Diagnosis of a horizontal root fracture during retreatment of a maxillary canine utilizing an electronic apex locator and monitoring with CBCT:  a case report

Introduction: The aim of this case report is todemonstrate the retreatment of a maxillary caninediagnosed with a horizontal root fracture utilizingan electronic apex locator and monitored with conebeam computed tomography. Case Report: A 35year old African American male was referred for rootcanal retreatment of a maxillary right canine prior toprosthetic rehabilitation. Following removal of guttapercha, an apex locator was utilized to determine thelength of the root canal. After a more comprehensivedental history, the patient confirmed a previouslyunreported history of dental trauma at this time,leading to the suspicion of a horizontal root fracture.Clinical microscopy detected a connective tissue in theapical third of the root canal and multiple periapicaland occlusal radiographs enhanced visualizationof a horizontal root fracture. The coronal segmentwas filled with an MTA apical plug and the apicalsegment remained stable. A recall after 1.5 yearswas performed with CBCT, which showed no apicalradiolucency. Discussion: The present case reportreinforces the precept that detailed dental history andcareful observation of radiographs are critical factorsfor obtaining an accurate diagnosis. Fundamentaladjuncts, such as microscopy, apex locators andCBCT imaging, can potentially aid in the diagnosisand the subsequent treatment plan of horizontal rootfracture.Keywords Cone-beam computed tomography; Apex locator Cuspid; Radiography; horizontal root fracture.

Download Full-text

Conservative Management of the Horizontal Root Fracture in the Middle Third using Fiber Post as an Intraradicular Splint

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4865 ◽

2020 ◽

Vol 8 (C) ◽

pp. 146-150

Author(s):

Sneha Dhruvkumar Vaswani ◽

Sathish Abraham ◽

Harshal Balasaheb Najan ◽

Rohini Ramesh Karad

Keyword(s):

Case Report ◽

Glass Fibre ◽

Dental Trauma ◽

Permanent Teeth ◽

Central Incisor ◽

Fiber Post ◽

Root Fracture ◽

Root Fractures ◽

Horizontal Root Fracture

BACKGROUND: Root fractures are uncommon injuries in permanent teeth and account for only 0.5–7% of dental trauma. It occurs more frequently in fully erupted permanent teeth, in which the completely formed root with closed apices is solidly supported in the bone and periodontium. This may lead to complex consequences due to the combined damage to the pulp, dentine, cementum, bone, and periodontium. They are transverse to oblique in direction and result from a horizontal impact. Their incidence is more in the middle third of the root than at the cervical and apical thirds. CASE REPORT: This paper describes a case of complicated horizontal root fracture at the middle third of the maxillary right central incisor. After receiving an endodontic treatment, the fractured root fragments of the maxillary right central incisors were united with the help of a glass fibre post. Eventually, the incisor was restored with a zirconia crown. CONCLUSION: Follow-up after a year revealed a well-stabilized assembly of the root fragments and the post.

Download Full-text

Changing Concepts in Reattachment of Tooth Fracture

Update Dental College Journal ◽

10.3329/updcj.v2i2.15535 ◽

2013 ◽

Vol 2 (2) ◽

pp. 42-46 ◽

Cited By ~ 1

Author(s):

MF Uddin ◽

M Naser ◽

MMR Howlader ◽

MS Alam ◽

MN Nabi

Keyword(s):

Case Report ◽

Case History ◽

Root Canal ◽

Dental Trauma ◽

Central Incisor ◽

Supernumerary Tooth ◽

Pulp Tissue ◽

Anterior Teeth ◽

History Of ◽

Natural Tooth

The majority of dental trauma involves anterior teeth, especially the maxillary central incisors. A crown fracture with pulp tissue involvement, severe sensitivity, and pain is certainly unpleasant for the patient. If the original tooth fragment is retained following fracture, the natural tooth structures can be reattached using adhesive protocols to ensure reliable strength, durability and aesthetics. This case report will discuss a case history of 21 year old patient who accidentally injured his maxillary left central incisor. After local anesthesia, the fractured part was carefully separated and at the same time, the Supernumerary tooth was removed. After completion of root canal treatment, the tooth fragment was successfully reattached with an adhesive tooth reattachment technique. DOI: http://dx.doi.org/10.3329/updcj.v2i2.15535 Update Dent. Coll. j: 2012; 2 (2): 42-46

