Left Central Incisor Tooth Research Articles

Age Estimation Using the Pulp-to-Tooth Area Ratio in an Indian Population Using Cone-Beam Computerised Tomography (CBCT): A Retrospective Study.

Age estimation, whether for living or deceased individuals, is crucial in forensic sciences. Traditionally, the pulp-to-tooth area ratio determined from periapical radiographs has been employed as a non-invasive method for estimating age. Cone-beam computed tomography (CBCT) represents a newer technique, providing three-dimensional images of teeth in living individuals. This study aims to estimate age using the pulp-to-tooth area ratio of four teeth (the permanent maxillary central incisor, lateral incisor, canine, and first premolar. The study included ninety subjects ranging in age from 18 to 70 years. This study concluded that the correlation between actual age and estimated age varied across different tooth types. There was a strong positive correlation between the maxillary right central incisor and maxillary right canine tooth, while the maxillary left canine tooth exhibited a slightly weaker but still positive correlation. This indicates that the maxillary right central incisor and maxillary right canine tooth are the most reliable for estimating age. Additionally, the study found that the linear regression results for estimating age based on the pulp-to-tooth area ratio, categorised by sex and each type of tooth, showed strong associations between age and the ratio for the maxillary left central incisor and maxillary left canine teeth in males, and for the maxillary left central incisor in females.

Investigation of the Mesiodistal Angulations of Maxillary Canines and Central Incisors for Missing Bilateral Maxillary Lateral Incisor.

(1) Background: A missing bilateral maxillary lateral incisor (MBMLI) causes aesthetic and functional problems and a multidisciplinary approach is required for treatment. This study aimed to compare the changes in the mesiodistal axial angulations of the maxillary canines and central incisors with orthodontic treatment of MBMLI. (2) Methods: A total of 56 patients with MBMLI were included in the study, and three groups were formed: the control group (Group 1, n = 20) with untreated ideal occlusion and the space opening (Group 2, n = 20) and space closure (Group 3, n = 16) groups as treated study groups. The mesiodistal angulations between the long axes of the maxillary right canine (tooth no 13), right central incisor (tooth no 11), left central incisor (tooth no 21) and maxillary left canine (tooth no 23), and the bicondylar plane, were measured on the panoramic radiographs taken pre (T0) and post treatment (T1). p < 0.05 was accepted for statistical significance. (3) Results: At T0, while there was no significant difference between the mesiodistal angulations of the right-left maxillary canines and central incisors in all groups (p > 0.05), the mesiodistal angulations of the canines in the Group 1 were significantly higher than the study groups (p < 0.05). With treatment, while the mesiodistal angulation of the canines increased in Group 2, it decreased in Group 3 (p < 0.05). On the other hand, the mesiodistal angulation of the central incisors decreased in Group 2 and did not change in Group 3 (p > 0.05). At T1, the mesiodistal angulation of the canines was found to be lower in Group 3 than in Groups 1 and 2, while the angulation of the central incisors was found to be lower in Group 2 compared to Group 1 (p < 0.05). (4) Conclusions: In the orthodontic treatment of MBMLIs, changes in the mesiodistal angulations of the maxillary canine and central incisors should be taken into account for satisfactory outcomes. It was concluded that there should be a tendency to select the space closure method in which normal mesiodistal angulations are obtained in maxillary central incisors for aesthetics and planned incisor position, and also at a low cost.

