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[Evaluation of the clinical effect of the teeth with subgingivally involved defect conserved by crown lengthening surgery].

PURPOSE: To evaluate the clinical effect of the teeth with subgingivally involved defect which were conserved by crown lengthening surgery. METHODS: 62 teeth, with defect subgingivally from 1.5 mm to 4 mm, mobility degree(MD)</= I degree, appropriate proportion between crown and root, underwent crown lengthening surgery by combining flap surgery and osteoectomy, and restored 4 weeks after operation and followed-up for one year. The parameters of MD, sulcus bleeding index (SBI) and maximal defect probing depth (PD) at different times were measured respectively. 46 anterior teeth were divided into two groups based on PD of pre-operation. The groups were as follows: minor defect group (<2.5mm) and major defect group (2.5 to 4mm). The results were evaluated by student's t test. RESULTS: The overall effective rate was 83.9%. PD and SBI demonstrated a significant improvement (P<0.01), but MD showed an increasing trend after operation (P<0.01). No significant difference about MD of anterior teeth in two groups was found before operation (P>0.05), but a significant increase about MD occurred in the major defect group one year after restoration (P<0.01), and there was significant correlation between MD of each stage after operation and PD of pre-operation in anterior teeth (r=0.489, 0.526, 0.531, P<0.01). CONCLUSIONS: According to the biological width principle, crown lengthening surgery may conserve these teeth with subgingivally involved defect, and has a good, long-time clinical effect. But MD showed an increasing trend after operation and significant cor.

Crown Lengthening↗

[Unilateral fusion of the right mesial permanent incisor with a supernumerary tooth: case report and therapeutic approach].

A rare case of unilateral fusion of mesial right maxillary permanent incisor with a supernumerary tooth and a concurrent finding of supernumerary tooth on the left side is presented. The fused tooth had 16 mm in mesiodistal crown diameter, with two separate pulps and roots. After separation and removal of the distal part of the crown, the tooth remnant was treated orthodontically and made up by a composite material, with enamel etching. A satisfactory esthetic appearance was achieved by team work, in collaboration with a pedodontist and orthodontist.

Child, Preschool↗

Altered passive eruption: an etiology of short clinical crowns.

The gingival complex plays a vital role in the overall beauty of a smile. To predictably achieve a successful esthetic and functional result, the dentist must be able to precisely predict the treatment outcome based on biologic determinants. In this article, the biologic requirements for gingival health are discussed. In addition, a differential diagnosis for excess gingival display and treatment options for this condition are discussed.

Adolescent↗

Management of the short clinical crown by indirect restorations.

This paper describes the acute and chronic causes of short clinical crowns and their management. Fracture or trauma are common causes of acute failures whilst toothwear is the most common cause for chronic causes. There are many methods of restoring teeth using conventional indirect techniques, which may alter the existing occlusal vertical dimension (such as orthodontic Dahl appliances), or conserving the vertical dimension by increasing the length of the teeth. These methods are described and illustrated to assist the practitioner choose the most appropriate restoration.

Crown Lengthening↗

Primary triple teeth: histological and CT morphological study of two case reports.

The macromorphology and micromorphology of two specimens of primary triple teeth using histological and CT analysis approach is analyzed. A single morphological pattern of triple teeth has been found and described: three nearly separate crowns with three separate pulp chambers, and three joined roots with three connected root canals. The characteristic triple teeth appearance occurred because a labial supernumerary tooth is the junction element between two teeth of normal series: the central incisor on the mesial side and the lateral incisor on the distal side. Primary triple teeth suggest an idiopathic abnormality in the distribution of the dental material originated very soon in the dental development. They can be considered as an early double fusion between three tooth germs, initially separate but in close proximity and developing synchronically.

Child, Preschool↗

Decoronation: how, why, and when?

Decoronation is a surgical method for treating ankylosed incisors in children and adolescents. The crown and root filling are removed, leaving the root in situ to be resorbed and covered with a mucoperiosteal flap. Early loss of a permanent tooth leads to loss of alveolar bone, especially in buccopalatal width. Decoronation preserves not only the width of the ridge but also the vertical height.

Adolescent↗

Microdontia after chemotherapy in a child treated for neuroblastoma.

OBJECTIVE: Chemotherapy used on paediatric oncology patients often causes disturbances in dental development. Aim of this case report is to present the late effects of chemotherapy on dental development in a patient treated for neuroblastoma at early age. DESIGN: Case report. RESULTS: This paper presents a female patient treated at early age with surgery and chemotherapy for a neuroblastoma (stage IVS) in the right thorax and massive liver metastases. The examination of the patient at age 11.7 years showed microdontia of six teeth. In three of them size and form of the crown were affected, while in the other three the size was reduced but the form was not affected. CONCLUSIONS: Chemotherapy on children treated for neuroblastoma can adversely influence tooth development. This has to be taken into consideration by the dentist when monitoring the development of the dentition and occlusion.

Antineoplastic Agents↗

Treatment of crown fractures with pulp exposure in primary incisors.

