11/192. Complete intrusion of a maxillary right primary central incisor. This clinical article presents a rare presentation of complete intrusion of a maxillary right primary central incisor. Routine examination of a 29-month old female patient revealed an intrusion injury where the primary central incisor was displaced through the floor of the nasal cavity. The traumatic impaction was erroneously diagnosed as an avulsion injury by the attending emergency room physician and later discovered by the dental team during routine care. The injury was documented with radiographs. The intruded incisor was removed through the right naris utilizing general anesthesia to manage behavior and surgical access. This article emphasizes the importance of radiographs and demonstrates the need to involve the dental professional in initial assessment of dental trauma. ( info) |
12/192. Bilateral pulmonary aspiration of intact teeth following maxillofacial trauma. tooth aspiration is one of the rare sequelae of dental trauma. When this does occur, the right bronchus is usually involved in adults due to the anatomical configuration. In this unusual case, two teeth were aspirated with one entering each lung. While the outcome from cases of aspiration of foreign bodies is usually favourable, this case serves to illustrate one of the possible unfavourable consequences. ( info) |
13/192. Anterior single-tooth replacement: clinical examination and treatment planning. The replacement of a single anterior tooth is a complex, challenging procedure that can be accomplished with implant-supported restorations as well as conventional porcelain-fused-to-metal and resin-bonded fixed partial dentures. A comprehensive diagnostic form may be beneficial in determining the most effective means of rendering treatment for each patient. This article demonstrates the use of this form, diagnostic models, and radiographs to diagnose and restore three patients who presented for the replacement of a single tooth in the anterior maxilla. ( info) |
14/192. Clinical management of avulsed permanent incisors using Emdogain: initial report of an investigation. The enamel matrix derivative Emdogain was recently approved for clinical use in a number of countries, including canada. It has been shown to stimulate regeneration of periodontal ligament following periodontal surgery in adults. This paper reviews pertinent clinical and laboratory studies of Emdogain and describes the protocol and methods used for a longitudinal outcome study of replantation of avulsed permanent incisors in children and adolescents. Application of these methods is described in an illustrative case report of Emdogain use. This paper is meant to inform clinicians and guide those who are instituting similar investigations. ( info) |
15/192. Reimplantation of an avulsed tooth after prolonged storage. This report demonstrates that if an intact avulsed tooth is retrieved, stored carefully and treated, it can be re-implanted successfully, even after more than 42 hours outside the alveolus. The tooth can regain its position as a stable member of the arch, and its osseous and gingival complex can be restored. ( info) |
16/192. A multidisciplinary approach to the treatment of an intruded maxillary permanent incisor complicated by the presence of two mesiodentes. Treatment of a traumatically intruded maxillary incisor with an immature apex remains controversial. Treatment options include observation, surgical repositioning, or orthodontic forced eruption. Likewise, the ideal timing of surgical removal of a mesiodens is highly controversial: immediate versus delayed intervention. The complications associated with untreated supernumerary teeth include: overretention of primary teeth, delayed eruption of permanent incisors, rotations, impaction, diastema, pulp necrosis and root resorption. Less common sequelae include enlarged follicular sacs, cystic degeneration and nasal eruption. This paper describes another risk factor associated with delayed removal of a mesiodens previously not mentioned in the dental literature, namely potential complications arising from a traumatic injury, in particular intrusion, of the maxillary permanent incisors. ( info) |
17/192. Bonded arch bars to manage traumatic injuries to the teeth and alveolar bone. A simple, rapid, painless, and bloodless method of successfully treating avulsed and partially avulsed teeth with or without associated dentoalveolar fractures is presented for management by the general practitioner in the office. It is a bonding technique with the key elements being a prefabricated malleable mesh backed arch bar in combination with any light curing composite procedure that is standard in the individual's office. ( info) |
| Three avulsed teeth that were replanted and splinted after approximately a 200-min dry extraoral period in two patients are presented. In case 1 calcium hydroxide treatment was performed 1 month after replantation, because the patient did not come for endodontic treatment on the day after replantation as requested. In case 2, calcium hydroxide treatment was initiated on the day after replantation. calcium hydroxide treatment was used to prevent or treat inflammatory root resorption. During the follow-up periods the teeth reported in these cases have remained in a stable, functional position and did not reveal clinical ankylosis or replacement resorption. ( info) |
19/192. prognosis of replanted primary incisors after injuries. Between 1979 and 1997, 58 avulsed primary teeth were treated at the Pedodontic Clinic of Niigata University Dental Hospital. Among these, we replanted six avulsed incisors of four patients and treated two teeth of two patients replanted at other dental clinics. Referring to the clinical records, oral photographs and radiographs, we examined the injury age, cause of injury, condition of tooth storage, length of time until replantation, and also the prognosis after replantation. Three teeth of two cases remained until eruption of their permanent successors, and one tooth of one case remained under observation without extraction. Although the other four teeth of three cases resulted in extraction, no secondary infection was detected due to replantation. The following reasons were suspected for the poor prognosis of the four teeth. One avulsed tooth was not fixed immediately after replantation. One replanted tooth might not have been compatible with the alveolar socket. In the other two teeth, the periodontal vital tissues might have been removed before replantation. It is generally suggested that replantation of primary teeth is not a good option. However, from the present results, it was considered that replantation can be an effectual method when the condition of the avulsed primary tooth is suitable. ( info) |
20/192. Bone-like tissue growth in the root canal of immature permanent teeth after traumatic injuries. Following a severe traumatic incident to permanent immature teeth, the growth of calcified tissue in the pulp space may occasionally occur. This calcified tissue may be diffuse or in intimate contact with the dentine. It has been suggested that a wide open apex, severe damage to the root sheath, and the absence of infection are only some of the predisposing factors leading to this metaplasia of pulp tissue into bone-like tissue. Five cases are described. ( info) |