Cases reported "Dentin, Secondary"

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1/22. Prophylactic treatment of dens evaginatus using mineral trioxide aggregate.

    Two case reports with dens evaginatus are presented. Each patient had one tooth affected. There was a prominent tubercle on the occlusal surface of the mandibular second premolar. Under local anesthesia and rubber dam isolation a partial pulpotomy was conducted and mineral trioxide aggregate was placed. After 6 months the teeth were removed as part of planned orthodontic treatment. Histological examination of these teeth showed an apparent continuous dentin bridge formation in both teeth, and the pulps were free of inflammation. These cases show that mineral trioxide aggregate can be used as an alternative to existing materials in the proplylactic treatment of dens evaginatus.
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ranking = 1
keywords = pulp
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2/22. Conservative management of an accidentally resected root: a 3-year follow-up.

    Despite all the effort by dentists to provide high levels of dental care in clinical practice, there is always the possibility of accidents occurring. This report describes a referred case that presented with irreversible pulpitis in tooth #19. The situation developed after accidental resectioning of the distal root of tooth #19 during the surgical extraction of tooth #18 by another dentist. The resultant open apex in the distal root of tooth #19 was managed conservatively. A positive apical stop was prepared at the root end of the distal root and sterile calcium hydroxide powder was used to create an apical barrier against which a gutta-percha filling was condensed. The treatment appeared successful at 3-year follow-up.
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ranking = 0.51599432354166
keywords = pulp, dental
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3/22. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract.

    A necrotic immature mandibular second premolar with periapical involvement in a 13-year-old patient was treated. Instead of the standard root canal treatment protocol and apexification, antimicrobial agents were used in the canal, after which the canal was left empty. Radiographic examination showed the start of apical closure 5 months after the completion of the antimicrobial protocol. Thickening of the canal wall and complete apical closure was confirmed 30 months after the treatment, indicating the revascularization potential of a young permanent tooth pulp into a bacteria-free root canal space.
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ranking = 0.5
keywords = pulp
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4/22. Unusual fracture of a mandibular second premolar: a case report.

    Root fractures of posterior teeth, which are defined as fractures involving cementum, dentin, and pulp, are relatively uncommon among dental traumas. This study describes an unusual horizontal fracture of a mandibular second premolar. The tooth was asymptomatic and the fracture unnoticed until the crown broke off completely. The patient had no recollection of a causative event nor was there any evidence of previous physical trauma. The tooth was extracted, embedded in resin, sliced, and examined with different light microscopes. It was concluded that the tooth had been damaged previously but not to the extent that the pulp was seriously damaged. Resorption over a period of time eventually caused the final fracture.
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ranking = 1.0026657205903
keywords = pulp, dental
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5/22. Cvek pulpotomy: report of a case with five-year follow-up.

    Partial pulpotomy (Cvek pulpotomy) is the treatment of choice for injured permanent incisor teeth with exposed vital pulp tissue and immature apices. This treatment preserves pulpal function, thus allowing continued root development. The present report describes the case of a permanent incisor with incomplete root end closure that underwent a Cvek pulpotomy, with subsequent apical closure. Five years post pulp therapy, the tooth remained symptom free.
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ranking = 5
keywords = pulp
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6/22. Repair characteristics of horizontal root fracture: a case report.

    Radicular fractures in permanent teeth are uncommon injuries among dental traumas, comprising 0.5-7% of the cases. Fracture occurs most often in the middle-third of the root and rarely at the apical-third. The present paper reports a clinical case of a horizontal radicular fracture located between the middle- and apical-third of a upper left-central incisor followed-up for over 3 years. The tooth was extracted owing to periodontal reasons. Histomorphologically, it showed pulp-vitality preservation and root healing by hard-tissue deposition.
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ranking = 0.50266572059028
keywords = pulp, dental
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7/22. The use of MTA in teeth with necrotic pulps and open apices.

    Three clinical cases have been treated with the use of an apical plug of MTA for apexification. All three cases were central incisors that had suffered premature interruption of root development as a consequence of trauma. According to the treatment protocol, the root canals were rinsed with 5% NaOCl; then, calcium hydroxide paste was placed in the canals for 1 week. Consequently, the apical portion of the canal (4 mm) was filled with MTA. The remaining portion of the root canals was then closed with thermoplastic gutta-percha. At 6-month and 1-year follow-up period the clinical and radiographic appearance of the teeth showed resolution of the periapical lesions. MTA appears to be a valid option for apexification with its main advantage being the speed at which the treatment can be completed.
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ranking = 2
keywords = pulp
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8/22. 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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ranking = 4
keywords = pulp
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9/22. Management of teeth with open apexes and necrotic pulps: representative cases.

    This paper briefly reviews the pros and cons of five methods used to treat a tooth with a necrotic pulp and an open apex (incompletely developed root), and presents representative treatments of open apex cases. These treatments include customized cone, short-fill, periapical surgery, apexification, and one-visit apexification.
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ranking = 2.5
keywords = pulp
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10/22. Influence of different endodontic methods of treatment upon the process of apical closure of immature pulpless human teeth and the structure of the newly formed calcified tissue in apical opening.

    A description is given of the pathohistological structure of the calcified tissue in the apical opening of four extracted immature pulpless human teeth treated by various endodontic methods. It is concluded that in the tooth treated by mortal extirpation there was neither histological healing nor any tendency for further apex formation. In both the tooth where vital extirpation was performed and in one of the teeth treated as apical periodontitis, the apices were formed from conglomerates of different calcified tissues, identical to the tissue which was formed under comparable conditions in experimental dogs. In the fourth human tooth also treated as apical periodontitis after treatment the apical opening closed with irregular dentine tissue. In this study consideration was given to the problem of the origin of the odontoblasts which co-exist with the hard destructive process present in some pulpless teeth. It is concluded that in the case presented in this study the irregular dentine was formed by the same odontoblasts which took part in the process of normal odontogenesis. This fact, should be respected in the course of endodontic treatment of immature pulpless teeth.
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ranking = 3.5
keywords = pulp
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