Left Central Incisor Research Articles

Endodontic and Surgical Management of Trauma-Induced Combined Internal and External Root Resorption with Periapical Cyst: A Case Report

Root resorption, involving the breakdown of hard tissues like dentin and cementum, can result from trauma and subsequent infection, potentially leading to tooth loss. This case report details the management of combined internal and external root resorption with a periapical cyst in a 32-year-old male. After trauma, the maxillary left central incisor (#21) presented with root resorption and a displaced apex. Endodontic treatment using MTA and surgical enucleation of the cyst were performed. A 12-month follow-up showed successful resolution and tissue regeneration. This case emphasizes the effectiveness of combining advanced endodontic and surgical techniques for complex resorption cases.

Comparative evaluation of the position of incisive canal and its proximity to the maxillary central incisor roots with different incisor inclinations – A CBCT study

Objectives: The aim of this study was to evaluate and compare the incisive canal position and its proximity to maxillary central incisor roots at different incisor inclinations. Material and Methods: A 105 CBCT samples have been then divided into three groups on the basis of U1-SN and U1-NA when traced on lateral cephalogram into normal, proclined, and retroclined. Several linear measurements have been made in the axial plane at three different levels, that are palatal opening, mid-root level, and apex, in relation to the incisive canal. Angular measurements were also made in the sagittal plane. Results: A significant difference was found between the proximity of the maxillary right and left central incisor to the incisive canal in the proclined and retroclined group at the mid-root level and at the apex. There has been a major variation between the angles developed by the incisive canal to the palatal plane in all three groups. A significant correlation was also found between the angle formed by the incisive canal to the palatal plane and the tooth’s long axis to the palatal plane. Conclusion: The proclined group exhibits the shortest distance between the incisive canal and the incisors, implying the need for meticulous planning in Class II Division 1 and bimaxillary protrusion cases. This planning is crucial when aiming for extensive retraction and intrusion to prevent any contact with an incisive canal, thus reducing the root resorption risk.

Influence of Using a Puncturing Method and Cooldown Period Before Pressing the Second-Layered Sheet on the Final Thickness of Double-Layered Sports Mouthguards: An Experimental Study.

The thickness of the mouthguard is a crucial factor in its protective ability for athletes. This study aimed to investigate the final thickness of double-layered sports mouthguards, which were fabricated using different methods before pressing the second layer. Seven upper working models (n = 7 per group) were prepared for mouthguard fabrication. The first 3-mm mouthguard sheet underwent heating, pressing, and vacuuming onto the model, followed by various protocols before the second 3-mm sheet was pressed. Group 1: The second sheet was pressed immediately. Group 2: The first sheet underwent a 1-h cooldown period before pressing the second sheet. Group 3: The interproximal areas of the first sheet were punctured followed by immediate pressing of the second sheet. Group 4: The first sheet was punctured followed by a 1-hcooldown before pressing the second sheet. After 24 h, the mouthguard thickness was measured at various points on the left and right central incisors and first molars using a digital caliper. The thickness analysis was performed using SPSS 29.0 with one-way ANOVA and Tukey post hoc analysis. At the labial surface of the central incisors, Group 4 exhibited the highest thickness, while Group 3 had the lowest (p < 0.001). Groups 1 and 2 did not show significant differences in thickness. At the incisal edges, Group 3 again had the lowest thickness (p < 0.05), with no significant differences observed among the other groups. There were no significant differences in thickness across all areas at the first molars, including cusp tips, pits, and buccal surfaces (p > 0.05). Group 4 demonstrated greater uniformity at the central incisors in thickness compared with the other groups. Using the puncturing method at interproximal areas combined with a cooldown period could enhance mouthguard thickness at the labial surfaces of the central incisors and improve its thickness uniformity.