MULTIDISCIPLINARY APPROACH OF IMPACTED PERMANENT MAXILLARY LEFT CENTRAL INCISOR AND CANINE

ABSTRACT Background: The permanent maxillary canines have significant incidence of impaction, being the most affected teeth after the third molars, while impacted maxillary insicor is the third most commonly impacted tooth. Objective: This case report is about a multidisclipinary orthodontic treatment of 12 years old female with chief complaint of unerupted anterior upper teeth. Case: A case with unerupted of permanent maxillary left central incisor tooth and permanent maxillary left canine tooth, with Angle Class 1 molar relation and crowded of mandibular teeth. Panoramic and occlusal radiograph showed impacted 21 tooth with severely root dilacerations and impacted 23 tooth in palatal and horizontal position. Case Management: The patient was treated with Edgewise technique. Surgical approach was applied 3 months after levelling and unravelling stage to extract 21 tooth due to its severely root dilaceration and to bond lingual button on palatal side of 23 tooth. Orthodontic traction of impacted 23 tooth was applied a week after being exposed to the position of 21 tooth. Thirteen months after traction, 23 tooth was totally erupted and need 8 additional months to reach its final position. The crown of 23 was reshaped with porcelain fused to metal crown and 63 tooth was left still and got conservative treatment with composite. Conclusion: Orthodontic traction and reshaping of impacted 23 tooth was succeeded to replace the position of 21 tooth with good occlusion and esthetic. Based on OPG after treatment, all teeth were in good root paralleling. The patient was satisfied with good occlusion and esthetic. Keywords: Impacted maxillary canine, Impacted maxillary incisor, Root dilaceration, Orthodontic treatment, Surgical exposure

COMPARATIVE EVALUATION OF TIMING AND CLOSURE OF IMMATURE ANTERIOR TEETH WITH OPEN APEX USING TWO DIFFERENT REGENERATIVE MATERIAL: A CASE REPORT-12 MONTHS FOLLOW-UP

Regenerative endodontic Procedures provide an unconventional approach which relies on the principle of tissue engineering. Pulp necrosis of immature permanent teeth may impair root development and apical closure of root canals. Completion of root development takes around 3 years after eruption of permanent teeth. Management of immature non vital teeth is very challenging for a clinician because teeth may have wide open apex and thin root canal walls that may diverge towards the apex. Conventional cleaning and shaping of the canals and obturation may not be possible because of the lack of apical stop. Since debridement of pulp canal space is difficult, there is an increased possibility of root perforation and cervical root fracture, besides the presence of an open immature root apex jeopardize the apical seal of a root canal treatment resulting in subsequent failure. The purpose of this report is to present the case of a patient wherein apexification of an immature permanent maxillary left central incisor tooth was induced by the Biodentine (Calcium trisilicate cement) and Metapex paste (Calcium hydroxide and Iodoform).

A Comparative Evaluation of Dentogingival Tissue Using Transgingival Probing and Cone-Beam Computed Tomography.

Background and Objective: Gingival biotype can be assessed using a variety of invasive and non-invasive procedures, such as direct probing, transgingival probing, ultrasound-guided approaches, and, for the more sophisticated, cone-beam computed tomography. The aim of this study was to evaluate gingival biotype in relation to transgingival probing and cone-beam computed tomography (CBCT). Materials and Methods: This study included a total of two hundred healthy individuals. Gingival thickness was assessed and measured from the right and left maxillary central incisor teeth using CBCT and transgingival probing of the attached gingiva. The measurements were analyzed with regard to tooth type (central incisor). Linear measurements for gingival biotype were measured using both methods. Correlations and differences between measurement methods were assessed. Results: The mean age of study participants was 32.49 ± 8.61 years. The radiographic measurements on CBCT were 1.34 ± 0.17 mm for the right central and 1.28 ± 0.21mm for the left central. The transgingival probing measurements were 1.31 ± 0.18 for the right central and 1.22 ± 0.21mm for the left central. Conclusion: As per the results of this study, there is a significant positive correlation between transgingival probing and CBCT measurements of gingival biotypes.

Management of Fractured Endodontically Treated Tooth by Fibre Optic Composite Post-Core-Crown: A Case Report

The restoration of endodontically treated tooth is a subject that has been evaluated and discussed widely in the dental literature. The goal of dental treatment is to provide optimal oral health, aesthetics and functions. The successful treatment of a badly broken endodontically treated tooth depends not only on the success of the endodontic treatment but also on good prosthetic reconstruction. The prosthetic treatment on a seriously damaged, endodontically treated tooth often requires an endodontic post as an additional retention element for core build up prior to crown restoration. This case report presents a male patient of 22 years of age with prosthetic crown fracture of endodontically treated maxillary left central incisor tooth. The following clinical case represents the clinical steps involved in the utilization of a fibre-reinforced composite post-core in a maxillary left central incisor and the subsequent treatment with a full veneer crown.&#x0D; Central Medical College Journal Vol 5 No 2 Jul 2021 PP 126-130

Computer-aided finite element model for biomechanical analysis of orthodontic aligners.

