Microapical surgery management of root resorption in anterior teeth caused by dental trauma: case report

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.

The status of knowledge, attitude and practice towards emergency management of avulsed tooth among dental students. a single center cross-sectional study

Objective: To evaluate the awareness of emergency trauma management and the potential role of dentists in handling tooth avulsion injuries. Method: The cross-sectional study was conducted at the Dental outpatients department of Jinnah Medical and Dental College, Karachi, from December 2020 to March 2021, and comprised dentists and final year dental students of either gender. Data was collected using a 17-item questionnaire to assess the awareness level regarding the knowledge of traumatic dental emergencies and the role of a dentist in handling a traumatic tooth injury. Data was analysed using SPSS 20. Result: Of the 170 subjects, 52(30.5%) were males and 118(69.4%) were females. Overall, 139(81.8%) subjects had prior knowledge regarding avulsion, 164(96.5 %) were aware of the term avulsed tooth, 106(62.4%) considered milk to be the best transport media for an avulsed tooth, 159(93.5%) knew the significance of extra-oral time, and all 170(100%) subjects said they wanted to study more about dental traumatic injuries. Conclusion: There was adequate knowledge about the term avulsion, transport media and extra-oral time, and there was evidence of interest about learning more among the subjects. Key Words: Avulsion, Emergency handling, Dental trauma, TDIs, Traumatic dental injuries, Knowledge, Appropriate management, Expert.

Multidisciplinary Approach to Complicated Crown-root Fracture Treatment: A Case Report

SUMMARY Treatment of complicated crown-root fractures is one of the most challenging within the various types of dental trauma and requires a multidisciplinary approach. This paper reports the complicated crown-root fracture of a maxillary right central incisor, in which there was esthetic, functional, and biologic (endodontic and biologic width invasion) involvement. A 15-year-old male patient presented to the dental clinic one month after suffering trauma with a complicated crown-root fracture on tooth 8. The patient had previously undergone endodontic treatment and was sent to have periodontal surgery to reestablish the biological width on the palatal surface. Following the surgery, a fiberglass post was cemented, and the fragment was reattached. This approach allows the exposure of the cervical margin, adequate isolation, and subsequent fragment reattachment in the same clinical appointment. Fragment reattachment is a viable approach as it is a simple and conservative procedure that restores the natural esthetic of the tooth and has superior resistance compared to a composite restoration. The patient’s cooperation in understanding the limitations of the treatment and maintaining adequate oral hygiene are very important to achieving a good prognosis of the case. After a 2-year clinical and radiographic follow-up period, the clinical protocol was found to be successful, and the tooth remained functional, esthetically favorable and asymptomatic.