scholarly journals Non-Vital Root Submergence for Preservation of Socket in an Adolescent - A Rare Case Report

2021 ◽  
Vol 10 (19) ◽  
pp. 1448-1450
Author(s):  
Neeta S. Padmawar ◽  
Rachita G. Mustilwar ◽  
Viddyasagar P. Mopagar ◽  
Sourabh R. Joshi ◽  
Vinay H. Vadvadgi ◽  
...  
Keyword(s):  
Bone Loss ◽  
Alveolar Bone ◽  
Treatment Plan ◽  
Treatment Options ◽  
Dental Trauma ◽  
Fracture Line ◽  
Mixed Dentition ◽  
Permanent Teeth ◽  
Root Fracture ◽  
Crown Root

Complex crown root fracture has been reported to be 5 % among the traumatic injuries to permanent teeth. In children, when fracture line extended sub gingivally, the treatment option remained was the extraction of tooth. This extraction led to alveolar bone loss and compromised the outcome of final prosthesis. Root submergence is one of the treatments options which can prevent bone loss and prepare future pontic site in a better way. In children, this technique can prevent not only bone loss but also the occurrence of space loss and development of tongue thrusting habit. Crown-root fracture is defined as a fracture involving enamel, dentin and cementum. It is reported in about 5 % of dental trauma to young children where root completion has not occurred.1 Treatment of these complex tooth fractures in aesthetic zone in growing age is always challenging for the paedodontists. The treatment should not interfere with the growth and development. Depending upon the extension of the fracture line which can result in exposure of the pulpal tissue, the crown-root fracture can be divided into two groups: complicated and uncomplicated. 2 Treatment options in cases of complicated crownroot fractures are complex, and require a multidisciplinary approach. Dental traumatology guideline and American Academy of Paediatric Dentistry has suggested fragment reattachment, orthodontic or surgical extrusion of apical portion followed by post placement, root submergence and extraction. 3 Factors like extension and direction of fracture line, pulpal involvement, tooth maturity and the length of root remaining in the alveolus govern the treatment choice. 4,5 Among above mentioned factors, position of facture line is the most important. As in case of subgingival facture line, risk of bacterial contamination is present and further this may result in gingival inflammation.6 When crown root fracture to permanent tooth occurs in mixed dentition period, goals of treatment are to preserve the tooth in arch without disturbing the growth & development of root and arch. But in case of complicated crown root fracture, when extraction is the only choice of treatment, future complications like space loss, crowding, habits like tongue thrusting and importantly loss of alveolar bone height should be kept in mind. Goals of treatment plan in such cases should be elimination of space loss, development of deleterious habit and maintenance of alveolar ridge for future pontic or implant site. Root submergence is the technique with which we can achieve these goals, keeping this in mind this case was planned and reported.

Dental Injuries and Management

2019 ◽  
Vol 35 (06) ◽  
pp. 607-613 ◽  
Author(s):  
Likith V. Reddy ◽  
Ritesh Bhattacharjee ◽  
Emily Misch ◽  
Mofiyinfolu Sokoya ◽  
Yadranko Ducic
Keyword(s):  
Clinical Examination ◽  
Alveolar Bone ◽  
Dental Trauma ◽  
Mixed Dentition ◽  
Permanent Teeth ◽  
Radiographic Evaluation ◽  
Hard Tissue ◽  
Tissue Injuries ◽  
Dental Injuries ◽  
Type Of Injury

