Reestablishing Biology, Function, and Esthetics for Fractured, Immature Incisors

2015 ◽  
Vol 40 (4) ◽  
pp. 341-349
Author(s):  
NIP Pini ◽  
JY Nagata ◽  
D Sundfeld-Neto ◽  
L Correr-Sobrinho ◽  
AdJ Soares ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Radiographic Examination ◽  
Central Incisor ◽  
Sensitivity Testing ◽  
Maxillary Central Incisor ◽  
Sealing Material ◽  
Sensitivity Tests ◽  
Direct Restoration ◽  
Pulp Exposure ◽  
Pulp Revascularization

SUMMARY A seven-year-old boy with enamel-dentin fractures on both maxillary central incisors presented to the Piracicaba Dental School–UNICAMP seven days after the trauma. At the clinical evaluation, there were no clinical signs of pulp exposure, neither tooth was mobile, and both affected teeth presented a positive response to sensitivity tests and a negative response for percussion and palpation. The radiographic examination showed an undeveloped root and opened apex for both teeth. Indirect pulp capping was performed on the left maxillary central incisor, followed by a direct restoration. After one month, the patient complained of pain in the left central incisor, which responded negatively to sensitivity testing. Pulp revascularization was performed only on this tooth and was followed for 18 months. During this period, the left maxillary central incisor did not recover sensitivity, although radiographic examination showed apical closure, a slight increase in root length, and the formation of a mineralized barrier between the root canal and sealing material. The technique achieved its goal of restoring biological aspects, function, and esthetics of traumatized teeth when using this multidisciplinary approach.

scholarly journals Nonsurgical Endodontic Retreatment of Advanced Inflammatory External Root Resorption Using Mineral Trioxide Aggregate Obturation

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Shivani Utneja ◽  
Gaurav Garg ◽  
Shipra Arora ◽  
Sangeeta Talwar
Keyword(s):  
Root Canal ◽  
Root Resorption ◽  
Clinical Symptoms ◽  
Mineral Trioxide Aggregate ◽  
Radiographic Examination ◽  
Apical Region ◽  
Central Incisor ◽  
Root Canal Filling ◽  
Maxillary Central Incisor ◽  
External Root Resorption

Inflammatory external root resorption is one of the major complications after traumatic dental injury. In this case report, we describe treatment of a maxillary central incisor affected by severe, perforating external root resorption. An 18-year-old patient presented with a previously traumatized, root-filled maxillary central incisor associated with pain and sinus tract. Radiographic examination revealed periradicular lesion involving pathologic resorption of the apical region of the root and lateral root surface both mesially and distally. After removal of the root canal filling, the tooth was disinfected with intracanal triple antibiotic paste for 2 weeks. The antibiotic dressing was then removed, and the entire root canal was filled with mineral trioxide aggregate. The endodontic access cavity was restored with composite resin. After 18 months, significant osseous healing of the periradicular region and lateral periodontium had occurred with arrest of external root resorption, and no clinical symptoms were apparent.

Esthetic Smile Rehabilitation through Autogenous Bonding of Dental Fragment: A Case Report

2012 ◽  
Vol 37 (1) ◽  
pp. 5-8
Author(s):  
L Gonçalves-Sena ◽  
AC Guimarães Rosa Dutra ◽  
P Corrêa-Faria ◽  
AM Botelho ◽  
ML Ramos-Jorge ◽  
...  
Keyword(s):  
Case Report ◽  
Execution Time ◽  
Functional Results ◽  
Composite Resins ◽  
Central Incisor ◽  
Maxillary Central Incisor ◽  
Natural Function ◽  
Pulp Exposure ◽  
Bonding Method

Autogenous tooth fragment bonding offers advantages over restorations with composite resins and porcelain, including better esthetics, greater durability, reestablishment of the natural function of the dental element and short execution time. A case is presented of a 14-year-old male patient who suffered an oblique crown fracture of the permanent right maxillary central incisor (11) due to a traumatic fall. The clinical examination revealed pulp exposure with no invasion of the biological space. Due to the extension of the fracture, endodontic treatment and the placement of an intra-root esthetic pin was needed. The tooth was restored using the autogenous fragment bonding method. Excellent esthetic and functional results were observed after two years of follow up.

scholarly journals Management of Impacted Maxillary Central Incisor: Modified Nance Arch Application

