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Miranda Candeiro GT, Parente Viana FL, Camelo Paiva H, Luiz Caldeira C, Faga Iglecias E, Gavini G. Endodontic Retreatment of a Maxillary Central Incisor with Two Root Canals in a Patient with Cleft Lip and Palate. IRANIAN ENDODONTIC JOURNAL 2019; 14:235-239. [PMID: 36814950 PMCID: PMC9940025 DOI: 10.22037/iej.v14i3.24911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 05/29/2019] [Accepted: 06/10/2019] [Indexed: 02/24/2023]
Abstract
The failures in endodontic treatments are often related to anatomical variations. Some anatomical changes in anterior teeth occur in patients with cleft lip and palate. This paper aims to report the endodontic retreatment of a maxillary central incisor with two roots and two canals on a patient who presents cleft lip and palate. A male patient, 11-year-old, reported pain when chewing related to the left maxillary central incisor tooth (tooth 21) which featured a sinus tract after primary endodontic treatment. In periapical radiograph, it was observed an alteration on the anatomy of the root on the tooth 21, which featured a radiolucent area on the dental apex and had been properly endodontically treated. In cone-beam computed tomography (CBCT) images the presence of an accessory root in the palatal region was observed, that had not been prepared, or filled. Thus, the non-treated accessory canal was instrumented with the crown-down technique and filled with gutta-percha and endodontic sealer. After 1 year of follow-up, the patient presented the tooth with a normal masticatory function and no painful symptoms. Therefore, it can be concluded that the additional root canals may be present and the CBCT is an important tool to evaluate the internal root morphology. In cleft lip and palate patients, the root canals morphology should be carefully analyzed due to high prevalence of dental anomalies which may influence the success in endodontic treatment.
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Affiliation(s)
| | - Francisca Lívia Parente Viana
- Post-graduation Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil; ,Corresponding author: Francisca Lívia Parente Viana, Federal University of Ceara, Rua Ronaldo Pontes Dias, 1362-Das Nações, Sobral, Brazil, ZIP: 62053-660. E-mail:
| | - Hermano Camelo Paiva
- Post-graduation Program in Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Celso Luiz Caldeira
- Post-graduation Program in Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Elaine Faga Iglecias
- Post-graduation Program in Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Giulio Gavini
- Post-graduation Program in Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
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Gupta B, Gupta S, Wadhwa J, Gupta A. Effect of Trauma to Primary Tooth on Permanent Maxillary Incisors: A Clinical Case Report. J Clin Diagn Res 2017; 11:ZD06-ZD08. [PMID: 28511520 DOI: 10.7860/jcdr/2017/23935.9382] [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: 09/04/2016] [Accepted: 12/13/2016] [Indexed: 11/24/2022]
Abstract
Trauma to primary tooth leads to abnormal variations in crown and root canals of permanent teeth that presents a challenge in diagnosis and clinical management to the practitioner. This article presents a detailed case report of the endodontic treatment of a three canalled maxillary central incisor and maxillary lateral incisor having single canal with open apex linked with periodontal defect. Root canals were prepared with hand files and canals were irrigated with 2.5% sodium hypochlorite solution. Calcium hydroxide was placed as an intracanal medicament. As the expected healing did not occur even after one month of calcium hydroxide therapy, so periapical endodontic surgery was performed using Platelet Rich Plasma (PRP). Satisfactory clinical and radiographic results were obtained at 12 months. Detailed knowledge of the anatomical variations in the root canal and awareness of their configuration is essential for the success of such cases.
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Affiliation(s)
- Bhawana Gupta
- Consultant, Conservative and Operative Dentistry, Private Practice, Gupta dental clinic, Rohtak, Haryana, India
| | - Sachin Gupta
- Reader, Department of Periodontics, Career Institute of Dental Sciences, Lucknow, U.P, India
| | - Jitesh Wadhwa
- Reader, Department of Orthodontics, K.D Dental College, Mathura, U.P, India
| | - Alpa Gupta
- Senior Resident, Conservative and Operative Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Geminated Maxillary Lateral Incisor with Two Root Canals. Case Rep Dent 2017; 2016:3759021. [PMID: 28119787 PMCID: PMC5227125 DOI: 10.1155/2016/3759021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 12/12/2016] [Indexed: 11/17/2022] Open
Abstract
This paper reports a case of gemination in a maxillary lateral incisor with two root canals and crown-root dilaceration. A 16-year-old male patient was referred for endodontic treatment of the maxillary left lateral incisor and evaluation of esthetic and functional complaints in the anterior region. The patient reported trauma to the anterior primary teeth. There was no spontaneous pain, but the tooth responded positively to the vertical percussion test and negatively to the pulp vitality test. Clinical examination showed esthetic and functional alterations and normal periodontal tissues. CBCT imaging confirmed the suspicion of gemination and crown-root dilaceration and also revealed the presence of two root canals and periapical bone rarefaction. The root canals were instrumented with Reciproc R40 and 1% NaOCl irrigation and were filled by lateral condensation of gutta-percha and AH Plus sealer. The tooth was definitely restored with composite resin to recover esthetics. Continued follow-up over 6 months has shown absence of pain or clinical alterations as well as radiographic image suggestive of apical repair.
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Monea M, Moldovan C. Rare Root Morphology of a Maxillary Central Incisor Associated With Gingival Hyperplasia: An Endodontic Case Report. Medicine (Baltimore) 2016; 95:e3617. [PMID: 27149498 PMCID: PMC4863815 DOI: 10.1097/md.0000000000003617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Dilaceration is a developmental disturbance characterized by the angulation of the crown or root of a permanent tooth, which is often related to trauma of primary dentition. We report a case of a dilacerated root in a maxillary central incisor associated with gingival hyperplasia in a patient under fixed orthodontic treatment, a combination of pathological conditions that had never been mentioned before in the scientific literature.A 10-year-old female patient presented to the Department of Odontology and Oral Pathology with tenderness to palpation and bleeding from the oral aspect of the central incisor, alerted by the proliferation of the gingiva. During clinical examination, the palpation performed with a dental probe revealed a carious lesion with dental pulp exposure on the distal aspect of right central incisor and the presence of a sessile mass of inflamed gingival tissue that proliferated inside the defect. On the preoperative radiograph a dilacerated root canal was noted, without periapical bone resorption.The main diagnosis was irreversible pulpitis and gingival hyperplasia and the treatment option was surgical removal of the inflamed tissue with histopathological examination and root canal treatment. Successful endodontic treatment with a good prognosis was recorded.The measurement of the root curvature proved to be extremely helpful in choosing the right endodontic technique and made the treatment easier than expected. An important observation was that, despite the rare clinical and radiographic aspect of this dilacerated tooth, the endodontic treatment proved to be relatively easy to perform and, therefore, the prognosis was considered favorable.
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Affiliation(s)
- Monica Monea
- From the Department of Odontology and Oral Pathology (MM), Faculty of Dental Medicine; and Department of Histology (CM), Faculty of Medicine, University of Medicine and Pharmacy, Tirgu Mures, Romania
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