| Neurilemmomas presenting as primary central bone tumors are extremely rare. Only 21 cases have been reported to have arisen in the jaws; all except for one have occurred in the mandible. The majority of these have been associated with the inferior dental nerve. A case of a central neurilemmoma arising in the anterior mandible is reported. Its probable origin is from one of the alveolar branches of the incisive nerve--an unusual site in the mandible. The radiographic features include expansion of cortical bone, resorption of roots of teeth, the presence of lace-like bony septa and a spotty calcification within the tumor. The treatment and the prognosis are briefly discussed. ( info) |
2/249. Root canal treatment of a root-fractured incisor tooth with internal resorption: a case report. A case is described in which root canal treatment with calcium hydroxide was used successfully to repair a fracture site with internal resorption of the tooth. ( info) |
3/249. Resin-ionomer and hybrid-ionomer cements: part II, human clinical and histologic wound healing responses in specific periodontal lesions. Twenty-five subjects with a total of 50 subgingival restorations participated in this study. At the beginning of the investigation, nine teeth that were considered hopeless because of the extent of their pathology were selected for extraction to evaluate histologically the restorations and their effect on the adjacent tissues. The purpose of this article is to demonstrate the responses to the clinical applications as well as to the placement of resin-ionomers in subgingival lesions. Clinical and histologic evidence of epithelial and connective tissue adherence to resin-ionomer restorative materials was observed during the healing process. ( info) |
4/249. Treatment of invasive cervical resorption: an analysis of results using topical application of trichloracetic acid, curettage, and restoration. OBJECTIVE: The purpose of this study was to carry out a clinical evaluation of the treatment of invasive cervical resorption. METHOD AND MATERIALS: Topical application of a 90% aqueous solution of trichloracetic acid, curettage, nonsurgical root canal treatment where necessary, and restoration with glass-ionomer cement were performed on 94 patients with a total of 101 affected teeth. A minimum of 3 years' follow-up was required, unless failure occurred before that time, in which case that treatment was included. Teeth were divided into four classes, depending on the extent of the resorptive process. Class 1 represented the least invasive resorptive lesion, near the cervical area with shallow penetration into dentin, while class 4 represented the most invasive resorptive process, which had extended beyond the coronal third of the root. RESULTS: In all class 1 and class 2 cases, the results showed complete success, judged by an absence of resorption or signs of periapical or periodontal pathosis. When overall success was judged by absence of resorption and periapical or periradicular pathosis, the success rate in class 3 lesions was 77.8%. Only 12.5% of teeth in class 4 were free of resorption and deemed to be clinically sound. CONCLUSION: The treatment regimen was successful in class 1 and class 2 cases, reasonably successful in class 3 cases, and generally unsuccessful in class 4 resorptions, where alternative treatment is recommended. diagnosis of lesions at an early stage is, therefore, highly desirable. ( info) |
5/249. Forced eruption: a multidisciplinary approach for form, function, and biologic predictability. There are several treatment options for patients with coronal fractures, subgingival caries perforations, and root resorption. Frequently, forced eruption is not considered, although in many cases of single-rooted teeth, forced eruption is the "gold standard" for producing an esthetic result without jeopardizing periodontal support for adjacent teeth. Sufficient tooth length, achieved through forced eruption, ensures the periodontal health of the "biologic width" and crown margin and thus a successful restorative outcome. ( info) |
6/249. root resorption: another long-term outcome. Case history is presented of an indigenous Zambian girl. Initial surgical repositioning is shown and at a later stage when the tooth had erupted into the nasolabial vestibule and an orthodontic correction was performed. Surgical trauma as well as orthodontic forces may have precipitated root resorption; however, the aim of saving a tooth has been achieved. ( info) |
7/249. replantation of avulsed teeth: considerations and complications. Avulsion of teeth is a traumatic dental injury which can be managed by replantation. Important considerations for successful replantations are highlighted. Several sequelae to replantation are discussed in relation to the clinical features observed in a patient seen 6 years after replantation of two avulsed upper incisors. Many of these complications might have been avoided if the patient had returned to the clinic for root canal therapy shortly after the teeth was replanted. ( info) |
8/249. Tooth root resorption associated with a familial bone dysplasia affecting mother and daughter. The dental findings are presented of a mother and daughter who suffer from an as yet unclassified bone dysplasia that shows features of both hereditary hyperphosphatasia and familial expansile osteolysis. Both patients have experienced progressive root resorption of permanent teeth, deafness, and high alkaline phosphatase levels. The mother has a more advanced bone dysplasia which has led to progressive skeletal deformity and bone pain. The kindred is consistent with an autosomal dominant pattern, and the mutation(s) is thought to be in chromosome 18q21-22 region. Conventional treatment strategies of root resorption offer only a poor prognosis for the dentition. Therapy using alendronate, a bisphosphonate compound and a potent inhibitor of osteoclastic activity, has reduced alkaline phosphatase levels, bone pain, and may offer an effective strategy to prevent tooth root resorption in this group of diseases. ( info) |
9/249. Management of an avulsed primary incisor. The case describes the management of an avulsed maxillary central primary incisor of a 3 1/2-year-old girl. The tooth was retained in the oral cavity for 30 min. After replantation it was splinted for 17 days. At day 11 the root canal was completely instrumented and obturated with a calcium hydroxide paste. The 1-year follow-up documented no pathologic clinical or radiographic findings. One and a half years after the trauma the tooth was extracted since a fistula and extensive external inflammatory resorption had developed. The permanent successor erupted along with its neighboring central incisor without any complications 6 months later. Conventional approaches for treating avulsed permanent teeth could also be applied to avulsed primary incisors to preserve them for a certain period without the additional risk of damaging their developing permanent successors. ( info) |
10/249. Deposition of calcified tissue around an overextended gutta-percha cone: case report. CASE REPORT: Root canal treatment was performed in a mandibular right second premolar with a periapical lesion and apical resorption. The root canal was prepared with K-files using the step-back technique and 3% NaOCl as an irrigant; during obturation gross overfilling of gutta-percha occurred. The tooth was permanently restored with a post and core along with a crown. Although healing of the periapical lesion occurred and the patient reported that he was symptom-free, the tooth was extracted after 4 years because of a subgingival root fracture. Following extraction the tooth was examined with SEM. The examination revealed the presence of newly formed calcified tissue at resorption sites on the root apex. This newly formed tissue extended from the surface of the root around the apex to the extruded gutta-percha cone to which it was well adapted, forming a bridge between the cone and the root. ( info) |