Multidisciplinary approach to the rehabilitation of a crown-root fracture with original fragment for immediate esthetics: a case report with 4-year follow-up

Dental practitioners frequently encounter dentoalveolar traumas. According to the severity of the trauma, a large spectrum of complications such as isolated tooth fracture, dentoalveolar fracture or fracture at maxillofacial region may occur. If the isolated tooth fracture occurs particularly at anterior region, the rehabilitation should satisfy both esthetic and functional problems. An unrestorable tooth should be extracted and this leads to more complex treatments such as implant or conventional prosthetic rehabilitations, which will restore the function, but impair the esthetics. Recently, powerful new generation dual-cured resin composites have been produced for reattachment of original fractured fragments. In this case, we presented treatment of oblique crown-root fracture of a maxillary central tooth from enamel-cement junction by the reattachment technique. We used dual cured resin composite (Panavia F) and a self-tapping screw-post (Dentatus) for reattaching the crown fragment. Orthodontic treatment was applied for intruding and leveling the tooth. Four years after treatment, the tooth exhibited good esthetics, good periodontal health and normal function. However, minimal relapse occurred in spite of orthodontic treatment. In conclusion, the reattachment technique is an alternative method, which offers satisfactory esthetic and functional rehabilitation of the fractured teeth.

The effects of ovulation induction during infertility treatment on gingival inflammation

BACKGROUND

Ovulation induction is the most common method of infertility treatment in which the ovaries are stimulated to produce multiple follicles. The aim of this study was to assess the effects of three drug protocols of ovulation induction: clomiphene citrate (CC) alone, CC combined with follicle stimulating hormone (FSH), and CC combined with human menopausal gonadotropin (HMG) on the gingival tissues of women who were undergoing infertility treatment.

METHODS

Study population was composed of 18 women using CC for three menstrual cycles or less and 16 women using CC for more than three cycles; 21 women using CC-FSH; and 24 women using CC-HMG who had at least four cycles of CC alone the previous year. All subjects were clinically examined for plaque levels (plaque index), gingival inflammation (gingival index), bleeding on probing, and gingival crevicular fluid volume. The results were compared with a control group of 20 women matched for age, educational and professional level, and oral habits and who had never used ovulation drugs.

RESULTS

Despite similar plaque levels (P>0.05), women using CC for more than three cycles and combined protocols of CC-FSH and CC-HMG had higher levels of gingival inflammation (P<0.01, P<0.001 and P<0.001, respectively), bleeding (P<0.001), and GCF volume (P<0.001) when compared to the control group and to the users of CC for three cycles or less.

CONCLUSIONS

The results of this study have shown that ovulation induction, which is the most common method in the management of infertility, exacerbates gingival inflammation, bleeding, and GCF volume and that the duration of the usage of these drugs is strongly associated with the severity of gingival inflammation.

Rothmund-Thomson syndrome: a case report

Rothmund-Thomson syndrome (RTS) is an extremely rare genetic disorder characterized by poikilodermatous skin changes, photosensitivity, and an increased risk of developing skin and bone malignancies. In this case report, the dental and periodontal features of RTS in a 16-year-old female patient are presented. The transmission electron microscopy performed on a gingival biopsy specimen showed structural defects of connective tissue. If the unusual ultrastructural findings of this case are confirmed as being consistent with other RTS patients, it is our opinion that this syndrome can be considered among the systemic diseases associated with early-onset periodontitis.

Evaluation of aerosol contamination during debonding procedures

The aim of this study was to show how the aerosol generated by the use of an air turbine handpiece during debonding procedures increases the potential risk factor for the distribution of infectious agents. A second aim of the study was to evaluate the effectiveness of a preprocedural chlorhexidine mouth rinse in reducing the number of colony forming units (CFU) found in aerosol samples. Blood agar plates were attached to the face shields and the dental chair table and were used for collecting the aerosol samples. In the first part of the study, 260 samples were collected for the baseline group in an empty room, 36 samples were collected for the control group (C), in which the orthodontist, dental assistant, and the patient were in the operatory room, and 42 samples were collected for the debonding group (DB). The microbiologic analysis showed significant differences between the baseline group and the control group (P < .05). Furthermore, aerosol contamination increased significantly during the debonding procedure when compared with the control group (P < .01). In the second part of the study, an air turbine handpiece was used to remove excess adhesive from the tooth surface on one side of the mouth and air samples were collected. The patients then were instructed to rinse their mouths with 0.2% chlorhexidine gluconate for 1 minute, and the orthodontist worked on the other side of the mouth and the air sampling was repeated. An insignificant reduction was found in the number of colony forming units following the chlorhexidine mouth rinse. Results of this study indicated that orthodontists are exposed to high levels of aerosol generation and contamination during the debonding procedure, and preprocedural chlorhexidine gluconate mouth rinse appears to be ineffective in decreasing the exposure to infectious agents. Therefore, barrier equipment should be used to prevent aerosol contamination.