41/87. Dentoalveolar trauma in a patient with chronic idiopathic thrombocytopenic purpura: a case report. A case is presented of a 13-year-old boy with chronic idiopathic thrombocytopenic purpura (ITP) who sustained traumatic labial luxation of both lower central incisors, with partial alveolar fracture resulting in displacement of the labial alveolar plate. Intravenous immunoglobulin (Fleibogamma, 1 g/kg body weight x 2 days) was administered, resulting in the patient's platelet count rising from 15,000/mm3 to 70,000/mm3. Under general anesthesia, the displaced lower labial alveolus and luxated teeth were repositioned and splinted 2 days following trauma. Healing was uneventful. Subsequently, both lower central incisors became nonvital and were endodontically treated. The dental treatment of this patient with ITP is discussed in terms of emergency management, and subsequent care. ( info) |
42/87. Mandibular endodontic-related paresthesia. A 57-year-old woman sought treatment for mandibular swelling (of two weeks duration), pain, and paresthesia in the region of the left canine and first premolar. The teeth had undergone endodontic therapy; in addition, they partially supported a long-span fixed partial denture. The patient was concerned about the possibility of a serious neoplastic condition. The initial panoramic radiograph demonstrated a large periapical pathology area associated with the first premolar. Eventually, both the canine and first premolar teeth were retreated, although the paresthesia did not resolve for approximately four months. A brief review of endodontic-associated paresthesia is provided, along with a description of the therapy and postoperative radiographs taken 20 months later. ( info) |
43/87. Periodontal-endodontic interdisciplinary treatment--a case report. Periodontal-endodontic lesions pose a difficult diagnostic and therapeutic challenge to the dental practitioner. A careful diagnostic examination consisting of a thorough patient and dental history, comprehensive clinical examination, and use of appropriate dental radiographs is necessary to arrive at a proper diagnosis of the periodontal-endodontic lesion. Despite these measures, it is not always possible to make an accurate diagnosis, which is imperative to provide the proper therapy in the correct treatment sequence. In some instances, endodontic or periodontal therapy alone may suffice; however, in other instances, a combination of endodontic and periodontal therapy may be required to successfully treat the case. In this article, classifications of periodontal-endodontic lesions are discussed, including the appropriate treatment and correct treatment sequence for each classification. prognosis of periodontal-endodontic lesions depends on the diagnosis, treatment, and chronicity of the lesion, as well as the duration of periodontal involvement. A clinical case is presented in which a periodontal endodontic lesion has been successfully treated with a combination of conventional endodontic therapy and regenerative periodontal surgery. ( info) |
44/87. Treatment selection for anterior endodontically involved teeth. Innovations in material science and clinical techniques have expanded the number of treatment options available for nonvital anterior teeth. These options include the use of composite to fill the access opening with no additional treatment, crown placement, orthodontic extrusion, crown lengthening with or without orthodontic extrusion, dowel restorations with crown placement, and fixed bridge or implant therapy when extraction is necessary. Clinicians need to understand the benefits and limitations of each option in order to provide their patients with optimum function and aesthetics. Using case presentations, this article describes predictable approaches for the diagnosis, treatment planning, and restoration or replacement of endodontically treated teeth in the anterior region. ( info) |
45/87. role of occlusion in endodontic management: report of two cases. The two clinical cases reported demonstrate that traumatic occlusion can play a role in the initiation and progression of pulp and periradicular inflammation. The symptom of persistent pain did not subside after the commencement of endodontic treatment. Traumatic occlusion was identified in both cases to be the main cause and hence occlusal adjustment was performed. This resulted in the gradual resolution of the symptoms. The findings suggest that occlusal trauma is often overlooked in the diagnosis and management of endodontic diseases. ( info) |
46/87. Adhesive fragment reattachment after orthodontic extrusion: a case report. In the treatment of crown fractures, adhesive fragment reattachment provides a good alternative to other restorative techniques, offering several advantages. The present paper reports a case in which the treatment of a cervical crown fracture was accomplished by reattaching the tooth fragment with a flowable resin composite. Orthodontic root extrusion was performed with a modified Hawley appliance prior to fragment reattachment. The clinical and radiographic results after 2.5 years were successful. ( info) |
47/87. Rebuilding core foundations for existing crowns using a custom-made template. This article describes a simple procedure for reproducing the internal contours of existing crowns to rebuild composite core foundations for endodontically treated abutment teeth. In the event of core fracture or recurrent caries under a crown, problems may be encountered when constructing a new dowel and core to retrofit an existing crown to the newly fabricated core. The procedure described in this article involves the use of a custom-made template and plastic foil to fabricate new composite core foundations for existing crowns. ( info) |
48/87. Management of endodontic failures: case selection and treatment modalities. General dentists should realize that endodontic failures can be retreated successfully, avoiding tooth loss. retreatment of endodontic failure and initial root canal therapy share similar biologic principles and treatment objectives. The criteria for successful root canal therapy are important factors that must be understood before teeth are retreated. This article demonstrates three retreatment modalities for managing endodontic failures as an alternative to tooth extraction. ( info) |
49/87. Orthodontic movement of a horizontally fractured tooth: a case report. Intra-alveolar root fractures are relatively uncommon, and sometimes may be healed without treatment. diagnosis of intra-alveolar root fracture is frequently made by exclusion of clinical signs of other traumatic injury, and by radiographic examination with films taken at different tube angulations. This case report presents a horizontal root fractured tooth that was healed satisfactory without treatment and moved orthodontically after prolonged time from trauma. ( info) |
50/87. An intrusion injury as an example of interdisciplinary aspects in dental traumatology: a case report. Traumatic injury to teeth presents a considerable challenge for the practitioner. Very often a variety of oral tissues are involved, such as enamel, dentin, periodontal ligament, alveolar bone, and mucosa. Extraoral lesions are often another focus of attention for the patient and the practitioner. To cover all these various demands and necessities in a proper and adequate manner, a sound knowledge and experience of many different dental fields is needed. This case report presents the treatment of an 8-year-old girl during which surgical, restorative, endodontic, and orthodontic practices cooperated to achieve an adequate rehabilitation of the patient. ( info) |