To design a finite element (FE) model that might facilitate understanding of the complex mechanical behavior of orthodontic aligners. The designed model was validated by comparing the generated forces - during 0.2-mm facio-lingual translation of upper left central incisor (Tooth 21) - with the values reported by experimental studies in literature. A 3D digital model, obtained from scanning of a typodont of upper jaw, was imported into 3-matic software for designing of aligners with different thicknesses: 0.4, 0.5, 0.6, 0.7mm. The model was exported to Marc/Mentat FE software. Suitable parameters for FE simulation were selected after a series of sensitivity analyses. Different element classes of the model and different rigidity values of the aligner were also investigated. The resultant maximum forces generated on facio-lingual translation of Tooth 21 were within the range of 1.3-18.3N. The force was direction-dependent, where lingual translation transmitted higher forces than facial translation. The force increases with increasing the thickness of the aligner, but not linearly. We found that the generated forces were almost directly proportional to the rigidity of the aligner. The contact normal stress map showed an uneven but almost repeatable distribution of stresses all over the facial surface and concentration of stresses at specific points. A validated FE model could reveal a lot about mechanical behavior of orthodontic aligners. Understanding the force systems of clear aligner by means of FE will facilitate better treatment planning and getting optimal outcomes.

English

Resorption of the tooth represents a multifactorial and a perplexing problem for all clinicians resulting in complete or partial loss of tooth structure. The present clinical demonstration describes management of the permanent maxillary left central incisor (tooth number #21) affected by external root resorption involving the mesial and distal surface of middle one-third of the root. Conventional nonsurgical endodontic treatment followed by MTA (Mineral trioxide aggregate) obturation (PRoRoot MTA, Dentsply, Tulsa Dental Specialties) was planned. The root canal of the affected teeth was debrided with Dual Rinse HEDP (Medcem Weinfelden, Switzerland) containing etidronate powder and chemomechanical preparation of the root canal was performed with XP endo shaper file system (FKG Dentaire, SA, Switzerland). Thirtysix months’ post-operative follow-up revealed complete healing of the external root resorption defect with no clinical and radiological signs and symptoms. In the present case simple non-surgical endodontic management of severe external root resorption was done in a permanent maxillary tooth by using a continuous chelation irrigation technique, intracanal medicament followed by obturation with bio-ceramic material produced satisfactory results in contrast to the recommended surgical management. Resorption of the tooth being a multifactorial and a perplexing problem for all clinicians results in complete or partial loss of tooth structure. According to the Glossary of Endodontic terms, Resorption is defined as a condition associated with either a physiologic or a pathologic process resulting in the loss of dentine, cementum, and/or bone.1 Traditionally resorption can present either as internal or as external resorption.2 External root resorption occurs on the outer surface of the root and are of dissimilar nature such as external surface resorption, external inflammatory root resorption, ankylosis, and external replacement resorption, the most common being external inflammatory root resorption.3 According to the Glossary of Endodontics, “Inflammatory resorption is defined as an internal or external pathologic loss of tooth structure and possibly bone, resulting in a defect; occurs as the result of microbial infection; characterized radiographically by radiolucent areas along the root”.1 It may result due to dental trauma, forceful orthodontic tooth movement, long standing infection of the pulp or periodontal tissues. External resorption presents as a major resorptive condition of the root without any clinical signs and symptoms.2 The non-surgical management of external inflammatory root resorption is based on its aetiology, which needs to be eliminated

Apexification with apical growth and closure using Metapex in a Necrotic Immature Permanent Tooth with Periapical abscess: A Case Report with 16 months follow-up.

The purpose of this report is to present the case of a patient wherein apexification of an immature permanent maxillary left central incisor tooth was induced by the Metapex paste (Calcium hydroxide and Iodoform). It has been reported in the literature of dentistry that apexification treatment in teeth with open apex is more than 40 years old. Apexification procedures had been carried out in different ways using various techniques and materials. Regardless of the type of materials used for apexification method by different authors, apexification procedures appear to be the most subtle and accepted clinical practice in non-vital young permanent teeth. In our case, radiographic examination showed the start of apical closure 6 months after the completion of the treatment protocol. The growth of root end and complete apical closure was confirmed 16 months after the treatment, indicating the implausible potential of Metapex to induce apical growth and closure in young permanent tooth with periapical lesion.&#x0D;

Influence of preoperative degree of tooth loosening and thickness of wire on the rigidity of wire composite splint.

