Multidisciplinary approach to traumatized teeth: a case report

Conservative approach for management of fractured maxillary central incisors in young adults

Ceramic restorations could be an acceptable treatment choice for fractured central incisors. A successful esthetic and conservative result to restore damaged anterior teeth can be obtained through proper evaluation, diagnostic wax-up, guided minimal preparations, ceramic selection, and bonding protocols. Handcrafted glass-based restorations can mimic contours and shape of natural teeth.

Complicated Crown-root Fracture Management Using the 180-degree Rotation Method

Aim

The aim of this article is to report a successful treatment of a complicated crown-root fracture.

Background

The management of complicated crown-root fracture in young patients is challenging as the fracture line is below the bone crest and the pulp is exposed. Treatment options include crown lengthening, orthodontic extrusion, and intentional replantation.

Case description

Here, a case of complicated crown-root fracture of tooth number 11 in a ten-year-old boy is presented. Intentional replantation with 180° rotation and slight extrusion and fixation was performed. In addition, root canal therapy was done and tooth was restored with a composite resin after four weeks. The patient was asymptomatic clinically and radiographically after three-year follow-up.

Conclusion

Intentional replantation with 180° rotation is a valuable treatment for crown root fractures.

Clinical significance

The management of complicated crown-root fracture using intentional replantation with 180° rotation can help to maintain natural dentition and interdental papilla.

How to cite this article

Mokhtari S, Hajian S, et al. Complicated Crown-root Fracture Management Using the 180-degree Rotation Method. Int J Clin Pediatr Dent 2019;12(3):247-250.

Orthodontic extrusion of Ellis Class VIII fracture of maxillary lateral incisor - The sling shot method

The aim of this paper is to evaluate the efficacy of forced extrusion using the sling shot elastic. A 21 year adult patient reported with an Ellis Class VIII fracture of the maxillary right lateral incisor. Root canal treatment followed by a fiber reinforced composite post was placed and core build up was done. A metal button was bonded to the tooth. Begg brackets were placed from the second premolar on one side to the second premolar on the opposite side. 0.016″ × 0.025″ stainless steel was placed in ribbon mode. The ligature wire was placed as a sling shot from the button on the fractured tooth to the two adjacent teeth. 4 mm of extrusion was achieved and there was no evidence of root resorption. Forced extrusion was achieved in four months. The sling shot method is a very effective method of ligation. Light forces are delivered over a long duration with definitive results as compared to the inconsistent force delivery with conventional extrusion mechanics.

Tooth Reattachment and Palatal Veneer on a Multidisciplinary Approach of Crown Fractures in Upper Central Incisors

Dental trauma is more common in young patients and its sequelae may have great impact on the esthetics, functions, and phonetics. This paper reports a case of trauma in both central incisors in a young 17-year-old patient who was treated using adhesive tooth fragment reattachment on tooth 2.1 and a palatal indirect composite veneer on tooth 1.1. Regarding the available literature and fracture extension, the treatment approach proposed for this case provided good functional and esthetic outcomes. Clinical and radiographic results after 1 year were successful. This case demonstrates the importance of establishing a multidisciplinary approach for successful dental trauma management.

Multidisciplinary approach to a subgingivally fractured incisor tooth: A case report

This case report describes a multidisciplinary approach using orthodontic forced eruption to facilitate prosthetic restoration of a subgingivally fractured maxillary permanent central incisor. A 14-year-old male patient presented at the pediatric dental clinic due to unesthetic appareance and for management of a fractured maxillary right central incisor tooth. Intraoral examination revealed that the maxillary right central incisor had sustained a crown-root fracture with pulp exposure. We treated the tooth endodontically and performed orthodontic root extrusion with a modified Hawley appliance prior to prosthetic rehabilitation. Approximately 2-3 mm of extrusion of the tooth was obtained within 8 weeks. A fiber post was then inserted into the root canal, and final restoration was completed with an all-ceramic crown. Follow-up 18 months after treatment revealed good periodontal health, esthetics and normal function.

A conservative single visit reattachment of fractured crown fragment

Injury of anterior teeth is a relatively common event that mainly affects children and adolescents. Dentists are confronted with managing dental trauma and restoring fractured teeth on a regular basis. Hence the techniques that speed and simplify the treatment, restore esthetics and improve long term success rate are considered of potential value. If an intact tooth fragment is present after trauma, immediate attachment of the incisal edge is a conservative yet, simple and aesthetic alternative. Fracture reattachment possesses challenging conservative and economically viable procedure within a single visit. The authors wuld report a case of fractured maxillary central incisor using fragment reattachment.

Treatment of horizontal root fractures using a triple antibiotic paste and mineral trioxide aggregate: a case report

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.

A new approach to endodontic treatment and operative procedure in nonendodontically treated posterior crown root fractures

We report a case of nonendodontically treated first upper premolar crown root fracture in which the palatal cusp fracture extended below the cementoenamel junction. Reattachment of the palatal cusp in its original position by acid-etch and flowable composite allowed the creation of a standard access opening as in an intact tooth, avoiding apex location errors and contamination of the root canal. During crown-lengthening surgery, the palatal cusp fragment was hollowed out and used as a natural individual matrix for placement of the core material.