JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 4 2008
Robert D. Walter DDS Authors
Porcelain laminate veneers have been proven to be a successful treatment modality for maxillary incisors in clinical practice and in controlled clinical studies. However, the data in clinical studies on the success of veneers for restoring mandibular incisors are limited. Clinically, the successful restoration of mandibular incisors with porcelain laminate veneers is one of the more challenging procedures in all of esthetic restorative dentistry. Limited coronal dimensions, the small amount of enamel available for bonding (particularly in the cervical areas), materials and techniques for the bonding procedures, and the response of the tooth,veneer complex to forces generated during the incisal loading in both functional as well as parafunctional contacts must be considered as potential sources of success or failure. This Critical Appraisal reviews three recent scientific articles to shed some light on these issues and, as in all research endeavors, leads the reader to identify additional areas of concern that might stimulate further scientific inquiry. The first publication studied predictors for enamel thickness for mandibular incisors. The second examined bonding protocols for exposed dentin and suggested immediate dentin sealing. The third paper addressed fracture behavior of mandibular incisors restored with porcelain laminate veneers in vitro. [source]

Managing the Challenge of Crowning the Single Central Maxillary Incisor

JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 5 2008
ARIEL RAIGRODSKI DMD
[source]

Maxillary Lateral Incisor With Two Roots

AUSTRALIAN ENDODONTIC JOURNAL, Issue 1 2001
Dr Ian J. Collins BDSc
ABSTRACT Variations in root canal morphology can lead to complications in endodontic treatment. A case of a maxillary lateral incisor with two roots is reported. [source]

Periodontal response to two intracanal medicaments in replanted monkey incisors

DENTAL TRAUMATOLOGY, Issue 6 2001
Y. L. Thong
Abstract , Intracanal medicaments are recommended for use in replanted teeth to inhibit inflammatory root resorption. This study compared the effect of calcium hydroxide (Pulpdent®) and a corticosteroid-antibiotic paste (Ledermix®) on periodontal healing and root resorption following replantation. Incisors of eight Macaca fascicularis monkeys were extracted, stored dry for 15 min and replanted. After 11 days, root canals in two adjacent maxillary incisors were treated with one medicament and contralateral incisors with the other medicament, or left as untreated controls. Animals were sacrificed 8 weeks later and the teeth prepared for histomorphometric evaluation of periodontal ligament inflammation and root resorption. Periodontal ligament inflammation and inflammatory root resorption were markedly inhibited by both calcium hydroxide and corticosteroid-antibiotic relative to untreated controls. Replacement resorption was lowest in the corticosteroid-antibiotic group, and significantly (P<0.05) more normal periodontal ligament was present in this group (79.6%) than in calcium hydroxide and control groups (64.6% and 62.7%, respectively). Treatment with the corticosteroid-antibiotic inhibited inflammatory resorption and was slightly more effective than calcium hydroxide in producing a periodontal healing response. [source]

Influence of food consistency on the rabbit masseter muscle fibres

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 1 2003
Geerling Langenbach
The plasticity of the masseter muscle was studied by comparing two groups of rabbits that were fed soft- and hard-diet for 87 d. Incisors of the soft-diet group were cut back to minimize the bite forces. Muscle fibres were immunohistochemically defined as fast- or slow-contracting fibres and their cross-sectional area was measured. The muscles of animals fed with the hard-diet were composed of fibres with larger cross-sectional areas than the soft-diet group. The relative difference was larger in slow-contracting fibres than in fast-contracting fibres. The results were similar for the different regions of the muscle. No changes in fibre composition were found. In conclusion, the difference in food consistency, as induced in this study, caused changes in the muscle fibre cross-sectional area that can be recognized from the altered necessary occlusal forces, which result from the modified forces developed by the masseter muscle. [source]

Managing Congenitally Missing Lateral Incisors.

JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 4 2005
Part III: Single-Tooth Implants
ABSTRACT Three treatment options exist for the replacement of congenitally missing lateral incisors. They include canine substitution, a tooth-supported restoration, and a single-tooth implant. Selecting the appropriate treatment option depends on the malocclusion, anterior relationship, specific space requirements, and condition of the adjacent teeth. The ideal treatment is the most conservative option that satisfies individual esthetic and functional requirements. Today, the single-tooth implant has become one of the most common treatment alternatives for the replacement of missing teeth. This article closely examines the many interdisciplinary issues that arise when treatment planning the placement of single-tooth implants in patients with congenitally missing lateral incisors. The specific criteria that must be evaluated illustrate the importance of an interdisciplinary treatment approach to achieve optimal esthetics and long-term predictability. This is the final article of a three-part series discussing the three treatment alternatives for replacing congenitally missing lateral incisors. [source]

Managing Congenitally Missing Lateral Incisors.

JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 1 2005
Part I: Canine Substitution
ABSTRACT Dentists often encounter patients with missing or malformed teeth. The maxillary lateral incisor is the second most common congenitally absent tooth. There are three treatment options that exist for replacing missing lateral incisors. They include canine substitution, a tooth-supported restoration, or a single-tooth implant. Selecting the appropriate option depends on the mal-occlusion, specific space requirements, tooth-size relationship, and size and shape of the canine. The ideal treatment is the most conservative option that satisfies individual esthetic and functional requirements. Often the ideal option is canine substitution. Although the orthodontist positions the canine in the most esthetic and functional location, the restorative dentist often needs to place a porcelain veneer or crown to re-create normal lateral incisor shape and color. This article closely examines patient selection and illustrates the importance of interdisciplinary treatment planning to achieve optimal esthetics. It is the first in a three-part series discussing the three treatment alternatives for replacing missing lateral incisors. [source]

Diagnosis and Management of Maxillary Incisors Affected by Incisal Wear: An Interdisciplinary Case Report

JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 6 2002
JUSSARA KARINA BERNARDON
ABSTRACT In the attempt to restore anterior teeth affected by erosion and bruxism, many clinicians have been frustrated with the constant restorative failures. Frequently, these failures are attributed to the restorative materials employed, especially in cases in which composite resins are used. However, some flaws of the restorations are related to the oversight of occlusal principles. The purpose of this article is to discuss the etiology, signs, and symptoms of incisal wear, with special attention to that caused by bruxism and chemical erosion. Relatively simple management techniques (e.g., occlusal adjustment, adhesive restorations) are proposed, and the diagnosis and management of a representative clinical case is presented. [source]

GDNF Expression in Terminal Schwann Cells Associated With the Periodontal Ruffini Endings of the Rat Incisors During Nerve Regeneration

THE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 8 2009
Megumi Ohishi
Abstract The terminal Schwann cells (TSCs) which play crucial roles in regeneration of the periodontal Ruffini endings (RE) exhibit immunoreaction for glial cell line-derived neurotrophic factor (GDNF). However, no information is available regarding the role of GDNF in the periodontal RE during nerve regeneration. This study was undertaken to examine the changes in GDNF expression in the rat periodontal RE following transection of the inferior alveolar nerve (IAN) using immunohistochemistry for GDNF and S-100 protein, a marker for the TSCs. We additionally investigated the changes in expression of GDNF in the trigeminal ganglion (TG) at protein and mRNA levels. A transection to IAN induced a disappearance of the TSCs from the alveolus-related part (ARP), followed by a migration of spindle-shaped cells with S-100 but without GDNF immunoreactions into the tooth-related part (TRP) by postoperative (PO) week 2. At PO week 2, GDNF immunoreacted cellular elements increased in number in the ARP although the spindle-shaped cells without GDNF reaction remained in the TRP. After PO week 4, many GDNF-positive TSCs appeared in the ARP though the spindle-shaped cells vanished from the TRP. A real time RT-PCR analysis demonstrated the highest elevation of GDNF mRNA in the TG at PO week 2. These findings suggested the involvement of this molecule in the maturation and maintenance of the periodontal RE during regeneration. Taken together with our previous and current studies, it appears that the regeneration of the periodontal RE is controlled by multiple neurotrophins in a stage-specific manner. Anat Rec, 2009. © 2009 Wiley-Liss, Inc. [source]