The treatment options of enamel dentin crown fractures with pulpal exposure in the primary dentition traditionally consist of direct pulp capping, pulpotomy, pulpectomy, or extraction. Many clinicians disagree on the most appropriate treatment, and individual preferences exist within dentistry. Partial pulpotomy, also known as the Cvek pulpotomy, is a mode of treatment which is widely used in the permanent dentition but less so in primary teeth. This conservative technique is described and its advantages over the others are presented. In addition, a report of a case with a 2-year follow-up is also included. The purposes of this article are: (1) to present the indications and contraindications of the various treatment modalities for primary incisors with complicated crown fractures; and (2) to suggest partial pulpotomy as a conservative and more appropriate approach for primary incisors with complicated crown fracture.

Calcium Hydroxide↗

Multiple fractures of primary molars caused by injuries to the chin: report of two cases.

Two cases of multiple fractures of the primary molars caused by injuries to the chin are presented. Clinical and radiographic examinations revealed a vertical fracture line in the maxillary and mandibular primary molars. Pulpotomy or pulpectomy treatment was performed on the affected teeth, which were then restored with preformed stainless steel crowns.

Accidental Falls↗

Dental findings and rehabilitation in familial osteodysplasia (Anderson type): a case report.

Familial osteodysplasia is a disorder of osteogenesis with an autosomal recessive pattern of inheritance which predominantly affects facial bones. No recent case had been reported, particularly from a dental point of view since the syndrome was first described by Anderson et al (JAMA 1972;220:1687-93). A 23-year-old male with familial osteodysplasia was presented in maxillofacial and dental aspects with clinical and radiological manifestations including malocclusion, abnormal teeth alignment, impacted teeth, shape disturbances including uncompleted coronal formation, root shortening with bulbous form, high angled mandible and elongation of the corpus of mandible. Recognition of the syndromal features prior to any dental intervention is of paramount importance because of increased inclination to spontaneous mandibular fractures. Hence, no surgical intervention was performed for impacted teeth. Following the extractions of severely mobile teeth, a definitive restoration was fabricated as distal-extension removable partial dentures with conus crown telescopic system. The aesthetic and functional outcome was satisfactory for the patient. In conclusion, dentists appear to play an important role in the recognition of familial osteodysplasia, based on maxillofacial and dentoalveolar findings. Awareness of the syndromal features, especially of spontaneous fractures, would detect the limitations for dental interventions and treatment planning.

Adult↗

Treatment of crown fractures with exposed pulps.

Traumatic injuries are a common cause of pulpal damage in anterior teeth. Crown fractures with exposed pulps represent 18 percent to 20 percent of the traumatic injuries that involve the teeth. This clinical study comprised 36 patients, who were referred for 40 crown fractures with pulp exposures. There were 39 maxillary incisors and one mandibular incisor. The partial pulpotomy (Cvek's technique) consists of amputating exposed pulp tissue to a depth of 1 to 2 mm below the point of pulp exposure. After partial pulpotomy, the pulpal wound is covered with calcium hydroxide; and the cavity is sealed with glass ionomer cement or a composite crown. Clinical and radiographic assessment of the hard-tissue barrier was done after three months. Patients were monitored for periods ranging from one to 12 years. The purpose of this clinical report was to evaluate Cvek's technique in the management of coronal fractures with pulp exposures and the long-term outcome of the partial pulpotomy in immature and mature teeth. In virtually all of the cases, this treatment was successful. Careful partial pulpotomy remains a prudent treatment choice with proper case selection.

Adolescent↗

Intentional replantation with 180 degrees rotation of a crown-root fracture: a case report.

Crown root fractures are frequently difficult to treat and have a bad prognosis. To restore the biological space, intentional replantation can be chosen when osteotomy/osteoplasty and dental traction are not viable. Intentional replantation with tooth rotation consists of extraction, 180 degrees rotation and replantation, thus restoring the biological space. After treatment of inflammatory resorption with calcium hydroxide, endodontic treatment was completed. The patient was followed up with clinical examination (mobility test, gingival sulcus depth) and radiographic analysis (to analyze root resorption: inflammatory and/or substitution, and the integrity of the alveolar cortex and the periodontal space) for 3 years and there were no signs of resorption.

Child↗

Avoiding "the space" by the treatment of compromised teeth.

The advent of implant therapy has given new a dimension to dentistry particularly where teeth have been irretrievably damaged or pathologically involved. There are many situations however, where endodontic or combined therapy may effectively retain compromised teeth and clinicians should carefully evaluate evidence-based treatment. The main areas discussed are: transverse and crown root fractures and invasive cervical resorption. Transverse root fractures have an excellent natural healing capacity and will also respond favourably to treatment if pulp necrosis occurs in the coronal segment. Studies have shown that crown root fractures can be effectively treated by combined endodontic-orthodontic-periodontic and prosthodontic therapy. Invasive cervical resorption has been classified into four classes depending on the degree of infiltration of resorptive tissue into the tooth structure. A study of treatment results following the topical application of 90% aqueous trichloracetic acid, curettage and restoration indicated that this regimen could be successfully applied to Classes 1, 2 and 3 resorption.

Aluminum Compounds↗