61/87. Management of the perforations due to miniplate application. Microdimensioned osteosynthesis using miniplates has been common practice in maxillofacial surgery. However, tooth injury during the application of the miniplates have been reported in few papers. In this case, a 32-yr-old female patient, whose two teeth were necrosed because of the perforation during screw insertion was presented. The reason of the perforations during the rigid internal fixation was the lack of radiographic assessment because of the pregnancy. Maxillary right first premolar and maxillary left canine were perforated and necrosed because of the screw insertion. The necrosed teeth were detected 1 yr after the rigid internal fixation. The root canals of nonvital teeth were filed using step-down approach. Cold lateral condensation of gutta-percha was used to fill the canals. Six-month recall visits were scheduled and there was no problem after 2-yr follow-up period. ( info) |
62/87. Bleaching non vital primary teeth: case report. Trauma and pulpal infections in primary dentition are part of the routine of the pediatric dentist. Common consequences in these cases are alterations in dental color, compromising patient's esthetics and his interaction in social environment. Bleaching intends to preserve dental structure already weakened and to show immediate esthetic results. This clinical case shows a bleaching technique in devitalized primary teeth using bleaching agent with 35% hydrogen peroxide activated by photo polymerizer. This technique is simple and shows immediate satisfactory results. ( info) |
63/87. Intentional replantation: a case report. Nonsurgical retreatment and surgical endodontics are not always viable solutions to endodontic disease. Access for retreatment may be limited by posts. Surgical endodontics may be limited by anatomical features including bone thickness and nerve and sinus proximity. Anatomical limitations and complex restorations may prevent implant placement. Intentional replantation is considered by many as a procedure of last resort when nonsurgical or surgical endodontics is contra-indicated. The treatment described demonstrates intentional replantation as a procedure to be considered when endodontic procedures or a dental implant are not possible. ( info) |
64/87. Intentional replantation for a periodontally involved hopeless incisor by using autologous platelet-rich plasma. The aim of the present case is to describe the use of autologous platelet-rich plasma (PRP) in an intentional replantation procedure for a periodontally involved lower right central incisor with 18 months follow-up. Brief information is also given on the preoperative preparation of PRP in the dental office. PRP preparation is a new biotechnology, and the prepared material contains thrombocyte concentrates and high levels of growth factors. This material promotes healing time in a range of various sites. In this case, a tooth with severe periodontal breakdown was treated with PRP with intentional replantation procedure. This tooth was previously treated with root canal treatment and root planing. The tooth was extracted, and was replanted with autologous PRP. Clinical and radiographic follow-up for 18 months demonstrated new bone formation around the apical portion of the root and all clinical parameters indicated a trend of healing. The mobility of this previously grade III mobile incisor returned to normal limits. We speculate that intentional replantation with PRP application may induce wound healing and may induce bone formation. ( info) |
65/87. Removal of separated files from root canals with a new file-removal system: Case reports. There have been many different devices and techniques developed to retrieve instruments fractured during endodontic procedures, but none of them can consistently remove separated instruments from root canals. Iatrogenic accidents such as perforation and canal destruction have been reported during the removal of separated instruments. The file removal process becomes even more difficult when breakage occurs in a curved canal or in the apical third of the canal. Four cases requiring removal of separated files from the apical third of curved canals are presented. All were successfully treated using a newly designed system and technique. ( info) |
66/87. Clinical study of a halogen light-activated bleaching agent in nonvital teeth: case reports. Clinical experience with an innovative, dual-action, in-office bleaching regimen that has both chemical and photoactivated mechanisms is described. This internal bleaching procedure was performed in three patients, each with different characteristics. In general, the results obtained were satisfactory. In the 6-month period of follow-up, no adverse effects related to the application of the bleaching agent were found. The different factors that may have influenced the results achieved are discussed. ( info) |
67/87. Aesthetic treatment of discoloration of nonvital teeth. Attempts to treat discoloration in nonvital teeth were first reported a century ago. This article discusses two potential causes of nonvital tooth discoloration-trauma and endodontic treatment-along with a step-by-step clinical procedure for treatment of the discoloration. In trauma, hemoglobin is released into the tissues; iron oxides, formed by oxygen and iron in hemoglobin, cause discoloration and swelling that infringes on pulp space, forcing the pulp to recede with a potential loss of tooth vitality. After endodontic treatment, either hemorrhaging, materials used, or incomplete removal and breakdown of necrotic tissue may cause staining. The learning objective of this article is to review the causes and the prevention/treatment of discoloration in nonvital teeth. ( info) |
68/87. Predictable aesthetic reconstruction of fractured anterior teeth with composite resins: a case report. Full-coverage rehabilitation is generally the treatment modality indicated for restoration of severely fractured anterior teeth. However, the advanced formulations of composite resins present improved physical properties, an expanded range of shade selection, and high sculptability, allowing predictable restoration of the anterior dentition and replication of the polychromatic characteristics of natural teeth. The learning objective of this article is to present the utilization of composite resin materials in the treatment of fractured maxillary anterior incisors, implementing the concepts of polychromatic characteristics, hue, translucency, opacity, chroma, value, strength, and polishability. Also presented are several practical clinical observations that will assist the practitioner in attaining predictable aesthetic results with composite resin material. ( info) |
| apexification is a process/procedure well recognized and accepted by clinicians and researchers alike. calcium hydroxide is most commonly used to induce an apical hard tissue barrier which may be composed of different tissues but its mechanism of action is still unknown. The epithelial cell rests of Malassez have been implicated in apexification although case reports exist which apparently dispute this. The following case report demonstrates an unusual case of apexification following root filling, surgery and retreatment where the role of the epithelial cell rests of Malassez is discussed. ( info) |
70/87. Acquired toxoplasmosis of a submandibular lymph node in a 9-year-old boy diagnosed by fine-needle aspiration cytology. toxoplasmosis is a parasitic infection which may be asymptomatic or produce lymphadenopathy, fever and malaise. In children the cervical lymph nodes are most commonly affected. This report describes a case of a 9-year-old boy who presented with submandibular lymphadenopathy associated with a non-vital primary tooth, which persisted following extraction of the tooth. A diagnosis of acquired toxoplasmosis was made on the findings of fine-needle aspiration cytology and subsequently confirmed by serological investigations, thus sparing the patient unnecessary hospitalization and surgery. The patient required amitryptyline as a nocturnal sedative and made a complete recovery within a few months without the need for further intervention. ( info) |