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Sancas MC, Pires PM, Primo LG. Conservative management of a horizontal root fracture in a primary maxillary central incisor: Case report. Dent Traumatol 2023; 39:82-87. [PMID: 36039396 DOI: 10.1111/edt.12788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 08/08/2022] [Accepted: 08/14/2022] [Indexed: 01/14/2023]
Abstract
Dental trauma occurs frequently in toddlers and the treatment protocols vary depending on each case. Thus, clinicians must not only plan the treatment but also consider any possible sequelae and characteristics related to the child and the family. The aim of this paper was to report a case of a three-year-old boy who had a horizontal root fracture in the middle third of the primary maxillary right incisor root (tooth 51) and crown discoloration of the primary maxillary left incisor (tooth 61) which were successfully treated with conservative management. The management was established in agreement with the family and was based on active surveillance. The clinical and radiographic follow-ups showed no changes besides pulp canal calcification of the left incisor throughout the eight years of follow-up. The pulps remained normal with no pathological signs throughout their life cycle and the permanent successors erupted normally, presenting an excellent result of the non-invasive approach adopted.
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Affiliation(s)
- Mariana Coutinho Sancas
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paula Maciel Pires
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Laura Guimarães Primo
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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2
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Liao WC, Chen CH, Pan YH, Chang MC, Jeng JH. Horizontal root fracture in posterior teeth without dental trauma: A diseased condition with special characteristics. J Formos Med Assoc 2022; 121:1625-1635. [DOI: 10.1016/j.jfma.2022.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/23/2022] [Accepted: 03/28/2022] [Indexed: 10/18/2022] Open
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Magacho Da Silva LF, Da Silva JR, Albieri F, Santos Pereira RD. Unusual Horizontal Root Fracture in a Mandibular Second Molar after Lower Wisdom Teeth Removal. Ann Maxillofac Surg 2019; 8:344-346. [PMID: 30693261 PMCID: PMC6327814 DOI: 10.4103/ams.ams_129_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Dental trauma is a common injury observed at dental practices that normally occurs in young patients. It especially affects the anterior teeth, although trauma to the posterior teeth can also be observed frequently when caused by high-impact trauma and masticatory forces. Horizontal root fracture in the posterior teeth is even more rare and involves a more specific type of trauma. This article reports the case of a second molar root fracture that happened during the removal of an impacted wisdom tooth. The patient had no discomfort associated with the event, and the tooth had no change in sensibility or mobility during follow-up. Seven months after the fracture, there was complete radicular healing even though no treatment was given.
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Affiliation(s)
| | - Jonathan Ribeiro Da Silva
- Department of Oral and Maxillofacial Surgery, General Hospital of Nova Iguaçu, Rio de Janeiro, Brazil
| | - Fabrizio Albieri
- Department of Oral and Maxillofacial Surgery, General Hospital of Nova Iguaçu, Rio de Janeiro, Brazil
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Gibbon VE, Carlson KJ, Grimoud AM, Jashashvili T. Use of high resolution computed tomography to diagnose ante-mortem dental root fractures in archaeological samples. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 22:143-148. [PMID: 30126700 DOI: 10.1016/j.ijpp.2017.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 10/11/2017] [Accepted: 10/11/2017] [Indexed: 06/08/2023]
Abstract
Dental root fractures are rarely documented in past human populations, but when they are observed, diagnosing ante-mortem events as causal factors can be difficult due to postmortem alteration. Can high resolution X-ray computed tomography (CT) improve our ability to diagnose if a dental fracture was caused ante- or post-mortem? To test this, a case study of two individuals with previously diagnosed dental root fractures were re-examined with high resolution CT to confirm or refute the original diagnoses. For individual 4170, use of high resolution CT supported the original diagnosis of an ante-mortem root fracture on the right mandibular central incisor that was made based on planar X-ray. With the new analyses, the root fracture was found to be associated with evidence of calcification, and with radicular and alveolar bone resorption, which are positive correlates of an ante-mortem origin. Resolving this level of detail of bone modification was not possible without using high resolution CT. For individual 4172, the use of high resolution CT enabled visualisation of fracturing and cracking throughout several molars and crowns of other teeth that were not evident in planar X-ray, suggesting that these fractures were likely produced by post-mortem taphonomic processes rather than ante-mortem events as originally diagnosed. In this case study, high resolution CT offered critical advantages compared to a planar X-ray approach, such as using 3D multiple slice views without superimposing alveolar bone and teeth as in planar X-ray imaging. This study demonstrates the potential of high resolution CT in confirming and refuting ante-mortem processes, and that visualisation of 3D structures is crucial for arriving at definitive diagnoses.