Context:A wire composite splint (WCS) is most commonly used in clinical practice for the management of luxation dental injuries (LDIs). Wire thickness and adhesive point dimensions influence the rigidity of WCS. However, the influence of presplint tooth mobility on the rigidity of splint is not yet addressed.Aim:The aim of this study is to identify the optimal thickness of WCS that achieves physiologic mobility in teeth with varying degrees of loosening (DoL) in a simulated LDI model.Settings and Design:In vitro study.Materials and Methods:Three typodont models with resin teeth were used. Right central incisor (Tooth 11) was simulated as an injured tooth and adjacent right lateral and left central incisor teeth (12 and21) acted as uninjured teeth. Each typodont model was modified to reproduce DoL 1, 2, and 3 in tooth 11 and categorized as Groups I, II, and III, respectively. The simulated injured tooth 11 was splinted with adjacent teeth 12 and 21 using 0.3, 0.5, and 0.8 mm WCS. Postsplinting DoL was assessed with Periotest.Statistical Analysis Used:Two-way ANOVA and post hoc Tukey test were used for intragroup and intergroup comparisons of pre- and postsplinting Periotest values (PTVs). Friedman's two-way ANOVA and Kruskal–Wallis test were used for the intragroup and intergroup comparison of splint effect.Results:Irrespective of the thickness of WCS, the postsplint PTVs corresponding to DoL 0 for simulated injured right central incisor tooth (11) were not achieved in Groups II and III. In three study groups, there was no statistically significant difference in the splint effect produced by 0.3 mm versus 0.5 mm WCS or 0.5 mm versus 0.8 mm WCS for tooth 11.Conclusions:The postsplint DoL for a luxated tooth is affected by both the degree of presplint tooth mobility and the thickness of the wire.

Early childhood tooth bud removal practice (“Ibyinyo”): preventable dental damage

Tooth bud removal called Ibyinyo is the practice of removing the developing tooth buds, usually done on an infant, typically performed by traditional healers who believe that this practice will reduce fever and diarrhoea in children. This practice is most prevalent in East-African countries, including Rwanda. These procedures are mostly performed in non-sterile conditions using basic sharp instruments. We will discuss the case of a 10-year-old female patient who was presented at the dental clinic, with two malformed permanent canine teeth. Clinical examination revealed malformed enamel and elongated permanent right maxillary canine tooth left mandibular canine tooth with crown malformation. She was also presented with retained (primary) left maxillary lateral incisor tooth and missing left maxillary canine tooth. In addition, the ectopic eruption of left maxillary central incisor tooth and missing permanent right mandibular canine tooth were noted. All these complications resulted from tooth bud removal that the patient had experienced in her early childhood. Her malformed right maxillary and left lower mandibular canine teeth were reshaped, using composite filling materials, to improve her appearance aesthetically. Ibyinyo is preventable damage, done out of ignorance and superstitious practices that can be stopped by growing social awareness. Therefore, educating parents through community-based campaigns on the detrimental consequences of early childhood tooth bud removal through Ibyinyo practice might be helpful to eradicate this harmful and unnecessary practice.

Endodontik Kaynaklı Ekstraoral Fistülün ve Periapikal Lezyonun Cerrahi Olmayan Endodontik Tedavisi

Cases with periapical lesions or extraoral sinus tracts have both aesthetic and functional problems. Non-surgical endodontic therapies to resolve these problems provide less traumatic solutions wıth higher cost-effectivity. A 14-year-old male patient was admitted to our clinic with complaints of swelling and skin lesion on the tip of his chin. Clinical and radiological examination revealed the cause of the extraoral sinus tract and periapical radiolucency as pulp necrosis associated with apical periodontitis in mandibular left incisors. Additionally, a radiopaque foreign object was detected in the middle third of the root canal of the mandibular left central incisor teeth. The foreign object was removed from the mandibular left central incisor and root canal fillings were performed for the mandibular left incisors teeth. Two weeks after the treatment, the extraoral sinus tract was completely healed and after 12 months the teeth were clinically asymptomatic and periapical tissue healing continued. The aim of this case report is to evaluate the success of the non-surgical endodontic treatment of the extraoral sinus tract and periapical lesion due to pulp necrosis and chronic apical periodontitis.