TREATMENT OF TOOTH AVULSION: A CASE REPORT

Dental trauma (DT) refers to injuries caused by impacts to the teeth and/or the hard and soft tissues within or outside the oral cavity. Among the various types of DT, avulsion, characterized by the complete displacement of the tooth from its socket. The success of treatment depends on timely management and proper professional care during and after reimplantation in preserving the tooth in the oral cavity. This study describes a case report of an avulsion of the upper left central incisor (21) that underwent reimplantation. The patient, a 10-year-old boy, had a history of bicycle fall, presenting with extraoral injuries to the cheek and chin, lip abrasions, and avulsion of tooth 21. The tooth was stored in milk and reimplanted 30 minutes after the accident. Clinical and radiographic examinations showed no bone fractures but revealed mobility of teeth 11 and 12 and avulsion of tooth 21. Treatment included cleaning, repositioning of the avulsed tooth, stabilization with a semi-flexible splint, and administration of antibiotics and analgesics. Endodontic therapy with mechanical instrumentation was successfully initiated after 20 days. This case highlights the importance of proper tooth storage and timing of reimplantation, leading to the restoration of patient’s aesthetics, chewing function, and self-esteem.

Early intervention of unerupted maxillary central incisor: A case series

Early intervention of an impacted maxillary central incisor is crucial to avoid space loss with tipping of the adjacent teeth and allows normal root development. This case series demonstrates the clinical considerations of a surgical-orthodontic approach in managing this eruption anomaly and its challenges. All three cases involved young patients aged 7–9 years with an impacted upper left central incisor and a positive history of dental trauma. An upper sectional fixed appliance was bonded to facilitate the closed eruption of the impacted central incisor. The treatment duration increases when more space is required for the impacted tooth. There was a marginal gingival discrepancy of all the treated central incisors with vertical relapse seen upon review, indicating the need for a careful surgical approach with good hygiene maintenance and a bonded retainer as retention. Early referral for the management of an impacted maxillary central incisor through a surgical-orthodontic approach is often successful, but treatment risks, duration, and retention regimen should be discussed with the parents for informed consent.

A multifunctional scannable mounting device for computer guided implant surgery: An in vitro study

As part of the growing digitization of the dental field, clinicians are looking for ways to simplify digital workflow, reduce chairside time, and provide new work patterns for future applications. Whether scanning with a multifunctional apparatus (MFA) scan body results in improved scanning is unclear. The purpose of this in vitro study was to compare the horizontal, vertical, and angular deviations with the MFA scan body with a commercially available scan body (SBIO). Sixteen identically printed edentulous maxillary models were used to plan two Ø3.8×11.5-mm implants in the right maxillary first molar and left maxillary central incisor locations. Two implants in each model were installed using a surgical guide. The models were scanned using an intraoral scanner with MFA and then rescanned twice, with SBIO using the intraoral scanner and a laboratory 3D scanner. The implants were digitally positioned according to the scanned MFA and SBIO locations in standard tessellation language (STL) files. These STL files were superimposed on the reference laboratory 3D scanner STL files. Linear measurements included implant apex/cervical horizontal/vertical deviations, as well as implant axis angular deviations. Normality was evaluated with the Shapiro-Wilk test. Paired samples t tests (2 sided) were used for the mean SBIO-MFA deviation difference. To compare the molar/incisor sites, paired samples Wilcoxon tests were used (α=.05 for all tests). No statistically significant differences were found between the MFA/ SBIO deviations, for each of the 10 sites × deviation combinations (P>.05). Overall, the lowest endpoint of the 95% confidence intervals among the 8 linear measurement comparisons was -0.107 mm (coronal vertical deviation, right maxillary first molar site) and -0.30 degrees between the 2 angular measurement comparisons. The current in vitro study demonstrated high accuracy for the novel MFA device, similar to that of the standard SBIO scan body. Furthermore, the current study offers an alternative technique to evaluate the accuracy of implant placement by using scanning and back programming over the traditional postplacement cone beam computed tomography (CBCT) scanning.

Surgical Management of Palatally Impacted Mesiodens in a Pediatric Patient: A Case Report

Supernumerary teeth are additional teeth or tooth-like structures that can develop either erupted or unerupted, beyond the normal complement of 20 primary teeth and 32 permanent teeth. A mesiodens is a specific type of supernumerary tooth located in the midline between the two central incisors. The presence of these extra teeth can lead to various clinical complications. This paper presents a case involving a palatally positioned, impacted mesiodens that was associated with an unerupted permanent left maxillary central incisor. Surgical removal of the mesiodens was performed, resulting in the successful eruption of the permanent incisor.