Dilaceration of maxillary central incisor: a literature review

DENTAL TRAUMATOLOGY, Issue 5 2010
Nikolaos Topouzelis
In early developmental stages, the permanent tooth germ of the maxillary incisor is situated palatally and superiorly to the apex of the primary incisor and gradually changes direction in a labial direction with its crown coming closer to the resorbing primary root. For reasons of this close relationship between the permanent tooth germ and the apex of the primary incisor, it is believed that an acute trauma to the primary predecessor can cause dilaceration of the long axis of the permanent successor. Clinically, dilaceration can be revealed by palpation high in the labial sulcus or in the hard palate, while its radiographic view is characteristic. The therapeutic approach to the dilacerated maxillary central incisors has to be carefully planned and needs the cooperation of several specialities to attain the final objective. [source]

The unmet treatment need of traumatized anterior teeth in selected secondary school children in Ibadan, Nigeria

DENTAL TRAUMATOLOGY, Issue 1 2010
Mojirade Deborah Ajayi
The aim of this study was to assess the prevalence of damage to permanent anterior teeth in school adolescents, the average duration of trauma and to ascertain the level of the unmet treatment need. A total of 1532 secondary school children between the ages 12 and 19 years participated in the study. They were randomly selected from public secondary schools in five local government areas in Ibadan using a multistage sampling method. Participants were examined with the aid of mouth mirrors and probes under natural light. Traumatic anterior dental injuries were recorded by the same investigator (DMA) according to WHO classification. One hundred and sixty-five participants sustained injuries to their anterior teeth. Their mean age was 15.47 ± 2.09 years, with a male to female ratio of 1.5:1. The commonest cause was fall (78.8%) with road traffic accident being the least (1.8%). The tooth most commonly injured is the upper left incisor (48.0%) closely followed by upper right central (43.1%). Enamel fracture was seen in 46.5% and enamel,dentine in 42.6% of the traumatized teeth. Most (79.4%) of the children sustained injury to one tooth only. Of the participants, only 30 (18.2%) had previous dental consultation while only nine (5.5%) consulted the dentist following the trauma; however, none of the teeth had any form of restoration. Average time elapsed between trauma and dental examination was about 3.5 years. Many participants had had injury for about 2 years before dental examination. In conclusion, there is a high unmet treatment need of traumatized anterior teeth in the study population. [source]

Traumatic injuries to permanent teeth in Turkish children, Ankara

DENTAL TRAUMATOLOGY, Issue 3 2009
Ceyhan Altun
From a total of 4956 children aged 6,12 years (mean age: 8.91 ± 1.95) applying to the Center, 472 children (9.5%) were found to have suffered dental injuries during a period of 2 years. Injuries were classified according to drawings and texts based on the WHO classification system, as modified by Andreasen and Andreasen. Injury rates were highest among children age 6 and ages 8,10. The most frequently injured permanent teeth were the maxillary central incisors (88.2%), and the maxillary right central permanent incisor made up 47.2% of all injured teeth. The most common cause of dental trauma was falling while walking or running (40.3%). Most injuries involved a single tooth (64.8%). The most common type of injury was enamel fracture (44.6%). There was a significant difference in gender, where boys more often suffered from a dental hard tissue and pulp injury than girls (P = 0.019), whereas there was no difference in gender (P = 0.248) in the distribution of periodontal injuries. Injuries were found to occur more frequently during the summer (P < 0.001). Children with increased overjet were 2.19 times more likely to have dental injuries than other children. Considering that the incidence of traumatic dental injury is highest among children ages 6 and ages 8,10 as well as the fact that patients with increased overjet are more prone to dental trauma, preventive orthodontic treatment in early mixed dentition may play an important role in reducing traumatic dental injuries. [source]

Surgical repositioning of a traumatically intruded permanent incisor in a patient with rheumatic fever: case report

