Cases reported "Dental Pulp Diseases"

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1/17. Reattachment of a subgingivally fractured central incisor tooth fragment: report of a case.

    A case report of a 9-year-old boy with a fractured maxillary right incisor and ulcerated pulp at the fracture line is presented. On satisfactory completion of a root canal filling one week later, the access cavity was restored with glass ionomer cement. The fragment was reattached by a light activated hybrid composite during the flap surgery. tetracycline hydrochloride was applied on open root surface for a better healing.
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2/17. Endo-Antral syndrome and various endodontic complications.

    The purpose of this paper was to examine the varied impact of the pathological spread of dental sepsis into the adjacent maxillary sinus. This complex of tissue destruction is called Endo-Antral syndrome; the usual radiographic diagnostic features are identified in the paper. The four different cases presented serve to illuminate a few of the many diagnostic and treatment challenges involved. Emphasis is placed on the utilization of a keen sense of wariness when endodontically treating maxillary posterior teeth whose apexes are close to the sinus. Dental examination should include an appraisal of antral health prior to root canal therapy to best plan treatment and to establish a base line against which to judge subsequent developments.
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3/17. Pulp canal obliteration in an unerupted permanent incisor following trauma to its primary predecessor: a case report.

    Trauma to a primary tooth may result in damage to the underlying developing permanent tooth bud because of the close proximity between the root of the primary tooth and its permanent successor. We report an unusual case where injury to the primary dentition resulted in pulp canal obliteration (PCO) of a permanent maxillary central incisor prior to its eruption. The other permanent maxillary central incisor was diagnosed as malformed because of trauma to the primary dentition at an earlier age. The occurrences of PCO or crown malformation dose not routinely disrupt the eruption of those teeth. Periodic assessment is required to determine the need for endodontic intervention.
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4/17. Cavitational bone defect: a diagnostic challenge.

    A patient with a history of trauma to the maxillary left anterior region presented with chronic pain of unknown etiology. root canal therapy and periradicular surgery failed to resolve the persistent pain. A second surgical procedure revealed a bone cavity superior and distopalatally to the apex of the maxillary left lateral incisor. The suspected etiology was necrotic bone removed from the bone cavity.
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5/17. Two root canals in a maxillary central incisor with enamel hypoplasia.

    Presented is a case of enamel hypoplasia of a maxillary central incisor which was referred for endodontic therapy. Radiographical examination revealed a tooth having one root and two canals. Endodontic therapy was performed under aseptic conditions.
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6/17. Acute pulpal-alveolar cellulitis syndrome. V. Apical closure of immature teeth by infection control: the importance of an endodontic seal with therapeutic factors. Part 2.

    During orthodontic treatment to promote eruption of maxillary and mandibular second bicuspids, a young male patient had a severe endodontic cellulitis of a mandibular bicuspid. Apexogenesis and resolution of the periapical lesion was achieved by infection control with nonspecific intracanal medication without calcium hydroxide, as stated by Das. A mild periodontal cellulitis occurred shortly thereafter and rapidly resolved. A second endodontic cellulitis, after apexogenesis without an endodontic seal, occurred shortly after completion of orthodontic treatment. This also quickly resolved, and the canal was effectively sealed. This case indicates the importance of an effective endodontic seal shortly after apexogenesis is induced by infection control. This report and others on the subject indicate that apexogenesis of nonvital permanent immature teeth by infection control is a predictable endodontic treatment procedure.
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7/17. Thermally induced pulpalgia in endodontically treated teeth.

    Two cases of thermally induced pulpalgia in teeth previously endodontically treated are presented. reproduction of the patient's chief complaint was the key to identifying the teeth involved. In both cases, the pulpalgia was stimulated by heat. After locating and treating an unfilled canal, the teeth have remained asymptomatic. Possible explanations for this occurrence are discussed.
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8/17. Acute pulpal-alveolar cellulitis syndrome V. Apical closure of immature teeth by infection control: case report and a possible microbial-immunologic etiology. Part 1.

    Das with Matusow and Goodall previously noted the rapid clinical apexogenesis of nonvital immature permanent teeth that are involved with an acute endodontic cellulitis. This apexogenesis was achieved by control of infection and by nonspecific intracanal medication without the use of calcium hydroxide. The case report confirms the clinical observations. The experimental canine endodontic cellulitis in a cebus primate was induced as an immunologic pulp infection with a facultative streptococcus species. The noted epithelial proliferation and organization into lacelike strands and bilaminar loops, similar to Hertwig's epithelial root sheath in root development, appear to be immunologic and genetic in origin, with an acceleration of the root maturation process.
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9/17. Failure of endodontic treatment due to a palatal gingival groove in a maxillary lateral incisor with talon cusp and two root canals.

    A case is presented in which endodontic treatment of a maxillary lateral incisor with a talon cusp and two root canals failed following a mistaken diagnosis. What was first diagnosed as an endodontic lesion was, in all probability, a primary periodontal lesion caused by the advance of bacteria from the gingival crevice to the apex along the radicular groove between the main tooth and the talon cusp.
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10/17. Case of mistaken identity: periapical cemental dysplasia in an endodontically treated tooth.

    A case of a patient with a history of root canal treatment and re-treatment and a persistent periapical radiolucency is reviewed. Following surgery, biopsy material was submitted and diagnosed as periapical cemental dysplasia (PCD). With careful diagnosis, PCD should be readily differentiated from endodontic pathosis, thus avoiding unnecessary root canal treatment. In this case, surgery was necessary to rule out other inflammatory disease or benign odontogenic entities.
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