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Affiliation(s)
- Victoria E Gibbon
- Department of Human Biology, University of Cape Town, Observatory, Cape Town, South Africa.
| | - Kristian J Carlson
- Department of Integrative Anatomical Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Evolutionary Studies Institute, University of the Witwatersrand, 2050 Johannesburg, South Africa
| | - Anne-Marie Grimoud
- Université de Toulouse, 3 Chemin des Maraîchers, 31062 Toulouse Cedex 9, France
| | - Tea Jashashvili
- Evolutionary Studies Institute, University of the Witwatersrand, 2050 Johannesburg, South Africa; Molecular Imaging Center, Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Department of Geology and Palaeontology, Georgian National Museum, 0105 Tbilisi, Georgia
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Parhizkar A, Nojehdehian H, Asgary S. Triple antibiotic paste: momentous roles and applications in endodontics: a review. Restor Dent Endod 2018; 43:e28. [PMID: 30135847 PMCID: PMC6103545 DOI: 10.5395/rde.2018.43.e28] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 04/10/2018] [Indexed: 12/23/2022] Open
Abstract
This study investigated the latest findings and notions regarding ‘triple antibiotic paste’ (TAP) and its applications in dentistry, particularly endodontics. TAP is a combination of 3 antibiotics, ciprofloxacin, metronidazole, and minocycline. Despite the problems and pitfalls research pertaining to this paste has unveiled, it has been vastly used in endodontic treatments. The paste's applications vary, from vital pulp therapy to the recently introduced regeneration and revascularisation protocol. Studies have shown that the paste can eliminate the root canal microorganisms and prepare an appropriate matrix for further treatments. This combination is able to remove diverse groups of obligate and facultative gram-positive and gram-negative bacteria, providing an environment for healing. In regeneration protocol cases, this allows the development, disinfection, and possible sterilization of the root canal system, so that new tissue can infiltrate and grow into the radicular area. Moreover, TAP is capable of creating a discipline in which other wanted and needed treatments can be successfully performed. In conclusion, TAP, as an antibacterial intracanal medication, has diverse uses. Nevertheless, despite its positive effects, the paste has shown drawbacks. Further research concerning the combined paste and other intracanal medications to control microbiota is a must.
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Affiliation(s)
- Ardavan Parhizkar
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Nojehdehian
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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L’Abbé EN, Symes SA, Pokines JT, Cabo LL, Stull KE, Kuo S, Raymond DE, Randolph-Quinney PS, Berger LR. Evidence of fatal skeletal injuries on Malapa Hominins 1 and 2. Sci Rep 2015; 5:15120. [PMID: 26459912 PMCID: PMC4602312 DOI: 10.1038/srep15120] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 09/16/2015] [Indexed: 12/31/2022] Open
Abstract
Malapa is one of the richest early hominin sites in Africa and the discovery site of the hominin species, Australopithecus sediba. The holotype and paratype (Malapa Hominin 1 and 2, or MH1 and MH2, respectively) skeletons are among the most complete in the early hominin record. Dating to approximately two million years BP, MH1 and MH2 are hypothesized to have fallen into a natural pit trap. All fractures evident on MH1 and MH2 skeletons were evaluated and separated based on wet and dry bone fracture morphology/characteristics. Most observed fractures are post-depositional, but those in the right upper limb of the adult hominin strongly indicate active resistance to an impact, while those in the juvenile hominin mandible are consistent with a blow to the face. The presence of skeletal trauma independently supports the falling hypothesis and supplies the first evidence for the manner of death of an australopith in the fossil record that is not attributed to predation or natural death.