AbstractTraumatic dental injuries affect 1 to 3% of the population, and disproportionately affect children and adolescents. The management of these injuries incorporates the age of patients, as children between 6 and 13 years of age have a mixed dentition. This helps to preserve the vitality of teeth that may be salvaged after a traumatic event. The clinical examination of these cases involves a thorough examination of the maxilla and mandible for associated fractures and any lodged debris and dislodged teeth or tooth fragments. The objective is to rule out any accidental aspiration or displacement into the nose, sinuses, or soft tissue. After ruling out any complications, the focus is on determining the type of injury to the tooth or teeth involved. These include clinical examination for any color change in the teeth, mobility testing, and testing for pulp vitality. Radiographic evaluation using periapical, occlusal, panoramic radiographs, and cone beam computed tomography is performed to view the effect of trauma on the tooth, root, periodontal ligament, and adjoining bone. The most commonly used classification system for dental trauma is Andreasen's classification and is applied to both deciduous and permanent teeth. Managing dental trauma is based on the type of injury, such as hard tissue and pulp injuries, injuries to periodontal tissue, injuries of the supporting bone, and injuries of the gingiva and oral mucosa. Hard-tissue injuries without the involvement of the pulp typically require restoration only. Any pulp involvement may require endodontic treatment. Fractures involving the alveolar bone or luxation of the tooth require stabilization which is typically achieved with flexible splints. The most common procedures employed in managing dental injuries include root canal/endodontics, surgical tooth repositioning, and flexible splinting. Recognition and treatment of these injuries are necessary to facilitate proper healing and salvage of a patient's natural dentition, reducing future complications to patients.

Management of trauma to the anterior segment of the maxilla: alveolar fracture and primary incisors crown and root fracture

2021 ◽  
Vol 33 (2) ◽  
pp. 16-20
Author(s):  
Muna S Khalaf ◽  
Bayan S Khalaf ◽  
Shorouq M Abass
Keyword(s):  
Soft Tissue ◽  
Primary Teeth ◽  
Alveolar Bone ◽  
Anterior Segment ◽  
Dental Trauma ◽  
Permanent Tooth ◽  
Permanent Teeth ◽  
Normal Position ◽  
Anterior Teeth ◽  
The Impact

Background: An injury to both the primary and permanent teeth and the supporting structures is one of the most common dental problems seen in children. Splinting is usually difficult or impossible to perform in the primary dentition (due to diminutive room size and lack of patient cooperation). Healing must, therefore, occur despite mobility at the fracture line, usually resulting in interposition of connective tissue. In some instances, infection will occur in the coronal pulp. The present study reported a case of trauma to the anterior primary teeth and alveolar bone in a four year old child. The trauma has caused fracture to the crowns and roots of the primary anterior teeth. The following case was managed in a procedure that may provide primary teeth subjected to trauma a better chance than extraction with a better prognosis. Case presentation: a 4 and a half year old child was subjected to trauma in anterior segment of maxilla. Suturing of the torn soft tissue was the first step followed by pulpotomy for the left primary lateral incisor. Fixation of the right primary central and lateral incisors was done by acid etch wire fixation. Both clinical and radiographic follow up was carried out for 6.4 years. Results: healing of the soft tissue was observed after one week and completed after two months. Fixation of the teeth continued for ten months. The fracture lines in the roots remained in position. Clinically there was no sign of any pulpal inflammation or necrosis. Radiographically, no signs of infection to the surrounding tissues could be seen, no resorption in the alveolar bone, external or internal resorption of the root did not happen also. After ten months fixation ended and the wire was removed. At that time there was normal resorption of the roots of the primary incisors in relation with the normal development of the permanent incisors. After 3 years both permanent central incisors erupted in their normal position. After 6.4 years all four permanent incisors erupted into occlusion in their normal position. Conclusion: primary teeth with root fractures and severely mobile coronal fragments can be treated by a conservative approach. The severity of the sequels is directly related to the degree of permanent tooth formation (child’s age), type of dental trauma and extent of the impact. Key words: trauma, primary incisors, fractured crown and root

scholarly journals Prevalence of Traumatic Dental Injuries in Patients Attending University of Alberta Emergency Clinic

2016 ◽  
Vol 10 (1) ◽  
pp. 315-321 ◽  
Author(s):  
Thamer Alkhadra ◽  
William Preshing ◽  
Tarek El-Bialy
Keyword(s):  
Alveolar Bone ◽  
Dental Trauma ◽  
Class Iii ◽  
Root Fracture ◽  
University Of Alberta ◽  
Number Of Patients ◽  
Dentoalveolar Trauma ◽  
Traumatic Dental Injuries ◽  
The University ◽  
Dental Injuries

