[A new method for the romoval of the fractured tooth root using a root canal reamer].
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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.
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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A case history is presented of a 10-year-old patient, who accidentally injured her maxillary central incisor. The fracture of the crown extended 2 mm below the crest of the alveolar bone. After a pulpotomy was done as a temporary measure, orthodontic appliances were placed by bonding brackets on the maxillary anterior teeth and fitting a sectional arch wire to extrude the fractured tooth. After successful extrusion, the fracture line was brought above the level of alveolar bone where successful restoration of the tooth by the acid-etch method could be accomplished.
In an in vitro experiment, the failure loads of 59 intact endodontically treated teeth with and without Kerr Endo-Post reinforcement were compared. Fifty-eight teeth fractured below the cementoenamel junction. One tooth fractured through the pulp chamber with a chisel fracture involving both the crown and root. Teeth without posts fractured through the middle or coronal one third of the root. Teeth with posts fractured through the body of the post. No statistically significant reinforcement was demonstrated by cementing a Kerr Endo-Post No. 100 into a sound endodontically treated tooth.
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