2015 ◽  
Vol 16 (5) ◽  
pp. 415-421 ◽  
Author(s):  
Bonolo Mannathoko-Molefhe ◽  
Hu Rongdang
Keyword(s):  
Case Report ◽  
Treatment Plan ◽  
Radiographic Examination ◽  
Central Incisor ◽  
Maxillary Central Incisor ◽  
Fixed Appliances ◽  
Medical University

ABSTRACT This is a case report of a patient who presented to Wenzhou Medical University—Orthodontic Department at 8 years of age with missing right maxillary central incisor. A detailed clinical and radiographic examination was carried out and treatment plan formulated to surgically expose the impacted incisor and use the modified nance arch (MNA) appliance for orthodontic traction of the tooth in line of arch as phase one treatment followed by phase two treatment with fixed appliances. How to cite this article Mannathoko-Molefhe B, Hu R. Management of Impacted Maxillary Central Incisor: Modified Nance Arch Application. J Contemp Dent Pract 2015;16(5): 415-421.

scholarly journals Foreign Body Management in The Maxillary Central Incisor of a Teenage Girl: A Case Report

2020 ◽  
Vol 4 (2) ◽  
pp. 31-33
Author(s):  
Rashmi Pundir ◽  
Chetna Jaiswal
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Radiographic Examination ◽  
Central Incisor ◽  
Maxillary Central Incisor ◽  
Tooth Structure ◽  
Source Of Infection ◽  
Foreign Objects ◽  
Great Possibility ◽  
Do So

Finding a foreign body lodged in the tooth structure of a tooth is quite uncommon occurrence and requires skill to remove the same. Its extraction requires a detailed case history followed by clinical, and radiographic examination to ascertain the size, position, and nature of the embedded objects so that the difficulty involved in its retrieval can be assessed. At times due to fear, a child hesitates from informing the parent regarding the lodgement and may only do so when one experiences pain. There is a great possibility that the foreign objects may act as a potential source of infection and lead to undesirable consequences. This case report will  discuss the lodgement, retrieval and management of foreign object (tip of lead pencil) in the maxillary left central incisor of female teenager aged 16 years.

scholarly journals Management of traumatically intruded permanent tooth with 30-month follow-up: A case report

2020 ◽  
pp. 45-49
Keyword(s):  
Permanent Tooth ◽  
Treatment Session ◽  
Radiographic Examination ◽  
Central Incisor ◽  
Severe Damage ◽  
Pulp Tissue ◽  
Maxillary Central Incisor ◽  
Favorable Prognosis ◽  
Current Report

Intrusive luxation often results in severe damage to the tooth, periodontium, and pulp tissue. Furthermore, treatment outcome is often unpredictable due to the presence of numerous injury-related variables affecting the treatment option and prognosis. The current report presents the case of a 14-year-old boy with a 9.0 mm intruded permanent right maxillary central incisor with a closed apex which was treated by orthodontic repositioning and root canal treatment with a favorable prognosis. At the last follow-up visit (30 months after the first treatment session), the tooth was asymptomatic, and radiographic examination showed normal periapical and periodontal appearance.

scholarly journals Intraradicular Splinting with Endodontic Instrument of Horizontal Root Fracture

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Ersan Çiçek ◽  
Neslihan Yılmaz ◽  
Mustafa Murat Koçak
Keyword(s):  
Mineral Trioxide Aggregate ◽  
Radiographic Examination ◽  
Central Incisor ◽  
Radiographic Findings ◽  
Maxillary Central Incisor ◽  
Central Tooth ◽  
Root Fractures ◽  
The Right ◽  
Dental Injuries

Introduction. Root fractures, defined as fractures involving dentine, cementum, and pulpal and supportive tissues, constitute only 0.5–7% of all dental injuries. Horizontal root fractures are commonly observed in the maxillary anterior region and 75% of these fractures occur in the maxillary central incisors.Methods. A 14-year-old female patient was referred to our clinic three days after a traffic accident. In radiographic examination, the right maxillary central incisor was fractured horizontally in apical thirds. Initially, following local infiltrative anesthetics, the coronal fragment was repositioned and this was radiographically confirmed. Then the stabilization splint was applied and remained for three months. After three weeks, according to the results of the vitality tests, the right and left central incisors were nonvital. For the right central incisor, both the coronal and apical fragments were involved in the endodontic preparation.Results. For the right central tooth, both the coronal and apical root fragments were endodontically treated and obturated at a single visit with white mineral trioxide aggregate whilst the fragments were stabilized internally by insertion of a size 40 Hedstrom stainless-steel endodontic file into the canal.Conclusion. Four-year follow-up examination revealed satisfactory clinical and radiographic findings with hard tissue repair of the fracture line.

