Cases reported "Root Caries"

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1/4. Simultaneous team approach of a crown-lengthening procedure and an operative restoration: technique and long-term effect.

    Traditionally, crown-lengthening procedures to expose subgingival caries for operative restorative work are carried out in a two-stage approach. A disadvantage of this procedure is that the gingival margin associated with the treated tooth moves apically; this may create an esthetic problem. Resin-modified glass-ionomer cement has been demonstrated to have good biocompatibility with dental hard and soft tissues. Surgical and restorative procedures were combined at the same appointment in an effort to achieve a restoration with minimal change in the gingival margin. Four patients have been treated with this one-stage team approach and followed for 8 to 13 months. The clinical results demonstrated this team approach procedure is excellent for the dentition when esthetics is a consideration.
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2/4. Treatment of combined endodontic-periodontic lesions by intentional replantation and application of hydroxyapatites.

    A case of combined endodontic-periodontic lesions on a mandibular first molar was treated by intentional replantation and application of hydroxyapatites. Four months after the surgery, a porcelain-mental full crown restoration was completed. The 15-month follow-up examination showed that the tooth was clinically and radiographically healthy and functioned well.
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3/4. Subgingival foreign body embedment in a preschool child: management with three and a half years follow-up.

    CASE REPORT: This is a case report of diagnosis and management of a foreign body embedded in the gingivae of a preschool child. A 3 year-old girl presented with pain, mobility and intraoral oedema of the upper left primary canine (#63). An angular, diffuse radiolucency on the mesial aspect of the primary canine was observed in the periapical radiograph and within this radiolucency, a linear radiopacity was noted in contact with the mesial surface of the root. A clinical diagnosis of severe localized periodontal involvement due to foreign body embedment was made. It was initially attempted unsuccessfully to remove the foreign body by subgingival root scaling and planning. The area was then surgically exposed. Upon flap elevation, a tubular plastic material similar to those used for the insulation of electric wires was found to encircle tightly the cervical area of the root of the primary canine, which was removed. Three months after the surgery, the gingiva of the affected tooth had attained its normal color but had started to recede for about 1 mm. One year post surgery, the gingival recession had progressed to 3 mm and a carious lesion had already developed at the denuded root surface. Three and a half years post surgery a mild inflammation of the buccal gingivae was apparent, but periodontal healing had occurred. CONCLUSION: The dentist must always consider the possibility of a foreign body embedment in the periodontal tissues of children and be familiar to the clinical signs and symptoms as well as the proper treatment procedures.
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4/4. Soft tissue augmentation on previously restored root surfaces.

    Three cases are presented demonstrating that soft tissue augmentation procedures can be accomplished on previously restored root surfaces. Diagnostic techniques to help determine ideal tooth length are discussed, and clinical examples of how to surgically manage the previously restored root surfaces are presented.
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