Objectives:This study evaluated the prevalence of dental trauma for patients attending the emergency dental clinic at the University of Alberta Hospital between 2006-2009. Patients’ examination and treatment charts were reviewed.Methods:Total number of patients’ charts was 1893.The prevalence of different types of trauma was 6.4 % of the total cases (117 patients). Trauma cases were identified according to Ellis classification and as modified by Hollandet al.,1988.Results:Logistic statistical model showed that 21.7% were Ellis class I trauma, 16.7% were Ellis class II trauma, and 6.7% were Ellis class III. In addition, 11.7 % presented with avulsion, 7.5 % presented with dentoalveolar fracture and 7.5% presented with sublaxation. Also, 17.55 % presented with tooth displacement within the alveolar bone, 3.3 % presented with crown fracture with no pulp involvement, 4.16 % presented with crown fracture with pulp involvement and 3.3 % presented with root fracture. In conclusion, the general prevalence of dentoalveolar trauma in patients attending the emergency clinic at the University of Alberta is less than other reported percentages in Canada or other countries.

scholarly journals Esthetic Rehabilitation of a Fractured Permanent Maxillary Central Incisor by Reattachment

2016 ◽  
Vol 6 (1) ◽  
pp. 52-56
Keyword(s):  
Case Report ◽  
Surface Texture ◽  
Simple Procedure ◽  
Dental Trauma ◽  
Central Incisor ◽  
Fiber Post ◽  
Root Fracture ◽  
Maxillary Central Incisor ◽  
Crown Root ◽  
Anterior Teeth

ABSTRACT Crown fractures of the anterior teeth are a common form of dental trauma mainly affecting children and adolescents. One of the options for managing crown fractures is the reattachment of the fractured fragment when the tooth fragment is available with minimal or no violation of the biological width. Reattachment of fractured fragments can provide good esthetics, as it maintains the tooth's original anatomic form, color, and surface texture. It also restores function and is a relatively simple procedure. This case report deals with the esthetic management of a crown-root fracture that was successfully treated with endodontic treatment followed by reattachment of fractured fragment with fiber post. How to cite this article Shaikh SAH, Shenoy VU, Sumanthini MV, Pawar RB. Esthetic Rehabilitation of a Fractured Permanent Maxillary Central Incisor by Reattachment. J Contemp Dent 2016;6(1):52-56.

scholarly journals Orthodontic Forced Eruption of Permanent Anterior Teeth with Subgingival Fractures: A Systematic Review

2021 ◽  
Vol 18 (23) ◽  
pp. 12580
Author(s):  
Elisabeth Reichardt ◽  
Ralf Krug ◽  
Michael M. Bornstein ◽  
Jürgen Tomasch ◽  
Carlalberta Verna ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Alveolar Bone ◽  
Root Resorption ◽  
Statistical Significance ◽  
Case Series ◽  
Dental Trauma ◽  
Permanent Teeth ◽  
Cochrane Library ◽  
Anterior Teeth ◽  
Forced Eruption

(1) Background: To assess orthodontic forced eruption (OFE) as a pre-restorative procedure for non-restorable permanent teeth with subgingival dental hard tissue defects after dental trauma. (2) Methods: A systematic electronic search of three databases, namely, MEDLINE, Cochrane Library, and EMBASE, revealed a total of 2757 eligible publications. Randomized controlled clinical trials (RCT), retro- and prospective clinical studies, or case series (with a minimum of three patients) were reviewed. (3) Results: Thirteen full-text papers were included: one RCT, one prospective clinical trial, two retrospective cohort studies, and nine case series. Within case series, statistical significance between age and cause of fracture (p < 0.03) was determined. The mean extrusion rate of OFE was 1.5 mm a week within a four to six weeks treatment period followed by retention. Three OFE protocols for maxillary single teeth are available: 1. OFE without migration of gingiva and alveolar bone, 2. OFE with gingival migration and slight alveolar bone migration, and 3. OFE with migration of both gingiva and alveolar bone. (4) Conclusions: The current state of the evidence suggests that OFE is a feasible pre-treatment option for non-restorable permanent teeth. OFE can promote the migration of tooth surrounding hard and soft tissues in the esthetic zone. Root resorption does not seem to be a relevant side effect of OFE.