Validation of finite-element-simulated orthodontic forces produced by thermoplastic aligners: Effect of aligner geometry and creep

PurposeFinite element (FE) models for determining the orthodontic forces delivered by clear aligners often lack validation. The aim of this study was to develop and validate accurate FE models for clear aligners, considering the small but important geometrical variations from the thermoforming process and the creep behavior of the aligner material. Methods and materialsThe tooth misalignment considered was a 2.4° torque aberration (rotation about the mesial-distal axis at the level of the center of resistance) of the maxillary left central incisor. FE models were created from Micro-CT scans of a model dental arch and five nominally identical aligners with the aforementioned misfit. Fitting of the aligners onto the dental arch was simulated using Abaqus's Interference Fit function, followed by surface-to-surface frictional interaction. Stress relaxation of the aligner material was measured using double-cantilever beam bending and modeled with a Prony series. The assembled FE models were validated by comparing the predicted forces and moments delivered to the maxillary left central incisor with experimental data, obtained with a custom-built but fully calibrated apparatus. ResultsGood agreement between prediction and measurement was obtained for both the short- and long-term forces and moments. In the short-term, i.e., after 30 s, the dominant force in the labial-lingual direction had a maximum difference of 2.9% between experiment and simulation, and the dominant moment about the mesial-distal axis had a maximum difference of 8.3%. In the long-term, i.e., after 4 h, the experimental and numerical forces had a maximum difference of 8.4%. There were statistically significant differences in the forces delivered among the nominally identical aligners, which were predicted by the geometrically accurate FE models and attributed to the variations in the points of contact between the aligners and the dental arch. The decay in force applied was affected by both the viscoelastic material behavior and friction between the aligner and arch. ConclusionFor accurate prediction of the forces and moments delivered by thermoplastic aligners, FE models that can accurately capture the point contacts between the aligners and the underlying teeth are essential. Stress relaxation of the aligners could be adequately modeled using the Prony series to represent the temporal changes of their elastic modulus.

ASSESSMENT OF THE ANATOMICAL STRUCTURE OF CANALIS SINUOSUS IN THE ANTERIOR MAXILLA TO AVOID SURGICAL COMPLICATIONS

Aims: The study's objective was to evaluate the canalis sinuosus (CS) anatomical structure in the front maxilla in order to prevent surgical problems in an adult Yemeni population sample acquired using cone-beam computed tomography (CBCT). Materials and Methods: A retrospective descriptive cross-sectional study was carried out to assess 226 participants' CBCT pictures. 452 sides in total were assessed. There were 140 females (61.9%) and 86 males (38.1%) among the samples. The age distribution was 18–34 years (65%) and over 35 years (35%), with a mean age of 32.13. Version 25 of the Statistical Package of the Social Sciences (SPSS) was used for all statistical analyses. Result: It was discovered that 160 right (35.4%) and 175 left (38.7%) of the 226 patients and 452 sides had CS. Among these individuals, 117 (51.8%) had unilateral CS and 109 (48.2%) had bilateral CS. The CS was 8.12 mm from the nasal cavity floor (D1), 6.99 mm from the buccal cortical bone ridge (D2), and 13.47 mm from the crest of the alveolar ridge (D3), as the mean distances were measured. Males and females had somewhat higher mean values for the linear measurements D1 and D3, but females had slightly higher mean values for the linear measurement D2. The CS had a mean diameter of 1.11 mm. Left central incisor area was the most commonly observed location of CS, and palataly was the most frequently recorded location of CS. Conclusion: Since the CS is present in 100% of adult Yemenis, it is imperative that general practitioners and maxillofacial surgeons become more knowledgeable about the position and structure of the CS. Peer Review History: Received 19 May 2024; Reviewed 12 July 2024; Accepted 23 August; Available online 15 September 2024 Academic Editor: Dr. Iman Muhammad Higazy, National Research Center, Egypt, imane.higazy@hotmail.com Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Prof. Gorkem Dulger, Duzce University, Turkey, gorkemdulger@yandex.com Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, sansan4240732@163.com

Double Teeth and Coexistent Anomalies: Examples From Continental Africa.

