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A case of intrusive luxation with accompanying root fracture of a deciduous upper left lateral incisor is described. In this case the separated root apex partly penetrated into and become fused with the permanent successor tooth.
Intentional replantation is an accepted endodontic procedure for treating teeth in cases in which intracanal and/or surgical endodontic treatments are not recommended. Although not a frequently used technique, intentional replantation is a treatment option that dentists should consider. An unusual case is described in which intentional replantation was required to maintain the tooth in the dentition. A 31 month follow-up evaluation revealed an asymptomatic, functional tooth with no radiographic signs of pathosis.
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From 1987 to 1992, 127 cases that involved maxillomandibular trauma, reconstruction, and various oral surgical procedures were managed with arch bars bonded to the teeth. The aim of this article is to present the method of application of the arch bar and to report the results of management with this technique stressing its use with 99 trauma patients.
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Treatment of traumatically intruded teeth is based largely on empirical clinical experience rather than on scientific data. The aim of this qualitative meta-analysis was to provide an evidence base to evaluate the orthodontic repositioning approach. In a MEDLINE search of the literature in English, 14 reported patients involving 22 teeth were found to have been treated by this modality. Additionally, 3 new patients, involving 9 intruded teeth and presented herein, were combined to form a total study sample of 17 subjects (7 girls, 10 boys, aged 8.9 +/- 1.2 years). Orthodontic extrusive forces were applied in the immediate posttrauma period (up to 3 months), with a variety of orthodontic appliances. Repositioning was achieved for 90.3% of the affected teeth but failed in 9.7% because of inflammatory resorption (2 teeth) or a misdiagnosis of root fracture (1 tooth). Early complications included loss of pulp vitality and external root resorption. All intruded teeth with closed root apices lost their vitality regardless of the degree of intrusion, whereas among those with incomplete apices, 45.5% that had been moderately intruded remained vital. External resorption was encountered in 54.8% of the teeth. Loss of marginal bone support was rarely encountered. Late complications included inflammatory root resorption in teeth with closed apices, in which endodontic treatment was not initially performed, and obliteration of the pulp tissue in teeth that remained vital. The results show that this method is superior to other treatment alternatives.
This case report describes the multidisciplinary management of an adolescent girl with traumatic loss of the maxillary right central lateral incisors, and a unilateral Class II crossbite malocclusion. A rapid palatal expansion appliance was used initially to correct the transverse deficiency and secondarily as an anchorage unit for unilateral molar distalization to correct the Class II molar relationship. Temporary incisors were extended from a Nance stabilizing appliance during premolar and canine retraction. A staged approach was used with bone grafting before the placement of 2 single-tooth implants. A favorable outcome was achieved through proper coordination among the orthodontist, the surgeon, and the restorative dentist.
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OBJECTIVE: The aim of this study was to describe demographic and clinical patterns of subjects hospitalized with complications associated with third molars (M3). STUDY DESIGN: The investigation was designed as a prospective cohort study composed of subjects admitted to hospital for management of M3-associated complications. The predictor variable was "clinical status of the M3" defined as (A) prophylactic M3 removal, (B) nonelective M3 removal, or (C) M3 present at the time of admission. Outcome variables were infection parameters, treatment costs, length of hospital stay, and days of disability. Postoperative complications (A and B) were compared to complications based on pericoronitis (C). Complications due to prophylactic removal (A) were compared to those arising from pericoronitis or from the removal of symptomatic teeth (B and C). RESULTS: From January 2003 to December 2004, 45 deep space infections, 6 mandibular fractures, 2 lingual nerve injuries, 1 parapharyngeal tooth luxation, and 1 osteomyelitis were noticed. Fifteen complications resulted from prophylactic surgery (A), 25 from nonelective removal (B), and 15 from pericoronitis (C). Direct treatment costs were 147,000 euro (A: 42,000 euro; B: 74,000 euro; C: 31,000 euro). In 10 of the 15 patients of group C, deep space involvement resulted immediately from the first episode of pericoronitis. Neither clinical markers of infection nor economic parameters showed significant differences between the groups. CONCLUSION: Within the catchment area of our institution, the majority of third molar-related hospitalizations resulted from diseased third molars or their removal.
This report presents 5 cases of intrusive luxation in immature permanent central incisors. The intruded incisors, with careful monitoring, were allowed to spontaneously re-erupt, which avoided the need to reposition the tooth either orthodontically or surgically. All of the teeth re-erupted spontaneously in a few months. The root development continued in all of the cases and all pulps remained vital. There were no other signs of pulpal and/or periapical pathology. It can be concluded that intruded immature permanent teeth can spontaneously re-erupt, conserve their vitality, and continue their root development without any surgical or orthodontic management.
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Use of the endodontic implant stabilizer presents a sound physiologic procedure for stabilizing mobile teeth. It can increase root length, alter rootcrown ratios, immobilize fractured roots and periodontally compromised teeth, or supply combinations of these benefits. Case selection, operative technique, and case reports with follow-up are presented in order to demonstrate uses and versatility.
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Dental trauma is a frequent condition which may occur alone or in combination with craniofacial trauma and/or other injuries. Many factors influence the gravity of the trauma and subsequent prognosis including age, anterior state, trauma etiology, treatment and follow up. In order to establish a prudent provisional or definitive expertise, the medical expert must have a panoramic view of the trauma. Time should be taken to consolidate facts and estimate prejudices on sound evidence. In certain cases outcome can be predicted. The medical expert should provide advice and counselling both for the patient and the mandating authority. In this article, iatrogenic dental accidents occurring during anesthesia or extraction will not be discussed.