DENTAL TRAUMATOLOGY, Issue 1 2009
Rosana Sales Dias
However, it is one of the most severe types of dentoalveolar trauma. By definition, intrusive luxation consists of the axial displacement of the tooth into the alveolar bone, accompanied by comminution or fracture of the alveolar bone. Here we report the treatment management of a traumatically intruded immature permanent central incisor by surgical repositioning undertaken in a 10-year-old child with rheumatic fever 10 days after sustaining a severe dentoalveolar trauma. The intraoral examination showed the complete intrusion of the permanent maxillary right central incisor and the radiographic examination revealed incomplete root formation. Prophylactic antibiotic therapy was prescribed and the intruded tooth was surgically repositioned and endodontically treated thereafter. The postoperative course was uneventful, with both clinically and radiographically sound conditions of the repositioned tooth up to 3 years and 2 months of follow-up. These outcomes suggest that surgical repositioning combined with proper antibiotic prophylaxis and adequate root canal therapy may be an effective treatment option in cases of severe intrusive luxations of permanent teeth with systemic involvement. [source]

Effect of root surface treatment with propolis and fluoride in delayed tooth replantation in rats

DENTAL TRAUMATOLOGY, Issue 6 2008
Jéssica Lemos Gulinelli
Nevertheless, an extended extraoral period damages the periodontal ligament and results in external root resorption. The purpose of this study was to assess by histologic and histometric analysis, the influence of propolis 15% (natural resinous substance collected by Apis mellifera bees from various plants) and the fluoride solution used as root surface treatment on the healing process after delayed tooth replantation. Thirty Wistar (Rattus norvegicus albinus) rats were submitted to extraction of their upper right incisor. The teeth were maintained in a dry environment for 60 min. After this, the pulp was extirpated and the papilla, enamel organ and periodontal ligament were removed with scalpel. The teeth were divided into three experimental groups: Group I , teeth immersed in 20 ml of physiologic saline; Group II , teeth immersed in 20 ml of 2% acidulated phosphate sodium fluoride; Group III , teeth immersed in 20 ml of 15% propolis. After 10 min of immersion in the solutions, the root canals were dried and filled with calcium hydroxide paste and the teeth were replanted. The animals were euthanized 60 days after replantation. The results showed that similar external root resorption was seen in the propolis and fluoride groups. Teeth treated with physiologic saline tended to have more inflammatory root resorption compared with those treated with fluoride or propolis. However, the comparative analysis did not reveal statistically significant differences (P > 0.05) between the treatment modalities when used for delayed tooth replantation. [source]

Calcific healing of a crown root fracture of a maxillary central incisor evaluated with spiral computed tomography and hounsfield units: a case report

DENTAL TRAUMATOLOGY, Issue 6 2008
Suresh Nandini
Calcific healing of a complicated oblique crown root fracture is rarely reported in literature. This article highlights the calcific healing of a traumatized maxillary central incisor with crown root fracture. This unique observation of healing following trauma was confirmed with the use of spiral computed tomography and Hounsfield units. [source]

Rapidly progressive internal root resorption: a case report

DENTAL TRAUMATOLOGY, Issue 5 2008
David Keinan
Usually the process is asymptomatic and diagnosed upon routine radiographic examination. This case report presents a rapid progression of internal resorption related directly to traumatic injury. A 16-year-old female arrived at the emergency room after a mild extrusion of the mandibular incisors. The initial treatment included repositioning and splinting of the teeth. Radiographs performed at repositioning and splinting demonstrated normal configuration of the incisor's roots. Ten months later progressive internal resorption of the left mandibular first incisor was diagnosed. While treating this tooth similar process was detected in the right mandibular second incisor and in the mandibular left second incisor. The lower right first incisor reacted inconsistently to vitality test. As a result of the severe and rapidly progressive nature of the process, root canal treatments were performed in all lower incisors. The follow-up radiographs demonstrate arrest of the internal resorption process. [source]

An unusual lateral luxation of an upper incisor owing to long-term boxing without protection

DENTAL TRAUMATOLOGY, Issue 5 2008
Ron Bechor
The tooth displacement gradually worsened over several months because the boxer received repeated blows to the head without using a mouthguard. Being a chronic dental trauma, rather than an acute lateral luxation, this case had several unique features: the labial plate of the alveolar bone was penetrated, the root apex was free in the vestibulum, the tooth was mobile (second degree) and radiographs revealed bone resorption. This case emphasized the need for a mouthguard to be used even with amateur boxing. The dental practitioner should educate his sportsmen,patients of the risk of sport-related dental trauma and the benefit of a mouthguard. [source]

