20.60%). Statistical analysis showed no significant relationship between the cause of the trauma and the complication (P=0.577) and between the delay of consultation and complication (P=0.143). However, an association between consultation time and patient orientation was found (P=0.009). Conclusion. Treatment of dental injuries is usually delayed and not given as much attention as general medical treatment that can explain the occurrence of pulpal and periodontal complications. Immediate consultation and treatment could improve long-term prognosis of the injured tooth.


2021 ◽  
Vol 16 (2) ◽  
pp. 163-167
Author(s):  
Gabriela GANEA ◽  
◽  
Mihaela Adela IANCU ◽  
Dumitru MATEI ◽  
◽  
...  

Coarctation of the aorta is a relatively frequent congenital heart disease. Depending on the severity of the coarctation and the possible existence of other congenital heart defects, the symptoms may vary. In the neonatal period, the patients may have signs of heart failure, hypoperfusion or even shock. Coarctation of the aorta can be diagnosed incidentally in adolescence or adulthood, usually presented with mild symptoms. The patient’s anatomy, size, age, and clinical course are taken into consideration when choosing the appropriate treatment. Although associated morbidity and mortality risks regarding surgical or interventional treatment are relatively low, it is neccesary to etabilsh a long term follow-up, given the possible post-surgical complications that may occur: recoarctation, aortic aneurysm, aortic dissection and hypertension. Long term prognosis of these patients mostly depends on the presence of systemic hypertension with its consequences leading to premature cardiovascular events. Another factor is the severity of associated defects: aortic stenosis, mitral valve abnormalities. The purpose of this review is to describe the main treatmet methods, indications for intervention and possible complications of the surgical and interventional treatment.


STEMedicine ◽  
2022 ◽  
Vol 3 (1) ◽  
pp. e115
Author(s):  
Jiang Wang ◽  
Yang Yang ◽  
Yingjie Wang ◽  
Yanli Liu ◽  
Yongjin Chen ◽  
...  

Root resorption (RR) is a common complication of traumatic dental injuries (TDIs), which could result in tooth loss and affect life in severe cases. The management of a traumatized tooth with RR remains a challenge for clinicians. In our presented cases, the impacted teeth had a history of trauma and underwent thorough non-surgical endodontic treatment; however, RR still occurred months later and could be observed through a periapical radiograph. Therefore, root canal therapy was performed under a dental microscope with a quick-setting calcium silicate cement to repair the RR site. After a long follow-up, the affected teeth showed almost complete healing of the periradicular tissues without sign of RR. This report demonstrates that external root absorption is typically a consequence of traumatized teeth. However, to date, there is still no effective method for its treatment. Here, we successfully applied microscopical surgery to the traumatized teeth experiencing root absorption and provided them with a new healing opportunity.


2011 ◽  
Vol 81 (5) ◽  
pp. 800-806 ◽  
Author(s):  
Krister Bjerklin ◽  
Chanelle Houmet Guitirokh

Abstract Objective: To evaluate the long-term clinical and radiographic effects of maxillary incisor root resorption in cases of ectopic canines treated during the late 1970s and 1980s in Jönköping, Sweden. Subjects and Methods: The material comprised 55 incisors in 38 subjects. The posttreatment follow-up time was 13 to 28 years. All subjects underwent intraoral radiography, 33 were referred for computed tomography or cone beam computed tomography, and 24 also underwent clinical examination. The severity of incisor root resorption was correlated with clinical characteristics. Radiographs of the resorptive lesions were documented in detail and compared with intraoral radiographs taken immediately posttreatment. Results: Four incisors in three subjects had been lost, in part because of root resorption. Of the 36 incisors with root resorption, the lesions were unchanged in 26 teeth, improved in three teeth, and exacerbated in seven. In one case the resorption had progressed to pulpal exposure, necessitating endodontic treatment. For most of the incisors, the periodontal ligament was more clearly defined and the lamina dura showed improved trabeculation. The clinical characteristics of the incisors with resorption were not significantly different from those of sound incisors. Conclusions: In this long-term follow-up, most cases of incisor root resorption induced by ectopic maxillary canines did not progress and teeth with root resorption showed no clinically relevant symptoms. The prognosis for long-term survival of teeth with resorbed roots is good, but in cases where extraction is indicated, lateral incisors with severe root resorption should be extracted in favor of healthy premolars.


