Management of non-vital immature root canal of right maxillary central incisor with Metapex-MTA Coating: A Case Report

Brief background: A tooth with Blunderbuss canal and periapical lesion is difficult to treat by traditional root canal procedures. The dentinal wall surrounding the Blunderbuss canal is very thin, fragile and prone to fracture with a slight blow/ trauma. Therefore, a new strategy is required to treat such a case. Materials and Methods: Canal was cleaned and irrigated with 5.25% NaOCl and 0.2% Chlorhexidine. It was temporized with Ca (OH) 2 for one week to obtain canal disinfection. After one week, Ca(OH) 2 was removed from the canal with a sterilized file and rinsed out with the help of saline. A 2-3mm thick Metapex layer was placed at the apical region of 11, followed by an MTA layer, once the apical MTA layer obtained sufficient strength; the rest of the canal was filled with MTA. Discussion: This new treatment procedure not only closes the open root apices but also provides strength to the dentinal wall. Metapex –MTA combination provides advantages of both the materials; like calcium hydroxide of Metapex stimulates odontoblast of residual apical pulp and MTA stimulates cementoblast cells to bring about root apex closure. Summery & Conclusion: Two year follow-up & a positive clinical outcome of this case were encouraging for the use of Metapex-MTA coating as an apical plug. The rest of the canal was filled with MTA to strengthen and supports the thin dentinal wall for better compliance with the occlusal forces. Key Words: Blunderbuss canal, MTA, Metapex

Non- Invasive Cone Beam Tomography (CBCT) to diagnose jaw bone Osteomyelitis in Sickle cell anaemia patients.

Patients suffering from haemoglobinopathies most commonly show bone infection as a complication, of which Sickle cell anaemia (SCA) patients are the most susceptible to osteomyelitis. There are very few documented cases of jaw bone osteomyelitis in SCA patients. Keeping in mind the number of children diagnosed with SCA in India, this article reports how a commonly available and non-invasive radiographic method, dental CBCT, can be used to timely diagnose jaw bone osteomyelitis. Key Words : Sickle Cell Anemia ,Chronic Osteomyelitis , Jaw , Mandible , Case Report India , Sickle Cell Anemia complications , Radiograph , CBCT , Third molar pain , Onion skin appearance , Punched out lesions

Aesthetic Restoration using Direct Composite Resin

Anterior Crown fractures are common among schoolchildren. This will impact on their functional, aesthetic and psychological behaviour, as the aesthetic zone clinician must propose the exact and minimally invasive treatment plan. Achieving promising result in both aesthetic and strength is the greatest desire for the patient as well as for parents. This is the case of fractured permanent maxillary central incisors treated using Direct Composite Resin Restoration. Key Words: Anterior Crown, Fracture, Aesthetic, Maxillary central incisors, composite restoration

DERMOID CYST OF FRONTO-ZYGOMATIC REGION IN A PAEDIATRIC PATIENT – A CASE REPORT

A one year old female patient was brought with a chief complaint of localized pain and a slow growing swelling with relation to the left eye region which was diagnosed as dermoid cyst involving the supraorbital rim. Complete surgical excision was done and postoperative follow up revealed resolution of symptoms along with aesthetic healing of surgical scar. Key Words : Dermoid cyst– Periorbital region– excision– cortical expansion

Apexification of blunder buss apex using novel internal matrix technique: A case report

Permanent teeth with incomplete root development results in teeth with short root, roots with very thin walls, and an inadequate crown-root ratio, which overshadows their survival prognosis. Further due to internal bleeding from the pulp the teeth may become gray or black-brown, posses a great esthetic challenge. This case presents both endodontic and aesthetic management of incompletely developed root at Cvek stage 1 with perio glass as apical matrix restored with MTA and aesthetic rehabilitation with zirconia premium crown. Key words : Blunderbuss apex, Bio-active glass, MTA

Amelogenesis Imperfecta: A Case Report

Amelogenesis imperfecta is a structural-developmental defect involving enamel. It may be hypoplastic, hypomaturation, or hypocalcified. Genetic mutation of enamel coding proteins noted in this heterogeneous group of hereditary disorder affecting both primary and permanent dentitions. Clinically the affected teeth depict discolouration, prone to disintegration and sensitivity. Radiological evaluation revealed very thin or absent of the enamel layer. Here, I am presenting a case report of amelogenesis imperfecta affecting a 19 year old, otherwise healthy, female patient. Key Words: Amelogenesis imperfecta, enamel, hypoplastic, Genetic mutation.