Replantation of an immature permanent central incisor following pre-eruptive traumatic avulsion

DENTAL TRAUMATOLOGY, Issue 5 2008
Esti Davidovich
Avulsion of a pre-eruptive left permanent maxillary incisor in a 6-year-old boy is presented. The immature tooth was replanted after rinsing with saline following 10 min dry extra-oral time. This case report describes treatment and a 2-year follow-up of the tooth. During the follow-up period, continuation of root development, pulp revascularization, and irregular dentin formation were demonstrated. The tooth is vital, functional, and esthetic. To the best of our knowledge, no such case of replantation of a pre-eruptive tooth has been reported previously. [source]

Immediate post-traumatic upper incisor reconstruction using composite resin materials

DENTAL TRAUMATOLOGY, Issue 1 2008
Vlatko Panduric
Clinical inspection revealed a complex crown fracture of the central incisor as well as a simple horizontal fracture of the lateral incisor crown of the enamel-dentin type. Vertical fracture separated the palatal enamel wall from the rest of the lateral incisor crown. After the completion of the endodontic sanitation, root canals were prepared for prefabricated composite posts and crown reconstructions were performed with the Finger Tip Technique by using composite resin materials. The advantage of this kind of reconstruction is preservation of the hard dental crown tissue removed in case of prosthetic therapy, especially in younger patients. Reconstruction can be finished in one visit, without the need for a dental technician and laboratory. [source]

Change in supporting tissue following loss of a permanent maxillary incisor in children

DENTAL TRAUMATOLOGY, Issue 6 2007
Helen D. Rodd
Abstract,,, Alveolar bone resorption is an inevitable consequence of tooth loss and may be detrimental to long-term dental aesthetics and function. The aim of the present study was to quantify the degree of tissue resorption following the loss of a permanent incisor in a young population. The study group comprised 11 boys and five girls who all required the extraction of a permanent maxillary central incisor due to trauma-related sequelae. Mean age at tooth loss was 10.8 years. Upper alginate impressions were taken at regular intervals following tooth loss and were cast in yellow dental stone. Study models were sectioned longitudinally through the mid-point of both the maxillary incisor socket and the contra-lateral incisor to provide a thin plaster section. Digital photographs were acquired of the edentulous (A1) and dentate (A2) surfaces of this section and image analysis software was employed to quantify the surface area of both A1 and A2. At 3 months postextraction, mean A1 was 15.7% less than mean A2. By 6 months mean A1 had further reduced and was 25.3% less than that of the corresponding dentate alveolus. However, at subsequent time intervals following tooth extraction (>6 months), tissue loss appeared to stabilise with an overall reduction in tissue area remaining at 22%. This reduction in supporting tissue area was found to be highly statistically significant (P = 0.002, anova). Furthermore, girls appeared to have an overall greater degree of tissue loss than boys (P = 0.015). Further research is indicated to explore factors influencing the degree of tissue loss following incisor extraction and the benefit of therapeutic interventions in limiting this resorption. [source]

Surgical extrusion of a crown-root fractured immature permanent incisor: 36 month follow-up

DENTAL TRAUMATOLOGY, Issue 6 2007
Zuhal K
Abstract,,, Crown-root fracture is defined as a fracture involving enamel, dentin and pulp and can be classified as either complicated or uncomplicated. The tooth with crown-root fracture presents a lot of problems during coronal restorations and extraction was formerly used in many cases. But loss of a permanent incisor in a young patient may create severe emotional problems and alternative treatment approaches must be considered. This report presents the successful results of a surgical extrusion of a complicated crown-root fractured, immature permanent incisor in a 9-year-old boy. Examination 36 months after the trauma indicated that the treatment had provided functional and esthetic results. [source]

Replantation after extended dry storage of avulsed permanent incisors: report of a case