2021 ◽  
pp. 036354652110101
Author(s):  
Benjamin F.H. Ang ◽  
P. Chandra Mohan ◽  
Meng Ai Png ◽  
John Carson Allen ◽  
Tet Sen Howe ◽  
...  

Background: In a study from our institution, ultrasonic percutaneous tenotomy of the brevis and the common extensor tendon for recalcitrant lateral elbow tendinopathy showed excellent safety profiles, high tolerability, efficiency, sustained pain relief, functional improvement, and sonographic evidence of tissue healing in 20 patients at 3 years’ follow-up. Purpose: To explore the long-term clinical and sonographic results of ultrasonic percutaneous tenotomy of the brevis and the common extensor tendon. Study Design: Case series; Level of evidence, 4. Methods: The same cohort of 20 patients was recalled after 7 years, and visual analog scale (VAS) for pain and Disabilities of the Arm, Shoulder and Hand (DASH) scores, need for secondary intervention, and overall satisfaction were assessed. They were also reassessed using ultrasound imaging of the brevis and the common extensor tendon to evaluate tendon hypervascularity, tendon thickness, and the progress or the recurrence of the hypoechoic scar tissue. Results: We successfully scored 19 patients and performed ultrasound on 16 patients with a median follow-up of 90 months (range, 86-102 months). There were no adverse outcomes and satisfaction remained at 100% (6 patients, satisfied; 13 patients, very satisfied). No patient developed a recurrence of symptoms and signs of lateral elbow tendinopathy, and therefore no secondary intervention was required. The improvement from baseline and early term scores was sustained ( P < .001 for all). At 90 months, there was a significant improvement in VAS scores and DASH–Compulsory scores compared with preprocedure scores and all follow-up times until 3 months. There was no difference in VAS scores and DASH–Compulsory scores at 90 months compared with 6 and 36 months. For DASH–Work scores, there was a significant improvement at 90 months compared with preprocedure scores, but there was no difference between DASH–Work scores at 90 months and scores at all other points of follow-up. At 90 months, hypervascularity remained resolved in 79% of patients, while all patients had reduced tendon swelling and sustained resolution or reduction of the hypoechoic lesion. Conclusion: At the long-term follow-up of 90 months, ultrasonic percutaneous tenotomy of the brevis and the common extensor tendon, previously shown to enhance recovery of lateral elbow tendinopathy, demonstrated good durability of pain relief and functional recovery that was previously achieved. This was accompanied by sustained sonographic tissue healing with no significant deterioration.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeong-Seon Lee ◽  
Joong-Gon Kim ◽  
Soyoung Lee

AbstractChildhood-onset polyarteritis nodosa (PAN) is a rare and systemic necrotising vasculitis in children affecting small- to medium-sized arteries. To date, there have been only a few reports because of its rarity. Thus, we aimed to investigate the clinical manifestations, laboratory findings, treatment, and long-term outcomes in patients with childhood-onset PAN and to evaluate the usefulness of the paediatric vasculitis activity score (PVAS). We retrospectively analysed the data of nine patients with childhood-onset PAN from March 2003 to February 2020. The median ages at symptom onset, diagnosis, and follow-up duration were 7.6 (3–17.5), 7.7 (3.5–17.6), and 7.0 (1.6–16.3) years, respectively. All patients had constitutional symptoms and skin manifestations, while five exhibited Raynaud’s phenomenon. Organ involvement was observed in one patient. The median PVAS at diagnosis was 7 (range: 2–32). Prednisolone was initially used for induction in all patients, and other drugs were added in cases refractory to prednisolone. All patients survived, but three patients with high PVAS at diagnosis experienced irreversible sequelae, including intracranial haemorrhage and digital amputation. In conclusion, early diagnosis and treatment may minimise sequelae in patients with childhood-onset PAN. This study suggests that high PVAS score at diagnosis may be associated with poor prognosis.


2021 ◽  
Vol 10 (2) ◽  
pp. 180
Author(s):  
Frédéric Bouisset ◽  
Jean-Bernard Ruidavets ◽  
Jean Dallongeville ◽  
Marie Moitry ◽  
Michele Montaye ◽  
...  

