[Preliminary results on preserving fractured tooth whose margin below the gingiva by using forced eruption].
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All dental emergencies must be considered true emergencies until determined otherwise. Prompt diagnosis and treatment of sports-related traumatic injuries to the teeth and supporting structures are essential to successful long-term clinical outcome. Emergency and long-term treatment techniques for crown fractures, tooth fractures, displaced teeth, and avulsed teeth are described from an endodontic perspective.
Surgical crown lengthening should not be attempted when tooth fractures extend into the middle third of the root. Excessive bone reduction on the fractured tooth and necessary blending of osseous contours over adjacent teeth may result in mobility or furcation involvement. In addition, the necessary osseous surgery may create precipitous changes in the bony architecture that will be bridged by soft tissues. This results in increased pocket depth and an unhealthy situation. If the tooth in question has a hopeless prognosis or the osseous surgical procedure would create a poor crown-root ratio, furcation involvement, mobility, or esthetic problems, crown lengthening should be avoided. In cases such as these, extraction may be indicated.
The purpose of the present study was to evaluate the quality of fired ceramic inlay restorations consisting of a feldspathic porcelain system (G-Cera Cosmotech II) after 6 years in vivo. A total of 49 fired ceramic inlays (for 27 premolars and 22 molars: class 1 in 11 teeth, class 2 in 36 teeth, and onlays in two teeth) were placed in 29 patients, and all restorations were evaluated at the time of placement, at 6 months, and 1, 2, 4, and 6 years after placement using modified USPHS criteria. Replicas made of the restorations were observed using a scanning electron microscope (SEM) to assess the state of the marginal area and wear of the restoration. Favorable color match was noted, and no bulk fracture, tooth fracture, or missing restorations were detected. Longevity was observed in 92% of the fired ceramic inlay restorations at 6 years (Kaplan-Meier method); however, marginal fracture was detected in six restorations (13%) and marginal discoloration in 11 (23%). SEM evaluation disclosed marginal microfracture in 49% of the restorations, wear in 19%, and wear of resin cement along margins in 36% at 6 years. No significant difference was observed in the incidence of each of these three characteristics between molars and premolars. This longitudinal 6-year clinical observation suggested that fired ceramic inlay restorations made by the G-Cera Cosmotech II system are aesthetic, durable, and clinically acceptable. Further follow-up is needed for the restorations showing marginal degradation and fracture from a microscopic and macroscopic perspective.
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Root fractures and subluxation of teeth often play only a minor role in the discussion of the therapy of traumatic tooth defects. This contribution discusses possible therapeutic approaches as well as prognosis and long-term results in cases of tooth root fractures and partially dislocated teeth. The primary aim of the therapy is to avoid further damage to the developing teeth of the first set, and to keep the permanent teeth in a proper condition for the maximum time possible.
Odontalgia in association with an acutely fractured tooth is a frequent reason for emergency department presentation. We describe the case of a patient who presented with a painful fractured molar tooth and was treated with topical application of 2-octyl cyanoacrylate tissue adhesive, resulting in prompt relief of her discomfort and a good temporary functional and cosmetic outcome. This product may prove useful in treating similar dental emergencies when access to emergency dental care is unavailable.
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A fragment of tooth missing for three years was found in the patients' lower lip. The fragment was surgically removed and cleaned. It was restored to its original position on the maxillary left incisor with an acid etch resin technique. After three months, the restoration was satisfactory.
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