Cases reported "Tooth, Nonvital"

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51/87. Reactive correction of a maxillary incisor in single-tooth crossbite following periodontal therapy.

    BACKGROUND: The reactive correction of a single tooth anterior crossbite following periodontal therapy is described. This case report provides new information regarding correction of a crossbite relationship and con- firms existing reports of tooth movement following periodontal therapy. methods: A 39-year-old woman in good general health presented with a history of recurrent periodontal abscesses of a maxillary incisor. Probing depths of the abscessed tooth ranged from 5 to 12 mm, and class 1 mobility was noted. Radiographs revealed that the tooth had previously been treated endodontically. The patient's periodontal diagnosis was generalized chronic moderate to severe periodontitis. Treatment considerations were complicated by a single-tooth crossbite relationship of the involved incisor and clinical evidence that the periodontal abscess communicated with an apical infection. Treatment of the abscess consisted of cause-related therapy, bone grafting, and occlusal adjustment. RESULTS: Five months after surgical treatment, an edge-to-edge incisal relationship was observed, the first indicator of tooth movement. Further correction to a normal incisal relationship resulted 1 year after modification of the proximal contact. At this time, there was normal probing depth with only slight recession and mobility. Bone fill was radiographically noted. CONCLUSION: It appears that some cases of maxillary incisor crossbite that are complicated by periodontal disease may be corrected, without orthodontic appliances, following periodontal treatment. ( info)

52/87. The effects of periradicular inflamation and infection on a primary tooth and permanent successor.

    Primary teeth and the permanent successors must be understood as interdependent units, where each one of them interacts with and depends on each other. Pulpal inflammation/infection of a primary tooth and the spread of this condition over the periradicular tissues can lead to alterations in the dental germ of the permanent successor and to the surrounding structures if no therapy is done, i.e. endodontics or extraction. This work will present cases of permanent teeth that showed alteration in eruption and / or in development, as a consequence of inflammation / infection of the preceding primary teeth, such as: hypoplasia, morphological alteration on the dental crown or total arrest of. radicular formation. The teeth analysed in this study belong to patients who attended the Universidade Federal de Santa Catarina Children's dentistry Clinic. The earlier these lesions are diagnosed, the less were the destructive effects and the consequences on the primary tooth/permanent germ unit. ( info)

53/87. Continued root formation of a pulpless permanent incisor following root canal treatment: a case report.

    AIM: To present a case of a pulpless permanent incisor that continued root formation following root canal treatment. SUMMARY: A healthy 8-year-old girl with a history of dental trauma resulting in a coronal fracture involving enamel, dentine and pulp was referred by her general dental practitioner for treatment and evaluation of tooth 21. The tooth had a necrotic pulp and periapical rarefaction was evident radiographically. The canal was prepared, dressed with Ca(OH)2 and then filled with a rolled gutta percha cone and Roth's root canal sealer. A radiograph exposed eight years post-treatment, showed evidence of continued apical formation. KEY learning POINTS: *Teeth with necrotic pulps and periapical rarefaction may show evidence of continued apical formation after root canal treatment. *Hertwig's epithelial root sheath may be more resistant than expected to trauma and infection. ( info)

54/87. Restoration of severely decayed primary incisors using indirect composite resin restoration technique.

    Caries of primary incisors is a common problem in paediatric dentistry in some countries. The restoration of primary incisors which have been severely damaged by early childhood caries or trauma is also a difficult challenge for clinicians. This case report describes an indirect technique for the restoration of primary anterior teeth using composite resin reinforced with a fibre-glass post. Over a one-year period, the crowns have demonstrated good retention and aesthetic results. The restorations were provided in two short chair-side sections, with satisfactory patient cooperation. ( info)

55/87. Reconstruction of devital teeth using direct fiber-reinforced composite resins: a case report.

    Nonrestored devitalized teeth are structurally compromised and represent one of the greatest challenges for the clinician. Restoration of endodontically treated teeth has been associated with the use of posts. Various post materials and designs have been introduced over the years; however, motivated by the desire to conserve the remaining sound tooth structure and thanks to properties of modern adhesive systems, clinicians have re-evaluated the dogma of traditional restorative dentistry and seek alternative methods to build up devitalized teeth. The use of direct Ultra High molecular weight polyethylene (UHMWPE) fiber-reinforced post systems is becoming popular among clinicians because enlargement of the root canal space is not required and the risk of root perforation eliminated. This article presents an experimental clinical technique to reconstruct severely damaged endodontically treated posterior teeth using direct fiber reinforced post systems. Particular attention is paid to the incremental and curing techniques adopted to build up the restoration. The problems that clinicians can encounter in bonding to teeth that have undergone endodontic treatment are also analyzed. Questions that have yet to be answered by scientific research are presented. ( info)

56/87. Endodontic management of an impacted premolar.