Endodontic Retreatment of a Maxillary Central Incisor with Two Root Canals in a Patient with Cleft Lip and Palate.

The failures in endodontic treatments are often related to anatomical variations. Some anatomical changes in anterior teeth occur in patients with cleft lip and palate. This paper aims to report the endodontic retreatment of a maxillary central incisor with two roots and two canals on a patient who presents cleft lip and palate. A male patient, 11-year-old, reported pain when chewing related to the left maxillary central incisor tooth (tooth 21) which featured a sinus tract after primary endodontic treatment. In periapical radiograph, it was observed an alteration on the anatomy of the root on the tooth 21, which featured a radiolucent area on the dental apex and had been properly endodontically treated. In cone-beam computed tomography (CBCT) images the presence of an accessory root in the palatal region was observed, that had not been prepared, or filled. Thus, the non-treated accessory canal was instrumented with the crown-down technique and filled with gutta-percha and endodontic sealer. After 1 year of follow-up, the patient presented the tooth with a normal masticatory function and no painful symptoms. Therefore, it can be concluded that the additional root canals may be present and the CBCT is an important tool to evaluate the internal root morphology. In cleft lip and palate patients, the root canals morphology should be carefully analyzed due to high prevalence of dental anomalies which may influence the success in endodontic treatment.

The Effect of Mandibular Symphysis Fracture on the Position of the Permanent Incisor Tooth Germ

Background: Among facial bones in children, mandible bone has the highest fracture rate, 8.4% of which is related to Symphysis fractures. Case Presentation: A 3.5-year-old girl with complaints about the mobility of the mandibular left primary central incisor without a history of recent dental trauma and caries referred to the Department of Pediatric Dentistry of Hamadan University. After radiographic evaluation, occlusal displacement of lower left permanent central incisor tooth germ and root resorption of lower left primary central incisor were seen. Conclusions: This case report implies that because of the close proximity of the root of the primary tooth to its developing permanent successor, jaw fracture and especially mandibular fracture combined with dental injuries (e.g., intrusion, avulsion, and extrusive luxation) can cause damages and significant displacement in permanent successor tooth germs.

Quantitative light-induced fluorescence assessment of white spots following semi-rapid maxillary expansion.

This study aimed to investigate if the semi-rapid maxillary expansion (SRME) can cause white spot lesion (WSL) formation using quantitative light-induced fluorescence digital (QLF-D). The SRME group comprised 15 patients (9 girls, 6 boys; 13.5 ± 1 years) who had transverse maxillary deficiency and underwent expansion with full-coverage expanders. The screw of the expanders in the SRME group was activated twice a day for the first week. After decementation at the end of the first week, the screw activation protocol was changed to 3 turns/ week. In the SRME group, the QLF-D images were captured before starting treatment and 3.18 ± 0.32 months later when the expansion treatment was completed. The control group consisted of 15 subjects (8 girls, 7 boys; mean age 14.2 ± 1.9 years) who never had orthodontic treatment. The images of the control group were obtained with 3 months interval. The images were analyzed in terms of demineralization using analysis software. The left central incisor was the only tooth that was affected by WSL formation in the SRME group after expansion. The left central incisor tooth's fluorescence levels were decreased and the lesion area increased significantly (p < 0.05). No significant mineralization changes occurred in the control group (p > 0.05). SRME resulted in WSL formation in the left central incisor, while other teeth were not affected by demineralization. Although providing adequate oral hygiene is easier during SRME due to the removable appliance, the orthodontist should still be aware that it may cause demineralization.