DENTAL TRAUMATOLOGY, Issue 4 2007
Funda Kont Cobankara
Abstract,,, A 15-year-old boy lost his maxillary right and left central incisor teeth in a bicycle accident. He was referred to our clinic 1 week after the injury. The crown-root integrities of both the teeth were not damaged. Although the teeth were stored under dry conditions for 1 week, reimplantation of the teeth was planned to retain the teeth in the mouth for as long a period as possible because of the patient's age. Following the debridement and sterilization of root surfaces in 2.5% NaOCl, root canals were prepared and filled with calcium hydroxide. Then, about 2 mm of the apexes were resected to ensure that the roots easily seated in the alveolar socket and the prepared cavities in root ends were obturated with the amalgam. The teeth were placed into their respective sockets and splinted temporarily. The root canal therapy was completed 5 weeks later. Ankylosis was observed radiographically after 10 months. The patient is now 23 years old and he is still able to use both the central incisors functionally. However, there is a pink appearance on the cervical buccal surface of left central incisor because of progressive replacement resorption. In this case, the new treatment plan is to perform a permanent restoration with dental implants following the extraction of both teeth. Even though the long-term prognosis is uncertain, this treatment technique has provided an advantage for the patient in his adolescent period by maintaining the height of alveolar bone and making the provision of an aesthetically acceptable permanent restoration at a later age possible. [source]

Reattachment of subgingivally fractured central incisor with an open apex

DENTAL TRAUMATOLOGY, Issue 3 2007
Ece Eden
Abstract,,, A case report of a 6-year-old girl with a fractured maxillary left central incisor with an open apex is presented. The procedure used to repair the fracture included flap surgery with an intrasulcular incision and endodontic treatment. The patient was called for 3 months regular follow-up to check the root formation. At the end of 32 months just before the root was obturated by guttaperka, she fractured the same tooth. Flap surgery was repeated and the tooth was restored. The root canal was obturated with a root filling paste and guttaperka as the apex was closed. Examination 10 months after treatment revealed good periodontal health, aesthetics and normal function. [source]

Severe periodontal damage by an ultrasonic endodontic device: a case report

DENTAL TRAUMATOLOGY, Issue 2 2007
John D. Walters
Abstract,,, Heat produced within a root canal during use of an ultrasonic instrument can be conducted through the dentin into periodontal ligament, bone and soft tissue. If severe in intensity or long in duration, it can induce damage to these tissues. This report describes a case in which an ultrasonic endodontic instrument apparently induced severe damage to alveolar bone, gingiva and nasal mucosa in a 42-year-old female. Overheating of a maxillary central incisor caused necrosis of soft tissue and bone on the facial and mesial aspects and triggered a protracted inflammatory response in the adjacent nasal cavity. To relieve the severe discomfort associated with this damage, the patient chose to have her maxillary incisors extracted and replaced by a removable partial denture. A defect in the soft tissue and bone was present at a follow-up visit 10 months after the extractions. While morbidity of this nature is rare, this case reinforces the need to maintain adequate cooling of ultrasonic instruments. [source]

Multidisciplinary treatment approach for crown fracture and crown-root fracture , a case report

DENTAL TRAUMATOLOGY, Issue 1 2007
Wilson Roberto Poi
Abstract,,, The increased incidence of traumatic injuries to anterior teeth is a consequence of leisure activities, where the most common injuries are crown fractures. Treatment of the dental trauma is complex and requires a comprehensive and accurate diagnostic and treatment plan. It is also important to consider the biological, functional, esthetic and economic aspects, as well as the patient's desire. The purpose of this article is to report a case that shows the multidisciplinary approach required to successfully manage the rehabilitation of a maxillary central incisor with a complex crown fracture and a maxillary lateral incisor, that at first presented an oblique crown-root fracture, and after the orthodontic extrusion, suffered a more apical new crown-root fracture. [source]

Immediate surgical repositioning following intrusive luxation: a case report and review of the literature

DENTAL TRAUMATOLOGY, Issue 6 2006
H. Cem Güngör
Abstract,,, This report presents a case of severe intrusive luxation of mature maxillary lateral incisor in a 10-year-old boy. The intruded tooth was immediately repositioned (surgical extrusion) and splinted within 2 h following injury. Tetracycline therapy was initiated at the time of repositioning and maintained for 10 days. Pulp removal and calcium hydroxide treatment of the root canal was carried out after repositioning. Splint was removed 1 month later. Definitive root canal treatment with gutta percha was accomplished at the second month recall. Clinical and radiographic examination 28 months after the surgical extrusion revealed satisfactory apical and periodontal healing. [source]