scholarly journals Assessment of the capacity of future Dentists to elaborate treatment plans for dental trauma

2020 ◽  
Vol 9 (8) ◽  
pp. e255985718
Author(s):  
Daniela Atili Brandini ◽  
Denise Pedrini ◽  
Caio Vinicius Lourenço Debortoli ◽  
Luiza Monzoli Côvre ◽  
Marina Fuzette Amaral
Keyword(s):  
Treatment Plan ◽  
Dental Trauma ◽  
Great Difficulty ◽  
Cross Sectional ◽  
Adequate Treatment ◽  
Root Fracture ◽  
Occlusal Adjustment ◽  
Treatment Plans ◽  
Dentoalveolar Trauma ◽  
Systemic Condition

The prognosis of dental trauma depends on professionals with solid and updated knowledge. The objective was to evaluate the ability of undergraduate dentistry students to develop treatment plans for dental trauma. This cross-sectional, observational, quantitative  study had a sample of 242 participants. A clinical case involving avulsion of tooth 11 and complex coronary root fracture of tooth 21 was selected. All data relating to the patient's exams were added to a clinical record, which was delivered to students in the final year of the undergraduate dentistry course for three years consecutive. The students were instructed to develop a treatment plan for this case. The factors most considered in avulsion treatment plans were: how, when and where the trauma occurred, the patient's age and systemic condition. Of the students, 39.7% developed an adequate treatment plan, the main mistake being the lack of occlusal adjustment. In addition, 9,9% of students had an adequate treatment plan for coronary artery fracture. The recovery of periodontal biological space and the indication of intraradicular retainers were the main difficulties. It is concluded that undergraduate dentistry students had great difficulty in formulating treatment plans suitable for more severe cases of dentoalveolar trauma involving several specialties.

scholarly journals Are Panoramic Radiographs Reliable to Diagnose Mild Alveolar Bone Resorption?

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Larissa Semenoff ◽  
Tereza Aparecida Delle Semenoff ◽  
Fabio Luiz Miranda Pedro ◽  
Evaristo Ricci Volpato ◽  
Maria Aparecida de Andrade Moreira Machado ◽  
...  
Keyword(s):  
Bone Resorption ◽  
Bone Loss ◽  
Alveolar Bone ◽  
Treatment Plan ◽  
Dental Practice ◽  
Research Protocol ◽  
Inclusion Criteria ◽  
Panoramic Radiographs ◽  
Significant Difference ◽  
Minimum Distortion

It is extremely important to assess variations between the most used radiographs in dental practice, since minimum distortion on obtained images may change diagnosis, treatment plan, and prognosis for the patient. For this, the distance between the enamel-cementum junction and the alveolar bone crest was measured on conventional and digitized periapical, bitewing, and panoramic radiographs and compared among them. From a total of 1484 records, 39 sets of radiographs that fulfilled the inclusion criteria of the study sample were selected. The measurements were grouped according to the intensity of bone loss. Statistically significant difference was found in the averages of the measurements assessed in radiographs with absence of bone loss between conventional panoramic and periapical radiographs, between digitized panoramic and periapical radiographs and between digitized bitewing and panoramic radiographs. By analyzing the results of this work and considering the research protocol used, one can conclude that small losses in height of alveolar bone crest observed in panoramic radiographs should be cautiously evaluated, as they may be overestimated.

scholarly journals RESECTION AND REGENERATION- A HOPE FOR THE HOPELESS

2020 ◽  
pp. 1-5
Author(s):  
Apeksha Annigeri B. ◽  
Rajiv Nidasale Puttaswamaiah ◽  
Avinash Janaki Lingaraju
Keyword(s):  
Alveolar Bone ◽  
Treatment Plan ◽  
Treatment Options ◽  
Case Series ◽  
Cost Effective ◽  
Ridge Preservation ◽  
Tooth Structure ◽  
Implant Placement ◽  
Long Term Prognosis