Whether gemination or fusion, double teeth are rare worldwide, including Africa based on few published data. New cases from the continent are tallied, and anomalies potentially associated with double teeth are identified. These findings should interest a range of dental researchers. The presence of double teeth was recorded in 97 modern and premodern North and sub-Saharan African samples (5631 inds.). They and coexistent anomalies are described relative to published examples. Prevalence was estimated as possible, using a Poisson model for 95% confidence intervals (CI). Three maxillary double teeth were identified: a primary left lateral incisor in a Nubian child (1938-1756 BC), permanent left central incisor in an adult Egyptian (3650-3500 BC), and permanent right central incisor in a modern (19th century) adult from Guinea. Each co-occurs, respectively, with a talon cusp, peg lateral incisor and, in the latter individual, second premolar crown variation with rotation, and third molar dens evaginatus. Double tooth prevalence is 0.048% (CI 0.001%-0.270%), with regional variation, in premodern, and 0.000% in modern North Africans. It is 0.000% for premodern and 0.048% for modern sub-Saharan Africans (0.008%-1.714%). The double incisors are comparable to other global examples, indicative of common developmental processes during odontogenesis. Prevalence is lower than published modern rates, to suggest some exceptionality in Africans as reported earlier for other dental variants. Finally, though circumstantial, double teeth and accompanying anomalies may share an etiology. Continuing research overall, and in Africa specifically, will promote an improved understanding of double teeth formation and expression.

Evaluation of stress distribution in restorations of maxillary central incisor with post-traumatic enamel-dentin fracture using two different techniques: A micro-computed tomography study

Aim: The aim of this study is to investigate the stress distribution created by two restorative techniques, adhesive reattachment of the fractured fragment and direct composite restoration, used in the treatment of a maxillary central incisor with enamel-dentin fracture. The analysis is conducted using the finite element stress analysis method on a three-dimensional (3D) model prepared based on micro-computed tomography data, following the application of different adhesive procedures on fractured teeth. Methodology: The avulsed left maxillary central incisor was scanned using a micro-computed tomography device. The obtained data was transferred to a computer and used for 3D modeling. In the models, a fracture line was created obliquely at a 45° angle, 3 mm away from the mesial surface towards the distoincisal corner of the tooth. Six restorations were planned on this model: three direct composite restorations and three adhesives, reattachments followed by composite application. The models for the adhesive reattachment method included: (1) internal dentin groove, (2) palatal composite laminate veneer, and (3) double palatal retentive groove. The models for the composite restoration technique included: (1) composite laminate veneer, (2) direct composite restoration following enamel beveling, and (3) composite application after double palatal groove preparation. Upon completion of the restorations, a 100-N force was applied from the palatal direction using the finite element stress analysis method. The results were analyzed to examine the amount and distribution of stress on the restorations and the tooth. Results: In all models, the highest stress values within tooth structures were observed in the enamel. The lowest stress value in the enamel layer was seen in model R-1, whereas the highest stress value was observed in model K-2. For direct composite restorations, the stresses on enamel, dentin, and restoration were relatively similar in each model, with no significant differences noted among these values. Among all applied composite restorations, the lowest stress value was observed in model R-3. When analyzing the stresses generated at the tooth-restoration and tooth-fractured fragment interface of the six models, the lowest stress in the enamel was observed in models R-1 and K-3, while the highest stress was seen in model R-3. Conclusion: According to the data obtained from the models, the shape of the restoration applied on the tooth, the technique used, and the location of the restoration affect the amount and distribution of stress accumulated in the tooth and restoration. However, the stress analysis results are not sufficient to evaluate the clinical success of restorations. There is a need for further studies utilizing different techniques to support the models used. How to cite this article: Olgaç Akgönül Ş, Çelenk S, Adıgüzel Ö. Evaluation of stress distribution in restorations of maxillary central incisor with post-traumatic enamel-dentin fracture using two different techniques: A finite element analysis based on micro-computed tomography data. Int Dent Res 2024;14(2):76-83. https://doi.org/10.5577/intdentres.535

Root canal configuration of human permanent anterior teeth: A cross-sectional study using cone-beam computed tomography in the Pakistani population.