Download Full-text

The importance of bioceramics and computed tomography in the late clinical management of a horizontal root fracture: A case report

Journal of Clinical and Experimental Dentistry ◽

10.4317/jced.56585 ◽

2020 ◽

pp. e514-e518

Author(s):

C. Girelli ◽

C. de Lima ◽

M. Lacerda ◽

R. Coellho ◽

F. Silveira ◽

...

Keyword(s):

Computed Tomography ◽

Case Report ◽

Clinical Management ◽

Root Fracture ◽

Horizontal Root Fracture

Download Full-text

A141 SPONTANEOUS ESOPHAGEAL PERFORATION: AN UNREPORTED COMPLICATION OF LYMPHOCYTIC ESOPHAGITIS

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.139 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 128-129

Author(s):

A LAGROTTERIA ◽

A W Collins ◽

A Someili ◽

N Narula

Keyword(s):

Computed Tomography ◽

Emergency Department ◽

Case Report ◽

Proton Pump Inhibitor ◽

Proton Pump ◽

Esophageal Perforation ◽

Distal Esophagus ◽

Chest Discomfort ◽

History Of ◽

Lymphocytic Esophagitis

Abstract Background Lymphocytic esophagitis is a new and rare clinicopathological entity. It is a histological pattern characterized by lymphocytic infiltrate without granulocytes. Its etiology and clinical significance remains unclear. The clinical manifestations are typically mild, with reflux and dysphagia the most commonly reported symptoms. Aims We describe a case report of spontaneous esophageal perforation associated with lymphocytic esophagitis. Methods Case report Results A previously well 31-year-old male presented to the emergency department with acute food impaction. His antecedent symptoms were acute chest discomfort and continuous odynophagia following his most recent meal, with persistent globus sensation. The patient had no reported history of allergies, atopy, rhinitis, or asthma. A previous history of non-progressive dysphagia was noted after resuscitation. Emergent endoscopy revealed no food bolus, but a deep 6 cm mucosal tear in the upper-mid esophagus extending 24 to 30 cm from the incisors. Chest computed tomography observed small volume pneumoperitoneum consistent with esophageal perforation. The patient’s recovery was uneventful; he was managed conservatively with broad-spectrum antibiotics, proton pump inhibitor therapy, and a soft-textured diet. Endoscopy was repeated 48 hours later and revealed considerable healing with only a residual 3-4cm linear laceration. Histology of biopsies taken from the mid and distal esophagus demonstrated marked infiltration of intraepithelial lymphocytes. There were no eosinophils or neutrophils identified, consistent with a diagnosis of lymphocytic esophagitis. Autoimmune indices including anti-nuclear antibodies and immunoglobulins were normal, ruling out a contributory autoimmune or connective tissue process. The patient was maintained on a proton pump inhibitor (pantoprazole 40 mg once daily) following discharge. Nearly six months following his presentation, the patient had a recurrence of symptoms prompting representation to the emergency department. He described acute onset chest discomfort while eating turkey. Computed tomography of the chest redemonstrated circumferential intramural gas in the distal esophagus and proximal stomach. Conclusions Esophageal perforation is a potentially life-threatening manifestation of what had been considered and described as a relatively benign condition. From isolated dysphagia to transmural perforation, this case significantly expands our current understanding of the clinical spectrum of lymphocytic esophagitis. Funding Agencies None

Download Full-text

Surgical Management of Horizontal Root Fracture with Platelet Rich Fibrin (PRF) Placement: Case Report of Two Cases

Dental Journal of Advance Studies ◽

10.1055/s-0038-1671967 ◽

2013 ◽

Vol 01 (02) ◽

pp. 125-128

Author(s):

Parul Bansal ◽

Kalpana Kanyal ◽

Vineeta Nikhil

Keyword(s):