scholarly journals Ten-Year Follow-Up of a Fragment Reattachment to an Anterior Tooth: A Conservative Approach

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Luiz Mendes ◽  
Laisa Laxe ◽  
Leandro Passos
Keyword(s):  
Treatment Plan ◽  
Tooth Bleaching ◽  
State University ◽  
Central Incisor ◽  
Maxillary Central Incisor ◽  
Anterior Teeth ◽  
Pulp Exposure ◽  
New Treatment ◽  
The Right

This report describes the 10-year follow-up data of a patient who underwent fragment reattachment to the maxillary central incisor after coronal fracture with pulp exposure as well as the procedures followed for functional and esthetic adjustments. A 9-year-old female patient presented at the clinic of dentistry at the State University of Rio de Janeiro with a coronal fracture and pulp exposure of the right maxillary central incisor that had occurred immediately after an accident. The intact tooth fragment was recovered at the accident site and stored in milk. The treatment plan followed was to perform direct pulp capping and tooth fragment reattachment. When the patient was 14 years old, adhesion between fragment and remaining tooth was lost, and fragment reattachment was performed. Five years later, the same tooth presented clinical discoloration and absence of sensitivity during pulp vitality tests. Subsequently, a new treatment plan was formulated, which included endodontic treatment, followed by nonvital tooth bleaching and light-cured composite resin restoration. An esthetic and natural-looking restoration was achieved. Tooth fragment reattachment is not a temporary restorative technique and requires functional and esthetic adjustments over time to maintain the biomimetic characteristics of traumatized anterior teeth and predictable outcomes.

scholarly journals Calcifying cystic odontogenic tumour associated with odontoma involving mixed dentition

2016 ◽  
Vol 19 (3) ◽  
pp. 101
Author(s):  
Angélica Mandú ◽  
Amanda Katarinny Gonzaga ◽  
Maria Luiza Lopes ◽  
Luciana Eloísa Nóbrega ◽  
Antonio Costa
Keyword(s):  
Clinical Signs ◽  
Excisional Biopsy ◽  
Odontogenic Tumor ◽  
Mixed Dentition ◽  
Radiographic Examination ◽  
Central Incisor ◽  
Odontogenic Tumour ◽  
Unerupted Tooth ◽  
Prolonged Retention ◽  
Radiolucent Lesion

<p>The calcifying cystic odontogenic tumor (CCOT) is a benign cystic odontogenic tumor relatively uncommon and may be associated with other odontogenic lesions. This manuscript describes a case of CCOT associated with odontoma in a 9-year-old girl, who presented with a slight swelling along with prolonged retention of a maxillary primary central incisor. Radiographic examination showed a unilocular radiolucent lesion containing radiopaque material, associated with an unerupted tooth. Taking into consideration the clinical diagnostic of odontoma, an excisional biopsy was carried out. Microscopic examination established the diagnosis of a CCOT associated with odontoma. The association of these lesions is rare in individuals in the first decade of life, particularly involving mixed dentition, as outlined in this case. The patient remains under care with no clinical signs of recurrence.</p>

A case report of sub-gingival cervical crown fracture reattachment using fiber post- A 22 months follow up

2021 ◽  
Vol 6 (4) ◽  
pp. 233-238
Author(s):  
Samiksha Sharma ◽  
Akshat Waran
Keyword(s):  
Treatment Plan ◽  
Complete Removal ◽  
Radiographic Examination ◽  
Facial Injury ◽  
Central Incisor ◽  
Fiber Post ◽  
Root Canal Therapy ◽  
Maxillary Central Incisor ◽  
Conservative Dentistry

A 15‐year‐old male presented to the Department of Conservative Dentistry and Endodontics immediately after a facial injury having complain of persistent pain in the teeth and the front upper lips. Upon examination it was revealed trauma of the upper incisors, also injury to the marginal gingiva of the front teeth. Further inspections showed slight laceration of the oral mucosa in the lower labial sulcus. Radiographic examination revealed fracture of crown of maxillary central incisor. The treatment plan which was decided comprised of complete removal of fractured crown followed by root canal therapy and immediate post placement and reattachment of the crown.