To analyse and document internal root morphological variations in permanent anterior teeth using conebeam computed tomography. The cross-sectional, retrospective study was conducted from January 21 to June 19, 2021, at Jinnah Magnetic Resonance Imaging and Body Scan, and comprised data from July to December 2020 related to all the patients who had been referred to the centre for dental cone-beam computed tomography scan. The scans were evaluated at the Radiology Department of the School of Dentistry at Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. The morphology of the roots and root canals in all permanent anterior teeth was examined. Root canal configuration was categorised using Vertucci's classification. Data was analysed using SPSS 20. Of the 211 patients, 116(55%) were females and 95(45%) were males. The overall mean age was 39.9±1.02 years (range: 15-65 years). All the permanent anterior teeth exhibited a single root, with the exception 2(0.9%) mandibular right and 4(1.9%) left canines which had double roots. Type I root canals were observed in all 211 (100%) maxillary right central incisors, maxillary left central incisors and maxillary left canines. Among maxillary right canines, 208(98.6%) had type-I root canals, and the corresponding value for maxillary right lateral incisors was 209(99.1%), and for maxillary left lateral incisors, the value was 210(99.5%). Root canal polymorphism had no significant association with gender (p>0.05). The presence of type-I root canal was common in permanent anterior teeth, and there was significant association of root canal polymorphism with gender.

Perception and Acceptance of Shade Variances in the Smile.

(1) This study aimed to evaluate the influences of differences in denture teeth shade on harmony ratings and esthetic quality. Particular attention was paid to the question of how the overall variance of shade differences in the dental arch influences the perception of shade differences between adjacent teeth. (2) A total of 51 pictures of upper front teeth with standardized different colors of the left central incisor and different color variance of the dental arch were created. Eighty participants without dental knowledge and of different age, sex and educational level rated the pictures on a visual analogue scale from 0 (strongly disagree) to 100 (strongly agree) with regards to esthetic and color equality. (3) Results: The color differences between two teeth were judged in a negative linear correlation to the evaluation of color and esthetic quality. There was a sex- and education-specific difference in color and harmony ratings. In relation to the age of the participants, there was a significant difference in the color rating (p = 0.01) but not in the harmony rating (p = 0.27). Lower rating of color difference and harmony was found for a color difference in the dental arch up to ΔE = 3.1. In contrast, higher color differences resulted in higher ratings. (4) There is an influence of personal parameters on color perception. Color inhomogeneity in a dental arch leads to significant differences in color and harmony rating in a non-linear relation.

Reattachment of Fractured Tooth Segment in Minimally Invasive Way - A Case Report

Dental trauma frequently results in coronal fractures of the front teeth. Root canal therapy followed by reattaching the fractured segment with fiber post reinforcement is a viable alternative in cases of complex fractures where the fractured segment is present and there is close approximation of the segment to the intact tooth. Reattaching a fractured piece is a quicker, less involved process that offers immediate relief, better aesthetics, and function restoration. The present case report is of a 11-year-old boy with an uncomplicated crown fracture of permanent maxillary right central incisor and a palatal uncomplicated crown–root fracture of his permanent maxillary left central incisor . The fractured fragment was reattached using nano-filled dual-cure composite resin and tooth restored with composite resin. The fragment showed opaque discoloration that reduced over time but still persisted after 1 year. During the follow-up period, no unfavorable radiographic changes were seen. The prognosis of the teeth was favorable with good esthetic results. Keywords: Fragment reattachment, Fragment rehydration, Periodontal health, Root fracture, Uncomplicated crown.

Surgical and orthodontic management of impacted maxillary central incisor in children: A case report

Impaction of maxillary permanent central incisor is a frequently reported case in dental practice, and its treatment is challenging because maxillary central incisors are of great important for both aesthetic and functional aspects, since they provide support of the lip and facial muscles. Early detection of such teeth is most important if complications are to be avoided. In this article, we report a case of a 12-year-old girl, in the Pediatric Dentistry Specialist, Dental and Oral Hospital, Airlangga University. Combined approach with surgical exposure and the application of an orthodontic force brought the impacted left maxillary central incisor down to its proper position in the dental arch.

Tooth autotransplantation and resin composite reshaping as a multidisciplinary approach for treating dental agenesia: A 10-year follow-up.

This case report describes the multidisciplinary approach performed in a 9-year-old male patient with dental agenesia affecting teeth 21 and 22. Autotransplantation of the right upper second premolar with incomplete rhizogenesis to the missing area was combined with coronary reshaping with resin composite and orthodontic therapy. The treatment began with the extraction of the deciduous upper left central incisor, bone preparation for the recipient site of the donor tooth, atraumatic extraction of the right upper second premolar and immediate autotransplantation in the surgically prepared recipient site. Subsequently, sutures to reposition the flap and a rigid splint were performed. After 12 months, coronary reshaping of the autotransplanted tooth with resin composite was carried out. Orthodontic treatment involving the use of a fixed appliance was used to correct the interdental spaces and achieve adequate occlusion. Clinical and radiographic follow-up 10 years after tooth autotransplantation and 9 years after reshaping revealed partial obliteration of the pulp chamber, root resorption, ankylosis and the presence of endodontic treatment. The long-term outcomes highlighted that tooth autotransplantation represents a biologically and cost-effective procedure for replacing missing teeth in young patients, particularly in cases of incomplete rhizogenesis of the autotransplanted tooth. This case report discusses tooth autotransplantation and resin composite reshaping as viable and long-term clinical options for treating young patients with dental agenesis.