Clinico-Radiological assessment of Unicystic Ameloblastoma of mandible – a case report

Ameloblastoma is a most common benign odontogenic tumour. It is slow growing but aggressive tumour which causes destruction of jaw bones. Clinically it is asymptomatic and can be noticed when the tumour increases gradually in size and causes facial asymmetry or detected during dental radiographic procedures for evaluating the missing or impacted teeth, especially third molar. Unicystic ameloblastomas account for 10-15 % of all intraosseous ameloblastomas. Here we discuss a case report of unicystic ameloblastoma with its clinical and radiological features along with emphasizing the three-dimensional imaging assessment of the case. Key words Ameloblastoma, jaw cyst, Odontogenic tumor, adamantinoma

Unique Presentation of “U Shaped” Impacted maxillary Central Incisor with Surgical and Pedodontic perspectives: A Case report

Background Dilaceration, a developmental disturbance, is thought to be due to trauma leading to change in the position of the calcified portion of the tooth and the tooth is formed at an angle. Such an injury to a permanent tooth, resulting in dilacerations, often follows traumatic injury to the primary predecessor. A study by Patiletal, on Indian population reported the prevalence of very rare developmental dental anomalies and dilaceration was found to be only about 0.5% in prevalence. Case details A 9 year old male reported to the department of paediatric dentistry with complaint of missing central incisor in maxillary left arch. Radiographic examination revealed impacted maxillary left incisor with very unique and unusual extreme curve in root of same tooth giving it a characteristic U morphology. As the patient reported in mixed dentition stage, both the surgical, prosthodontic and pedodontic perspectives were kept in mind before planning for the treatment. Surgical removal was planned as it was not possible to save and place the tooth in the arch. Although surgical removal was challenging due to extreme curve and highly placed position of tooth, surgical removal was done successfully with roots and crown broken in two sections in spite of proper care during extraction procedure. Edentulous space was replaced with groper’s appliance considering mixed dentition stage of the patient after successful healing as per the pedodontic perspectives. Conclusion U shaped presentation of single rooted tooth is a one of the rarest findings. In children with age of interception, treatment should be planned wisely taking into consideration surgical, prosthodontic and pedodontic perspectives together. Key Words U shaped root, dilaceration, impacted tooth, surgical and pedodontic perspectives

Endodontic management of incisors with horizontal root fractures using H-file as endodontic implant – Two Case Reports.

Accidental injury to anterior region with fractured and mobile teeth can be an awful experience to young female patient. Treating such patient requires knowledge judgment and skill of the operator. In the present case report multiple horizontal root fracture in cervical third region with mobile undetached crown was successfully stabilized by a very simple procedure using hedstrome endodontic file as an endodontic implant. In a two year follow-up period the tooth was completely asymptomatic clinically as well as radiographically. Immobilization of fractured root by endodontic instrument with MTA considered to be a simple ,reliable and cost effective method to save a tooth that would have been difficult to restore with good long term prognosis. Key-words: Incisors, Horizontal Root Fractures, H File

Hemimandibulectomy for an aggressively recurrent benign tumor- A case report

With vast literature available, treatment of choice for an aggressive benign tumour still remains a dilemma for an operating surgeon. Treatment modality depends on various factors such as site, age, associated co-morbidities etc. In this article, management of aggressive benign tumour which showed recurrence within 6-8 months following conservative management is presented. Key words Ameloblastoma – Recurrence – Locally aggressive – Radical management- Hemimandibulectomy