Long-term effect of different treatment modalities for traumatized primary incisors presenting dark coronal discoloration with no other signs of injury

DENTAL TRAUMATOLOGY, Issue 1 2006
Gideon Holan
Abstract,,, The aim was to compare the long-term outcomes of root canal treatment with that of follow-up-only in traumatized primary incisors in which dark discoloration is the only sign of injury. Root canal treatment was performed in 48 dark discolored asymptomatic primary incisors following trauma. Twenty-five of them [root canal treatment (RCT) group] were followed till eruption of their permanent successors. Ninety-seven dark discolored asymptomatic primary incisors were left untreated and invited for periodic clinical and radiographic examination. Of these, 28 [follow-up (FU) group] were followed till eruption of their permanent successors. The parameters examined included early extraction of the traumatized primary incisor, early or delayed eruption of the permanent successors, ectopic eruption of the permanent successor and signs of enamel hypopcalcification or hypoplasia in the permanent successor. Chi-square test was used for statistical analysis. Seven of 25 (28%) of the RCT group and 32% (nine of 28) of the FU group required early extraction. Five of 25 (20%) of the RCT group and 21% (six of 28) of the FU group showed early or delayed eruption of the permanent successors. Sixteen of 25 (64%) of the RCT group and 79% (22 of 28) of the FU group showed ectopic eruption of the permanent successors. Enamel hypopcalcification or hypoplasia in the permanent successors was equally found (36%) in both groups (nine of 25 in the RCT group and 10 of 28 in the FU group). None of differences was statistically significant. Root canal treatment of primary incisors that had change their color into a dark-gray hue following trauma with no other clinical or radiographic symptom is not necessary as it does not result in better outcomes in the primary teeth and their permanent successors. [source]

Odontoma-like malformation in a permanent maxillary central incisor subsequent to trauma to the incisor predecessor

DENTAL TRAUMATOLOGY, Issue 5 2005
Paulo Nelson-Filho
Abstract,,, This report describes a case of a patient (1 year and 8 months old) with traumatic avulsion of the maxillary right primary central incisor and morphological changes in the germ of the permanent successor. One year after the trauma, an odontoma-like malformation developed. This malformation was removed 6 years after trauma and orthodontic treatment was started. Clinical follow-up and periodic radiographs are necessary after traumatic avulsion of primary teeth to monitor possible sequelae in the permanent successor. An odontoma-like malformation requires a multidisciplinary approach. [source]

Orthodontic extrusion of subgingivally fractured incisor before restoration.

DENTAL TRAUMATOLOGY, Issue 3 2005
A case report: 3-years follow-up
Abstract,,, Orthodontic forced eruption may be a suitable approach without risking the esthetic appearance in tooth fracture below the gingival attachment or alveolar bone crest. Extrusion of such teeth allows elevating the fracture line above the epithelial attachment and so the proper finishing margins can be prepared. Restoration after orthodontic eruption may present a more conservative treatment choice in young patients compared with the prosthetic restoration after extraction. This case describes a multidisciplinary approach using the orthodontic forced eruption facilitating the composite restoration of a fractured upper permanent central incisor. [source]

Prevalence of crown fractures in 8,10 years old schoolchildren in Canoas, Brazil

DENTAL TRAUMATOLOGY, Issue 5 2004
Maximiano Ferreira Tovo
Abstract,,, The objective of this work was to evaluate the prevalence of children with crown fractures in permanent anterior teeth in 206 schoolchildren (104 girls and 102 boys) between the ages of 8 and 10 years, enrolled in three public schools in the city of Canoas, Brazil. The prevalence found was 17% with no significant difference between boys and girls, as well as between the ages. The most affected tooth was the maxillary central incisor, and a majority of the children showed only one affected tooth (88.6%). The types of fracture most commonly found were oblique and horizontal, and the portions of dental structures most affected were ,enamel only' and ,enamel and dentin'. Only seven children (20%) sought out dental treatment. [source]