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.

Cone-Beam Computed Tomography Study of Incisive Canal and Maxillary Central Incisors in Dravidian Population.

En-masse maxillary anterior retraction is necessary to attain an esthetic profile in Angle's class I bimaxillary dentoalveolar protrusion and Angle's class II division 1 malocclusion. The objective of this study was to evaluate configurational relationships between maxillary incisors and incisive canal in Angle's class I bialveolar protrusion and Angle's class II division 1 malocclusionby cone-beam computed tomography (CBCT). A total of 108 adult CBCT scans of 54-skeletal class I bialveolar protrusion and 54-skeletal class II division 1 malocclusions were retrospectively analyzed. Angles between palatal plane and axis of maxillary alveolar border (θ1),incisive canal (θ2), and maxillary right central incisor (θ3) were measured in relation to the midsagittal plane. Linear measurements such as incisive canal width (IC-IC), medial inter-root distance (Rm-Rm), posterior inter-root distance (Rp-Rp), anteroposterior distance from Rm to tangent of right central incisor (11 Rm-Cat), and left central incisor (21 Rm-Cat)corresponding to three vertical levels (L1, L2, and L3) were assessed in axial cross-sectional plane. Association among angular measurements was examined by Spearman correlation coefficient analysis. Mann-Whitney U test compared variables of linear measurements at three vertical levels. Estimated distance from incisor root to incisive canal was 5-6 mm in both groups slightly influenced by skeletal class and vertical levels but not gender. Mann-Whitney test demonstrated significant differences between groups at three vertical levels (p<0.05). Only θ2 revealed a significant difference (p<0.05) between malocclusions compared to θ1 and θ3. The angular measurements for both malocclusions were positively correlated (p<0.05). Sagittal root-canal cortical plate distance varied significantly in both malocclusions (5-6 mm). Inter-root distance (Rp-Rp) was greater than incisive canal width (IC-IC) at all three vertical levels indicating a reduced possibility of canal invasion after maximum retraction at posterior levels.

Management of avulsion-induced external root resorption of permanent maxillary left central and lateral incisors - a one-year follow-up case report

The presented case elicits the successful management of external root resorption in an avulsed permanent central and lateral incisor due to failure to initiate root canal treatment (RCT) at the right time and prolonged splinting. A 13-year-old female child reported a complaint of pain in her upper anterior teeth region. The child gave a history of avulsed 21 and 22, which was replanted. External inflammatory root resorption in (21 and 22) and peri apical abscess (11) was noted in the radiograph. External inflammatory root resorption was treated endodontically with corticosteroid-antibiotic medicaments and obturated with mineral trioxide aggregate (MTA). Obturation was done only after restoring tooth stability and symptom resolution. Replacement resorption was noted radiographically during the follow-up visit. This case underscores the importance of meticulous endodontic care and adherence to treatment timelines, providing valuable insights for clinicians managing similar challenging cases.

Dens in dente: A review of literature with a rare case report

Dens invaginatus (DI) (dens in dente) is a developmental anomaly resulting from an invagination in part of variable depth of the enamel organ into the dental papilla in the surface of the crown before calcification of the dental tissues. They are a target for caries leading to pulp necrosis and apical pathosis, so the diagnosis and early prevention measures are important. When treatment is necessary, conservative, endodontic, and periodontal possibilities are very effective. Surgical interventions are only rarely indicated. This article presents a unique case report of unilateral DI of Type III (Ohlers) involving the maxillary left central incisor as well as a comprehensive review of literature on history, aetiology and classification. Early detection and management are recommended before the development of pulpal and periodontal pathosis that further complicates the prognosis. Postoperative follow-up subsequent to treatment is essential for effective long-term clinical management.