Chemical oral burn cum erosive gingival lesion arising from self-medication for toothache

Chemical burn of the oral mucosa occurring as a result of a noxious agent placed in direct contact with the mucosa either by the patient or a dentist is frequently associated with gingival erosion. The objective of this study was to report a case of chemical oral burn with erosive gingival lesion due to self medication with nonsteroid anti inflammatory drug topically in patient with acute apical abscess. We report a case of 63-year-old male public servant with health insurance that presented to the periodontology clinic with chemical oral burns and erosive gingival lesion due to topical application of nonsteroidal anti-inflammatory drug for relief of toothache from apical abscess of lower left central incisor (tooth 31). The patient was advised to discontinue topical application of Anacin. Full-mouth scaling was done, oral hygiene instructions given, warm saline mouthrinse therapy prescribed, and patient referredb to the conservative clinic where root canal treatment. Increased public awareness is required regarding chemical injuries that can result from topical self-medication. Dentists must recognize the local effects of topically applied aspirin as well as other medications on the oral mucosa and incorporate them into the treatment plan to prevent complications.

Partial Pulpotomy of Immature Anterior Permanent Teeth with Complicated Crown Fractures: Report of Two Cases

Aim: This report aims to present the application of partial pulpotomy procedures in fractured maxillary central incisors with immature roots. The application of this treatment approach in fractured immature permanent teeth is advantageous but a number of challenges exist particularly when the affected teeth are severed with complicated fractures&#x0D; Methodology: Two cases of complicated crown fractures are reported. A 7-year-old male patient with broken maxillary left central incisor tooth and 8-year-old female patient with fractured maxillary right and left central incisor teeth were referred to the clinic after trauma. Partial pulpotomies were performed and MTA was applied directly onto the pulps.&#x0D; Results: Hard tissue barrier was observed after treatments.&#x0D; Conclusions: Partial pulpotomy is a valid treatment approach in which part of an exposed vital pulp is removed while preserving the vitality and function of the remaining part.&#x0D; &#x0D; How to cite this article: Sharawy WW, Ahmed HMA. Partial pulpotomy of immature anterior permanent teeth with complicated crown fractures: Report of two cases. Int Dent Res 2017;7:71-75.&#x0D; Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Esthetic correction of calcified tooth discoloration by walking bleach technique

This article has no abstract. The first 100 words appear below:A 33 year old male patient came to the outpatient Department complaining of the bad appearance of his upper left central incisor tooth. He had no history of trauma in that area but the tooth was discolored gradually (Figure 1A). Furthermore, the tooth was asymptomatic. There was no pain and discomfort during mastication. The patient had gastric irritation for the last 5 years and still using omeprazole irregularly. The clinical examination indicates that the left central incisor tooth was yellowish in color and the dentine was found to be exposed (Figure 1B). There was gross tooth tissue loss at the labial surface that includes the incisal edge of the tooth.

A five-year follow-up of a root fracture in a ten-year-old boy

The management of horizontal root fracture still presents a challenge to clinicians. The case of a 10-year-old boy with a horizontal root fracture in the left maxillary central incisor (tooth number 21) is described here. The fracture was present at the junction of the apical and the middle thirds. We report both the emergency care and the 5-year follow-up. At the same time, an orthodontic treatment was planned for a retained maxillary cuspid (tooth number 23), first composed of a high-pull headgear and then by a fixed multi-bracket appliance. Today, the tooth number 21 remains vital and symptomless. This report highlights the successful management of a horizontally fractured tooth requiring orthodontic treatment. Our work also underlines the advantages of 3D images [cone-beam computed tomography (CBCT)] in positive and differential diagnosis especially in the event of a suspicion of post-traumatic complication.

Management of a Complicated Crown Fracture in a Tertiary Care Hospital

Restoration of a fractured tooth is routinely performed in clinical practice. Many factors are considered in an effort to provide optimal mechanical properties, aesthetics, longevity as well as patient acceptance. In this type of challenging endeavour, main effort should be made to save as much of the coronal tooth structure to increase survival rate of endodontically-treated teeth. This case report presents a 35-year-old male with an oblique complicated crown fracture of maxillary left central incisor tooth. The procedure used to repair the fracture was gingivectomy followed by endodontic treatment. The root canal was filled with a root canal sealer and gutta-percha points. After root canal obturation, the tooth was restored with a glass fiber post and composite resin without additional crown coverage. The restoration made it possible to maintain the remaining tooth structure in a good occlusion and resulted in a high level of patient satisfaction.J Enam Med Col 2017; 7(1): 35-38