Preservation of tooth structure has always been the prime aim of dental practice. Teeth with advanced periodontal disease in multirooted teeth often pose a significant challenge to the clinician, complicating the treatment plan and compromising long term prognosis. The outcome of the treatment is determined by proper case selection and surgical, endodontic and prosthetic parameters. Resective and regenerative osseous procedures are often employed to help preserve the tooth structure, alveolar bone involving the retained root of multirooted teeth and are cost effective over the other treatment options like ridge preservation/augmentation followed by implant placement. This case series describes application of resective and regenerative techniques for molars with extensive combined periodontal-endodontic disease.

scholarly journals Spinal Cord Injury Induced Osteoporosis: Case Report and Current Literature

2021 ◽  
Vol 9 (2) ◽  
pp. 155-159
Author(s):  
Abdulai Bangura ◽  
Thomas Shuler ◽  
Lisa Wright ◽  
Anne Lake
Keyword(s):  
Bone Mineral Density ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Bone Loss ◽  
Bone Mineral ◽  
Treatment Plan ◽  
Treatment Options ◽  
Definitive Treatment ◽  
Mineral Density ◽  
Cord Injury

Background: Among the various etiologies of osteoporosis, spinal cord injury has a drastic progression of the disease, causing weekly bone loss. There is no definitive treatment for the prevention of osteoporosis in these individuals. This review illustrates the recent findings on the pathophysiology, treatment, and management of spinal cord injury-induced osteoporosis. Furthermore, we cover a case of a male patient who experienced severe bone loss after a spinal cord injury at the age of 21 years. The Case: We have a 57-year-old man with a history of AIS grade A spinal cord injury, level T11 with rod fixation from a motorcycle collision at age 21. His fracture history following the injury includes tibia, femur, and vertebral fractures. Bone mineral density imaging revealed notable T-scores ranging from -3.1 to -3.4 at the hip and femurs. Treatment plan consisted of teriparatide, dietary supplements, and physical therapy. Biomarkers from baseline to post one month of treatment revealed the following: procollagen type 1 N-terminal propeptide from 38 mcg/L to 70 mcg/L and C-terminal telopeptide from 209 pg/mL to 88 pg/mL, representing an increased bone formation and decreased bone resorption, respectively. After two years, bone mineral density T-scores improved to -2.7 on the left and the patient was capable of standing for the first time with the assistance of a standing frame. Conclusion: Our case exemplified the progression of the disease and treatment options. A basis for the derivation of future innovative therapies has been covered. Favorable treatments and management are described in the review.

scholarly journals Oral rehabilitation in mixed dentition: the challenge of replacing permanent teeth

2017 ◽  
Vol 5 (1) ◽  
pp. 2
Author(s):  
Flavio Warol ◽  
Iony Lopes Bispo ◽  
Rodolfo Carvalho Oliveira ◽  
Roberta Barcelos ◽  
Angela Scarparo
Keyword(s):  
Treatment Plan ◽  
Health Condition ◽  
Functional Restoration ◽  
Mixed Dentition ◽  
Permanent Teeth ◽  
Radiographic Examination ◽  
Oral Rehabilitation ◽  
Normal Occlusion ◽  
Chronological Sequence

Aim: To present the report of a female patient, 10 years old, referred for treatment in the Dentistry Clinic of a Brazilian public university.Case report: The patient's oral health condition was unfavorable with biofilm accumulation, pain report and chewing difficulty. After anamnesis, clinical and radiographic examination, the treatment plan included removal of infectious foci (54, 55, 64, 65, 74, 75, 85, 16, 36 and 46) followed by prosthetic rehabilitation. At this stage, the functional restoration of the lower arch was restricted by the imminent eruption of the premolars. In the upper arch, the maintenance of the mesio-distal diameters aims to guarantee the chronological sequence of successors irruption and establishment of normal occlusion. During the monthly follow-up consultations the patient presents a more spontaneous smile, although she still needs constant reinforcement in oral hygiene habits.Conclusions: The rehabilitation of patients with loss of permanent teeth during the mixed dentition phase should consider the peculiarities of this period for the restoration of health without altering the normal pattern of occlusal development.

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