scholarly journals Root Canal Retreatment menggunakan Kombinasi Kalsium Hidroksida dan Chlorhexidine sebagai Medikamen Intra Kanal Insisivus Sentral Kiri Maksila

2014 ◽  
Vol 21 (2) ◽  
pp. 165
Author(s):  
Andina Novita Sari ◽  
Tri Endro Untara
Keyword(s):  
Calcium Hydroxide ◽  
Enterococcus Faecalis ◽  
Root Canal ◽  
Antimicrobial Agents ◽  
Radiographic Examination ◽  
Ph Effects ◽  
Central Incisor ◽  
Incisor Tooth ◽  
Maxillary Central Incisor ◽  
Root Canal Retreatment

Enterococcus faecalis adalah bakteri yang paling banyak terdapat pada infeksi saluran akar yang telah dirawat endodontik. Chlorhexidine mempunyai daya anti bakteri spektrum luas dan telah digunakan dalam endodontik sebagai bahan irigasi maupun medikasi intrakanal. Chlorhexidine mempunyai efek bakterisidal dan fungisidal karena chlorhexidine diserap ke dalam permukaan sel bakteri dan menyebabkan rusaknya integritas sel membran. Kalsium hidroksida digunakan karena mempunyai keuntungan seperti biokompatibel, bahan antimikroba dengan efek pH yang tinggi dan stimulasi jaringan keras. Campuran kalsium hidroksida dan chlorhexidine digunakan untuk alternatif melawan bakteri Enterococcus faecalis. Tujuan dari laporan kasus ini adalah untuk melaporkan kesuksesan perawatan saluran akar ulang pada gigi incisivus sentral kiri maksila dengan periodontitis periapikal akut menggunakan kombinasi kalsium hidroksida dan chlorhexidine sebagai medikamen intrakanal. Seorang pasien wanita 24 tahun datang dengan keluhan gigi insisivus sentral kiri atas yang terasa sakit sejak 4 tahun yang lalu. Gigi terasa sakit saat diperkusi, namun palpasi dan mobilitas normal. Gigi tersebut mengalami trauma dan patah 6 tahun yang lalu dan telah dilakukan perawatan endodontik. Pemeriksaan radiografi menunjukkan obturasi gigi 21 yang tidak hermetis dengan radiolusensi di periapikal dengan batas difus, pelebaran ligamen periodontal dan terputusnya lamina dura. Perawatan berupa perawatan saluran akar ulang menggunakan kombinasi kalsium hidroksida dan chlorhexidine sebagai medikamen intrakanal. Root canalretreatment dengan cleaning dan shaping ulang yang baik dengan menggunakan medikasi intrakanal berupa kombinasi kalsium hidroksida dan chlorhexidine 2% diharapkan mempunyai efek antimikroba yang sinergis untuk mencapai kesuksesan root canal retreatment. Root Canal Retreatment Using Calcium Hydroxide as Intra Canal Medicament On The Maxillary Left Incisor. Enterococcus faecalis bacteria is most abundant in the root canal infection treated endodontically. Chlorhexidine has a broad antibacterial spectrum and has been used as an endodontic irrigant and intracanal medication. Chlorhexidine has a bactericidal and fungicidal effect as chlorhexidine absorbed into the bacterial cell surface and cause damage to the integrity of the cell membrane. Calcium hydroxide is a biocompatible, antimicrobial agents with high pH effects and stimulates hard tissue formation. A mixture of calcium hydroxide and chlorhexidine is used to control bacteria Enterococcus faecalis alternative. The purpose of this case report is to report on the success of root canal treatment in the left maxillary central incisor with acute periapical periodontitis using a combination of calcium hydroxide and chlorhexidine as intracanal A 24 years old female patient presents with left upper central incisor tooth ache since 4 years ago. The tooth was hurt to percussion, but normal to pulpation as well as the mobility. The tooth has a history of previous trauma and broken 6 years ago and has performed endodontic treatment. Radiographic examination showed obturation teeth 21 are not hermetic with periapical radiolucency in diffuse boundaries, widening of the periodontal ligament and the dissolution of the lamina dura. Root canal re-treatment using a combination of calcium hydroxide and chlorhexidine as intracanal medicaments were performed. In conclussion, the root canal cleaning and shaping retreatment can be performed using a combination of calcium hydroxide and chlorhexidine as intracanal medication.

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