Background: Available data comparing long-term prognosis according to the type of acute coronary syndrome (ACS) are scarce, contradictory, and outdated. Our aim was to compare short- and long-term mortality in ST-elevated (STEMI) and non-ST-elevated myocardial infarction (non-STEMI) ACS patients. Methods: Patients presenting with an inaugural ACS during the year 2006 and living in one of the three areas in France covered by the Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) registry were included. Results: A total of 1822 patients with a first ACS—1121 (61.5%) STEMI and 701 (38.5%) non-STEMI—were included in the study. At the 28-day follow-up, the mortality rates were 6.7% and 4.7% (p = 0.09) for STEMI and non-STEMI patients, respectively, and after adjustment of potential confounding factors, the 28-day probability of death was significantly lower for non-STEMI ACS patients (Odds Ratio = 0.58 (0.36–0.94), p = 0.03). At the 10-year follow-up, the death rates were 19.6% and 22.8% (p = 0.11) for STEMI and non-STEMI patients, respectively, and after adjustment of potential confounding factors, the 10-year probability of death did not significantly differ between non-STEMI and STEMI events (OR = 1.07 (0.83–1.38), p = 0.59). Over the first year, the mortality rate was 7.2%; it then decreased and stabilized at 1.7% per year between the 2nd and 10th year following ACS. Conclusion: STEMI patients have a worse vital prognosis than non-STEMI patients within 28 days following ACS. However, at the 10-year follow-up, STEMI and non-STEMI patients have a similar vital prognosis. From the 2nd year onwards following the occurrence of a first ACS, the patients become stable coronary artery disease patients with an annual mortality rate in the 2% range, regardless of the type of ACS they initially present with.


2017 ◽  
Vol 23 (14) ◽  
pp. 1950-1954 ◽  
Author(s):  
Jinhua Zhang ◽  
Fang Liu ◽  
Yiqi Wang ◽  
Ying Yang ◽  
Yuehong Huang ◽  
...  

Understanding the characteristics of neuromyelitis optica spectrum disorder (NMOSD) with recurrent short partial transverse myelitis (SPTM), which is very rare, contributes to the differential diagnosis of multiple sclerosis (MS). We present two Chinese aquaporin-4 immunoglobulin G (AQP4-IgG)-seropositive NMOSD cases who had at least twice SPTM during 4 and 6 years of follow-up, respectively. Their SPTMs have been mild and responded well to corticosteroids just like in the case of MS. The findings highlight the need of searching for serum AQP4-IgG (cell-based assay strongly recommended) in patients with recurrent SPTM and suggest that those patients may have a mild acute attack phase and favorable long-term prognosis.


Author(s):  
Martin Geyer ◽  
Karsten Keller ◽  
Kevin Bachmann ◽  
Sonja Born ◽  
Alexander R. Tamm ◽  
...  

Abstract Background Concomitant tricuspid regurgitation (TR) is a common finding in mitral regurgitation (MR). Transcatheter repair (TMVR) is a favorable treatment option in patients at elevated surgical risk. To date, evidence on long-term prognosis and the prognostic impact of TR after TMVR is limited. Methods Long-term survival data of patients undergoing isolated edge-to-edge repair from June 2010 to March 2018 (combinations with other forms of TMVR or tricuspid valve therapy excluded) were analyzed in a retrospective monocentric study. TR severity was categorized and the impact of TR on survival was analysed. Results Overall, 606 patients [46.5% female, 56.4% functional MR (FMR)] were enrolled in this study. TR at baseline was categorized severe/medium/mild/no or trace in 23.2/34.3/36.3/6.3% of the cases. At 30-day follow-up, improvement of at least one TR-grade was documented in 34.9%. Severe TR at baseline was identified as predictor of 1-year survival [65.2% vs. 77.0%, p = 0.030; HR for death 1.68 (95% CI 1.12–2.54), p = 0.013] and in FMR-patients also regarding long-term prognosis [adjusted HR for long-term mortality 1.57 (95% CI 1.00–2.45), p = 0.049]. Missing post-interventional reduction of TR severity was predictive for poor prognosis, especially in the FMR-subgroup [1-year survival: 92.9% vs. 78.3%, p = 0.025; HR for death at 1-year follow-up 3.31 (95% CI 1.15–9.58), p = 0.027]. While BNP levels decreased in both subgroups, TR reduction was associated with improved symptomatic benefit (NYHA-class-reduction 78.6 vs. 65.9%, p = 0.021). Conclusion In this large study, both, severe TR at baseline as well as missing secondary reduction were predictive for impaired long-term prognosis, especially in patients with FMR etiology. TR reduction was associated with increased symptomatic benefit. Graphic abstract


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