Cases reported "Dental Pulp Exposure"

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1/10. Direct pulp capping with a dentin adhesive resin system in children's permanent teeth after traumatic injuries: case reports.

    Traumatic injuries in the permanent teeth of children and adolescents are one of the most frequent causes of dental treatment. The article presents the use of an enamel and dentin adhesive resin system, Syntac, and resin composite materials, Tetric and Variolink, as materials of choice for direct pulp capping after traumatic pulpal exposure (Ellis Class III). Exposed pulp in 10 patients was covered with Syntac and then Tetric and Variolink after etching of dental tissues with phosphoric acid. The follow-up period was from 12 to 48 months. In 1 patient, the treatment was a failure. In the remaining 9 patients, no signs or symptoms of pulpal inflammation or necrosis were observed during the clinical examination.
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2/10. Reattachment of a fractured maxillary incisor crown--case report.

    Management of traumatic injuries to the teeth is a challenge to the practising dentist. It has no prescriptive method for occurring, possesses no significant predictable pattern of intensity or extensiveness and occurring at times when dentists are least prepared for it. It may not only leave physical scars but also a psychological impact on its victim. Yet, more than half of all children traumatize either their primary or permanent teeth before leaving the school, coupled with the dynamic panorama of sporting activity worldwide and the significant increase in violence among the populations. tooth trauma and its management loom as a major challenge to the dental practitioner. A case of a 11 year old boy with Ellis Class 3 traumatic injury to the maxillary left central incisor is reported. A pulpectomy was performed followed by reinforcement and reattachment of the crown fragment and restoration with composite resin.
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3/10. tooth fragment reattachment: fundamentals of the technique and two case reports.

    Coronal fractures must be approached in a methodical and clinically indicated way to achieve successful restoration. One option for treatment is reattachment of the dental fragment. Reattachment creates a very positive emotional response in the patient and simplifies the maintenance of the patient's original occlusion. This article discusses dental fragment reattachment techniques and presents clinical cases of coronal fracture involving enamel, dentin, and pulpal exposure.
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4/10. Congenital defect of maxillary primary central incisor associated with exposed pulp and gingival [fibrosis]: case report.

    This report describes a rare case of hypoplastic primary incisor in which the pulp was exposed at the crown portion and covered by the gingiva in a 1-year-11-month-old boy. The patient was referred to us due to swelling of his labial cervical gingiva of the maxillary right primary central incisor, and on examination, extended to the hypoplastic labial surface. Radiographically, there was a round radiolucent area on the crown including the edge. Surgical removal of the swollen gingiva revealed a large defect of the labial aspect of the incisor, showing pulpal tissue inside. The tooth was treated by vital pulpotomy. Histopathologically, the removed gingival tissue contained many pieces of dysplastic tooth elements in the lamina propria portion which should have been connected to the exposed pulp. The findings suggested that pulp exposure resulted from focal dental hypoplasia not from resorption of the tooth.
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5/10. Restoration modalities of severely injured anterior teeth--gingival integration, papillae support, and predictable imperfections.

    This article presents 4 cases, each describing a different dental trauma and a different treatment modality. Because of various limitations, none of the results presented is esthetically perfect, but the outcomes were acceptable to both the operators and the patients. Such limitations should be predicted and discussed with patients before beginning treatment and should be regarded as acceptable compromises, unless other less conservative treatments are to be used.
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6/10. Treatment of severe pre-eruptive intracoronal resorption of a permanent second molar.

    Pre-eruptive intracoronal resorption is a lesion often located within the dentin, adjacent to the dentin-enamel junction, in the occlusal aspect of the crown. As the lesions resemble caries, they are often referred as "pre-eruptive caries." The purpose of this case report was to describe the diagnosis and treatment of a permanent molar with pre-eruptive intracoronal resorption and to elaborate on possible associated clinical problems. After surgical exposure of the unerupted tooth, the tooth structure in the resorbed area was removed and the tooth was restored with glass-ionomer material. Three months after the treatment, partial pulpotomy had been performed and the restoration was replaced by amalgam. Elaboration on possible associated clinical problems is provided.
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keywords = caries
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7/10. Single-session treatment of a major complication of dens invaginatus: a case report.

    Dens invaginatus is a dental malformation that may give rise to several complications. Caries of the invagination can severely weaken the whole tooth, making it susceptible to fracture. Subgingival fractures are major complications threatening tooth survival and usually require periodontal/orthodontic/prosthetic treatment if long-term viability is to be ensured. This article describes a case of single-session restoration of a fractured invaginated tooth by means of endodontic treatment followed by fragment reattachment.
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8/10. Preserving pulpal health of a geminated maxillary lateral incisor through multidisciplinary care.

    AIM: To report the multidisciplinary care of an unaesthetic geminated maxillary lateral incisor tooth, which allowed its preservation in the mouth. SUMMARY: Preoperative examination of an unsightly geminated maxillary lateral incisor (tooth 22) demonstrated two pulp chambers and open apices, with normal pulp sensitivity responses. At surgery, a periodontal mucoperiosteal flap was reflected and the distal part of the geminated tooth was removed. The exposed root canal of the preserved tooth was sealed with mineral trioxide aggregate (MTA). The extraction socket and osseous defect was grafted with decalcified freeze-dried bone allograft (DFDBA) before flap closure. During follow-up, distal caries in tooth 22 and a diastema between tooth 22 and 23 were managed with composite resin restorations. Forty-two months postoperatively, normal thermal and electrical pulp sensitivity tests confirmed pulp health. Convincing apexogenesis and dentinogenesis of the developing root was confirmed by radiographic examination. Acceptable periodontal health including 3-4 mm clinical probing depths was achieved. Optimizing aesthetics and occlusion was accomplished without orthodontic treatment.
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keywords = caries
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9/10. Nonendodontic coronal resection of fused and geminated vital teeth. A new technique.

    A new technique has been devised to resect vital malformed large dental crowns stemming from developmental fusion and gemination. In two cases from separate patients, resection of the fused crown with sharp osteotomes resulted in exposed pulp chambers that were subsequently allowed to heal. Root canal treatment was not necessary. Case follow-up at 12 and 4 years after orthodontics showed pulp vitality. A review of the literature as well as an explanation for healing modality were included.
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10/10. Dens evaginatus: review of the literature and report of several clinical cases.

    Dens evaginatus (DE) presents as an innocuous looking tubercle of enamel on the occlusal surface of a tooth, most commonly a bicuspid. Problems can arise when the tubercle is either worn, ground, or fractured off, resulting in pulpal exposure and possible loss of vitality of the tooth. dentists who perform orthodontic treatment should be aware of this dental anomaly, which occurs in at least two per cent of the Asian and Native Indian populations. bicuspid extraction cases should involve the extraction of the anomalous premolars rather than the normal ones. In addition, the dentist should be mindful of occlusal changes that may occur during treatment or occlusal equilibration, both of which can jeopardize the vitality of teeth with DE. Pulp capping or partial pulpotomy has been postulated to be one of the most reliable forms of vital tooth treatment when pulp exposure is encountered following the sterile removal of the tubercle. When pulp exposure is not encountered, preventive resin composite sealing of the dentin or class I amalgam cavity preparation seems to be the treatment of choice.
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