Case Report ◽

Tissue Regeneration ◽

Surgical Approach ◽

Permanent Teeth ◽

Periodontal Tissue ◽

Root Fracture ◽

Platelet Rich Fibrin ◽

Periodontal Tissue Regeneration ◽

Root Fractures ◽

Horizontal Root Fracture

AbstractRadicular fractures in permanent teeth are uncommon injuries among dental traumas, being only 0.5 - 7% of the cases. Horizontal root fractures can be managed endodontically or combined endodontic and surgical approach. Treatment varies according to the displacement and vitality of the fragments. This paper presents a case report of two cases of horizontal root fracture, present between the middle and apical third of central incisors, which were managed by combined endodontic and surgical approach, while in second case it was followed by PRF placement to facilitate osteoinduction and periodontal tissue regeneration.

Download Full-text

Esthetic Rehabilitation of a Fractured Permanent Maxillary Central Incisor by Reattachment

Journal of Contemporary Dentistry ◽

10.5005/jp-journals-10031-1141 ◽

2016 ◽

Vol 6 (1) ◽

pp. 52-56

Keyword(s):

Case Report ◽

Surface Texture ◽

Simple Procedure ◽

Dental Trauma ◽

Central Incisor ◽

Fiber Post ◽

Root Fracture ◽

Maxillary Central Incisor ◽

Crown Root ◽

Anterior Teeth

ABSTRACT Crown fractures of the anterior teeth are a common form of dental trauma mainly affecting children and adolescents. One of the options for managing crown fractures is the reattachment of the fractured fragment when the tooth fragment is available with minimal or no violation of the biological width. Reattachment of fractured fragments can provide good esthetics, as it maintains the tooth's original anatomic form, color, and surface texture. It also restores function and is a relatively simple procedure. This case report deals with the esthetic management of a crown-root fracture that was successfully treated with endodontic treatment followed by reattachment of fractured fragment with fiber post. How to cite this article Shaikh SAH, Shenoy VU, Sumanthini MV, Pawar RB. Esthetic Rehabilitation of a Fractured Permanent Maxillary Central Incisor by Reattachment. J Contemp Dent 2016;6(1):52-56.

Download Full-text

RETRIEVING BROKEN INSTRUMENT IN HALF OF THE APIKAL ON CANINES TEETH WITH H-FILE BRAIDING TECHNIQUE

ODONTO Dental Journal ◽

10.30659/odj.8.2.146-150 ◽

2021 ◽

Vol 8 (2) ◽

pp. 146

Author(s):

Yunita Styaningrum ◽

Yoanita Dwi Andina ◽

Yulita Kristanti

Keyword(s):

Case Report ◽

Female Patient ◽

Root Canal ◽

Composite Resin ◽

Cost Effective ◽

Class I ◽

Root Section ◽

History Of ◽

Composite Resin Restorations ◽

Initial Root

ABSTRACTBackground: Broken instruments affect the outcome and prognosis. A broken instrument will prevent the procedure of cleaning and shaping, irrigation and obturation of the root canal on the obstructed root section causing failure in endodontic treatment. There are some treatments for broken instrument including retrieving a broken fragment file and bypassing it on the root canal. the aim of the case report aims to provide an alternative for retrieving broken instruments using the H-file braiding technique. Method: A 38-year-old female patient came to the Dental Conservation Clinic RSGM Prof. Soedomo FKG UGM. A patient got a history of initial root canal treatment in a clinic, which ended with a separated file on canine teeth left upper. No complain pain, from the investigation radiographic there is an instrument broken in half apical. The teeth 23 seen temporary restoration cavity class I is still in good. Retrieving broken instruments using the H-file braiding technique, preparation with step back techniques, obturation with warm vertical condensation technique and class I composite resin restorations with fiber-reinforced retention. Result: No complain pain after 2 weeks retrieving broken instrument.Conclusion: The technique of the H-file braiding technique is one technique to retrieve a broken instrument, this procedure is simple, cost-effective, harmless to the teeth and gives root canal sealing.