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Affiliation(s)
- Ericka N. L’Abbé
- Department of Anatomy, University of Pretoria, Private Bag x323, 0007, Arcadia, South Africa
| | - Steven A. Symes
- Department of Anatomy, University of Pretoria, Private Bag x323, 0007, Arcadia, South Africa
- Department of Applied Forensic Sciences, Mercyhurst University, 501 East, 38th St, Erie, PA, 16546, USA
| | - James T. Pokines
- Forensic Anthropology Program, Boston University School of Medicine, 72 East, Concord St, Boston, MA, 02118, USA
| | - Luis L. Cabo
- Department of Applied Forensic Sciences, Mercyhurst University, 501 East, 38th St, Erie, PA, 16546, USA
| | - Kyra E. Stull
- Department of Anatomy, University of Pretoria, Private Bag x323, 0007, Arcadia, South Africa
- Department of Anthropology, Idaho State University, 921 South, 8th Ave, Pocatello, ID, 83209, USA
| | - Sharon Kuo
- Department of Applied Forensic Sciences, Mercyhurst University, 501 East, 38th St, Erie, PA, 16546, USA
- Department of Pathology and Anatomical Sciences, University of Missouri, One Hospital Drive, Columbia, MO, 65212, USA
| | - David E. Raymond
- Department of Mechanical Engineering, California State University Los Angeles, 5151 State University Drive, Los Angeles, CA, 90032, USA
| | - Patrick S. Randolph-Quinney
- School of Anatomical Sciences, University of the Witwatersrand, Parktown, 2193, South Africa
- Evolutionary Studies Institute, University of the Witwatersrand, Private Bag 3, Wits, 2050, South Africa
| | - Lee R. Berger
- Evolutionary Studies Institute, University of the Witwatersrand, Private Bag 3, Wits, 2050, South Africa
- Centre for Excellence in Palaeosciences, University of the Witwatersrand, Private Bag 3, Wits, 2050, South Africa
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Clarkson RM, John K, Moule AJ. Horizontal Palatal Root Fracture in a Vital Upper First Premolar. J Endod 2015; 41:759-61. [DOI: 10.1016/j.joen.2015.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 01/03/2015] [Accepted: 01/06/2015] [Indexed: 10/24/2022]
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Makowiecki P, Witek A, Pol J, Buczkowska-Radlińska J. The maintenance of pulp health 17 years after root fracture in a maxillary incisor illustrating the diagnostic benefits of cone bean computed tomography. Int Endod J 2014; 47:889-95. [PMID: 24289865 DOI: 10.1111/iej.12221] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 11/26/2013] [Indexed: 12/20/2022]
Abstract
AIM To demonstrate the maintenance of pulp health in a tooth with a fractured root without any complications or endodontic treatment and the advantage of cone bean computed tomography (CBCT) compared with traditional radiographs in the diagnosis of root fractures. SUMMARY The horizontal fracture of a maxillary central incisor is described that was an incidental finding on a routine radiographic examination 17 years after trauma. The tooth was asymptomatic. Intra-oral radiography revealed a complicated multiple root fracture with separation of the root fragments, which was not confirmed by CBCT. This case report illustrates spontaneous healing of root fracture and the reparative potential in the area of root fracture including preservation of pulp health and also demonstrates that CBCT is a more reliable imaging technique than conventional radiographs regarding root fracture diagnosis. KEY LEARNING POINTS The dental pulp is characterized by the ability to heal spontaneously in cases of root fracture. CBCT has advantages in diagnosing root fractures over intra-oral radiographs. CBCT should be employed with caution due to its increased radiation dose compared with periapical radiography.
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Affiliation(s)
- P Makowiecki
- Department of Conservative Dentistry, Pomeranian Medical University, Szczecin, Poland
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Erdem AP, Ozdas DO, Dincol E, Sepet E, Aren G. Root healıng wıth MTA after horıizontal fracture. Eur Arch Paediatr Dent 2013; 10:110-3. [DOI: 10.1007/bf03321611] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Er K, Celik D, Taşdemir T, Yildirim T. Treatment of horizontal root fractures using a triple antibiotic paste and mineral trioxide aggregate: a case report. ACTA ACUST UNITED AC 2009; 108:e63-6. [PMID: 19540446 DOI: 10.1016/j.tripleo.2009.03.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Revised: 03/12/2009] [Accepted: 03/12/2009] [Indexed: 12/11/2022]
Abstract
This case report describes the treatment of a horizontal root fracture in a maxillary central incisor (tooth #8) using a triple antibiotic paste and mineral trioxide aggregate. A nonsurgical endodontic treatment was performed to a coronal root canal fragment of tooth #8. During the treatment procedure, 1% sodium hypochlorite solution was used for irrigation and a triple antibiotic paste was used as an intracanal medicament. The coronal part of the canal was obturated with mineral trioxide aggregate totally. At follow-up examination after 12 months, the tooth was asymptomatic and radiographically showed repair of the fracture region. Healing was achieved without any need for further interventions.
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Affiliation(s)
- Kürşat Er
- Department of Endodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
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