    This report demonstrates a simple endodontic solution to an interdisciplinary case of a patient with multiple gene deficiencies. An adolescent patient presented with an impacted premolar that could not be extracted due to high-risk conditions. A suspicious degree of radiolucency around the crown was clinically diagnosed as dentigerous cyst. The treatment dilemma and implementation are discussed. This case report offers a different treatment option for impacted teeth when significant differential diagnosis of a pericoronal lesion dictates treatment. ( info)

57/87. Clinical evaluation of the use of fiber posts and direct resin restorations for endodontically treated teeth.

    PURPOSE: Restoration of root-treated teeth is routinely performed in clinical practice with a choice of therapeutic options, considering many factors to provide optimal mechanical properties, esthetics, and longevity. The aim of the present work was to present a preliminary clinical report on the use of fiber posts and direct resin composites for restoring root-treated teeth. MATERIALS AND methods: Thirty-eight anterior and 62 posterior endodontically treated teeth were selected from 3 private prosthodontic offices. The protocol used included endodontic treatment, with translucent fiber posts (DT post) bonded to the post-space using a '1-bottle' adhesive (One-Step, Bisco) and a dual-cure resin cement (DuoLink, Bisco). Direct resin restorations were performed using a micro-hybrid resin composite (Gradia Direct, GC) and a layering technique. Both opaque dentin and enamel and translucent enamel shades were used. RESULTS: patients were recalled after 6, 12, 24, and 30 months, and the restorations assessed according to predetermined clinical and radiographic criteria. These clinician-mediated evaluation methods confirmed the good clinical performance of the restorations. CONCLUSION: Restoration of endodontically treated teeth with fiber posts and direct resin composites is a treatment option, that in the short term conserves remaining tooth structure and results in good patient compliance. ( info)

58/87. Spontaneous dissection of the internal carotid artery manifesting as pain in an endodontically treated molar.

    BACKGROUND: Dental pain is a common occurrence, whereas spontaneous dissection of an internal carotid artery is rare. CASE DESCRIPTION: The authors describe a patient who experienced a spontaneous dissection of an internal carotid artery that manifested initially as dental pain in an endodontically treated molar. CLINICAL IMPLICATIONS: It is important for dental practitioners to be familiar with unusual causes of dental pain. In this case in which the cause of dental pain was uncommon, the authors referred the patient appropriately, thus avoiding potentially serious complications. ( info)

59/87. Three-dimensional, non-destructive visualization of vertical root fractures using flat panel volume detector computer tomography: an ex vivo in vitro case report.

    AIM: To detect and to visualize radiographically vertical root fractures in extracted teeth with a prototype of a novel, high resolution, three-dimensional flat panel volume detector computer tomograph (FD-VCT) system. SUMMARY: Five teeth with root fillings and clinical symptoms such as fistulas and isolated periodontal pockets of 8 mm or more were extracted after dental radiography indicating lateral or periapical lesions. Vertical root fractures or cracks were suspected because of the symptoms and clinical findings were evident after extraction in all cases but fracture lines were not visible on routine dental radiographs acquired before extraction. The extracted teeth were explored with a prototype of a FD-VCT. Using the FD-VCT, in all cases vertical root fractures or crack lines could be detected clearly in different views, depiction-modes and cross-sections at a spatial resolution of 140 microm. The evaluation of the fracture lines and teeth could be performed in three-dimensional views. The FD-VCT findings were confirmed by detailed inspection of the extracted teeth. KEY learning POINTS: The FD-VCT is an innovative diagnostic tool for non-destructive, three-dimensional evaluation of extracted teeth in pre-clinical and experimental studies. The FD-VCT allows precise visualization and evaluation of vertical root fractures or cracks in extracted teeth. Clinical application of the system may be possible if technical modifications reduce the exposure dose: the high resolution detector systems of the FD-VCT should be combined with radiation systems that focus the radiation to the area of interest. ( info)

60/87. Histological observations of periradicular healing following root canal treatment.

    The purpose of this study was to observe histologically the sequence of events leading to resolution of periradicular tissues, with a view to advancing the perception of periapical healing. Our material consisted of periapical specimens obtained from 15 single-rooted, endodontically treated teeth of patients aged 25-40 years. All the teeth required extraction because of complicated crown-root fracture following trauma, iatrogenic aetiology (cervical root resorption following bleaching) or extensive carious lesions. The patients were informed that, based on their clinical condition, surgical procedures should be performed under flap reflection in order to extract the fractured root. informed consent, which was necessary for the surgery, was obtained in all cases. A small block section containing the apical root tip and surrounding periapical tissues was removed prior to root extraction. The results of histological examination revealed osteoblastic activty and osteoid bone formation six days after the root canal instrumentation. periapical tissue healing was observed despite the presence of overfilled material. The lining epithelium was infiltrated with chronic inflammatory cells and surrounded by collagen bundles and newly formed bone. ( info)
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