Download Full-text

Inferior alveolar nerve paraesthesia after overfilling into the mandibular canal, confirmed by cone-beam computed tomography: a case report

Brazilian Dental Science ◽

10.14295/bds.2021.v24i2.2421 ◽

2021 ◽

Vol 24 (2) ◽

Author(s):

Claudemir de Souza Júnior ◽

Ricardo Machado ◽

Renee Ashley Batts ◽

Lucas da Fonseca Roberti Garcia

Keyword(s):

Computed Tomography ◽

Case Report ◽

Cone Beam Computed Tomography ◽

Root Canal ◽

Inferior Alveolar Nerve ◽

Mandibular Canal ◽

Cone Beam ◽

Filling Material ◽

Mandibular Molar ◽

Patient Reported

The filling material should be restricted to the root canal, and not extend to the periradicular tissues. Overextension occurs when there is an overflow of gutta-percha and sealer, whereas overfilling refers to the overflow only of sealer beyond the apical foramen. Both may cause several negative clinical consequences. Nevertheless, an accurate diagnosis of where they occurred cannot always be performed by conventional radiographic examination, because of the two-dimensional aspect of the image. This paper describes a clinical case of labiomandibular paraesthesia after overfilling into the mandibular canal (MC), as diagnosed by cone-beam computed tomography (CBCT), later used to perform the treatment planning. A 34-year-old Caucasian female patient sought a private dental clinic complaining of pain in the right mandibular posterior region. After taking the anamnesis and performing clinical and radiographic exams, the patient was diagnosed with pulp necrosis in the second right mandibular molar, and underwent root canal treatment. The final radiography showed overextension or overfilling, probably into the MC. About 2 hours after the procedure, the patient reported paraesthesia of her lower right lip and chin. A CBCT confirmed a small overfilling into the MC. For this reason, vitamin B12 was prescribed as the first treatment option. After 7 days, the patient reported a significant decrease in paraesthesia, and was completely normal after 15 days. This case report shows that CBCT is an effective radiographic diagnostic tool that can be used as an alternative in clinical cases of labiomandibular paraesthesia caused by overextension or overfilling. Keywords Endodontic treatment; Overfilling; Paraesthesia; Conebeam computed tomography.

Download Full-text

Assessment of the capacity of future Dentists to elaborate treatment plans for dental trauma

Research Society and Development ◽

10.33448/rsd-v9i8.5718 ◽

2020 ◽

Vol 9 (8) ◽

pp. e255985718

Author(s):

Daniela Atili Brandini ◽

Denise Pedrini ◽

Caio Vinicius Lourenço Debortoli ◽

Luiza Monzoli Côvre ◽

Marina Fuzette Amaral

Keyword(s):

Treatment Plan ◽

Dental Trauma ◽

Great Difficulty ◽

Cross Sectional ◽

Adequate Treatment ◽

Root Fracture ◽

Occlusal Adjustment ◽

Treatment Plans ◽

Dentoalveolar Trauma ◽

Systemic Condition

The prognosis of dental trauma depends on professionals with solid and updated knowledge. The objective was to evaluate the ability of undergraduate dentistry students to develop treatment plans for dental trauma. This cross-sectional, observational, quantitative study had a sample of 242 participants. A clinical case involving avulsion of tooth 11 and complex coronary root fracture of tooth 21 was selected. All data relating to the patient's exams were added to a clinical record, which was delivered to students in the final year of the undergraduate dentistry course for three years consecutive. The students were instructed to develop a treatment plan for this case. The factors most considered in avulsion treatment plans were: how, when and where the trauma occurred, the patient's age and systemic condition. Of the students, 39.7% developed an adequate treatment plan, the main mistake being the lack of occlusal adjustment. In addition, 9,9% of students had an adequate treatment plan for coronary artery fracture. The recovery of periodontal biological space and the indication of intraradicular retainers were the main difficulties. It is concluded that undergraduate dentistry students had great difficulty in formulating treatment plans suitable for more severe cases of dentoalveolar trauma involving several specialties.

Download Full-text