Maxillary Left Central Incisor Research Articles

Multidisciplinary Approach for Correction of Obstructive Sleep Apnea

ABSTRACTObstructive sleep apnea (OSA) is the most common type of sleep apnea and is caused by complete or partial obstructions of the upper airway. In this study we are presenting a case report of 11-year-old male patient with enlarged adenoids and tonsils, convex profile, receded chin, lower lip trap, class II skeletal and dental relationship with increased overjet. Surgical removal of enlarged adenoids was done before commencement of twinblock therapy. After this, two-step advancement with expansion in both arches utilizing twin blocks was planned. Four months into the treatment, patient reported with history of facial trauma with avulsed maxillary left central incisor. Twin block was then modified with pontic as replacement for maxillary left central incisor. Sagittal correction resulting in class I molar relationship was achieved in next 6 months. Fixed appliance therapy was followed. The design of the appliance and the results achieved after the postfunctional therapy are presented in this case report.How to cite this articleMadhaswar AB, Ravindranath VK, Daga PN. Multidisciplinary Approach for Correction of Obstructive Sleep Apnea. J Contemp Dent 2016;6(3):189-193.

Management Of Crown Root Fracture Of Maxillary Central Incisors – A Multidisciplinary Approach: A Case Report And An Overview

This case report describes the successful management of complicated crown root fracture of maxillary central incisors and their subsequent treatment to restore form function and esthetics. A 26 year old female had fractured her maxillary central incisors. The right central incisor had fracture which involved mesial 23rd of the crown and the maxillary left central incisor had fracture line which extended distally with fracture fragment still in place. The teeth were first endodontically treated orthodontically extruded crown lengthening was done with apically displaced flap and ostectomy followed by which a post and core therapy was performed and a final restoration was given. This article presents the infrequently utilized treatment method of orthodontic extrusion and how it can serve as an alternative to the sacrifice of the natural root system.

Cone-beam computed tomography evaluation of the association of cortical plate proximity and apical root resorption after orthodontic treatment.

We investigated the effects of proximity of the root apex to the maxillary labial cortical plate, palatal cortical plate, and incisive canal cortical plate on apical root resorption. Cone-beam computed tomography was used to measure the amount of root resorption and root apex movement around maxillary right and left central incisors in 30 adults who underwent four-bicuspid extraction followed by treatment with multibracket appliances. The patients were divided into three groups on the basis of the direction of root apex movement, after which the correlation between the amount of root resorption and root apex movement was determined. Mean apical root resorption was 1.80 ± 0.82 mm (range, 0.18-3.96 mm). The amount of root apex movement was positively correlated with the amount of root resorption on the side of pressure. Root apex proximity to the maxillary labial cortical plate, palatal cortical plate, and incisive canal cortical plate was associated with apical root resorption. Orthodontic treatment plans should carefully consider root proximity to the maxillary cortical plate. (J Oral Sci 58, 231-236, 2016).

Esthetic Correction of Rotated Maxillary Central Incisor by Conservative Approach

ABSTRACT Tooth rotation is a dental anomaly of position, in which there is a displacement of the tooth within the alveolar bone around its longitudinal axis. Although it is a common finding in the premolar—molar region, rotations of the maxillary centrals are extremely rare and such aberrations are multifactorial in their origin. It is important to have a thorough understanding of such anatomical variation, which can cause occlusal and esthetic problems in patients, to alert the dental surgeons, so that they are well prepared to carry out esthetic and functional rehabilitation of the teeth involved. A successful management of 180° rotated maxillary left central incisor by conservative approach is described here. How to cite this article Nanjannawar GS, Gadodia RB, Kamat SB, Chopade R. Esthetic Correction of Rotated Maxillary Central Incisor by Conservative Approach. World J Dent 2016;7(4):217-220.

Management of Oehlers Type II Dens in Dente with Open Apex and Alveolar Bone Defect.

A 22-year-old male patient was referred to Department of Conser-vative Dentistry and Endodontics with a chief complain of pus discharge in upper left teeth region. Clinical examination showed oedema, sinus opening and pus discharge in relation to maxillary left central incisor, which did not respond to thermal tests (heat and cold) but responded positively to palpation and percussion [Table/Fig-1a,b]. On radiographic examination the upper left central incisor showed a bulbous root associated with open apex and periapical radiolucent area. It clearly showed that there was a tooth within a tooth extending nearly up to the root apex [Table/Fig-1c]. A clinical diagnosis of dens in dente Type II with open apex was made. The treatment options were discussed with the patient and informed consent was obtained. The treatment plan consisted of removal of dens in dente followed by root canal treatment, periapical surgery, retrograde filling of root with MTA and bone graft for regeneration of lost periodontal tissue. With rubber dam isolation the dens in dente was carefully separated and removed with help of a diamond bur and ultrasonic tips [Table/Fig-1d-f]. The canal was instrumented circumferentially and enlarged. Chlorhexidine was used as an irrigant as use of sodium hypochlorite carried the risk of extrusion into the periapical region through the open apex. Calcium hydroxide-iodoform paste (Metapex) was used as intra-canal medicament and the canal was obturated with gutta-percha cones after seven days when the patient was asymptomatic. Rest of canal was laterally condensed using accessory cones, and the access cavity was sealed with non-eugenol temporary cement (Cavit, 3M ESPE). After this under local anaesthesia, a mucoperiosteal flap was reflected and severe osseous destruction was observed on facial surface of tooth #21 [Table/Fig-2a]. After thorough debridement of the periapical osseous defect, a canal template was placed inside the canal and the defect was repaired with Resin Modified Glass Ionomer Cement [Table/Fig-2b]. Apex was sealed with MTA (ProRoot MTA, Dentsply) and the large osseous defect was filled with hydroxyapatite bone graft (G-bone, Surgiwear) covering the defect surface [Table/Fig-2c]. Flap was repositioned and sutured with 3-0 silk non-resorbable interrupted sutures [Table/Fig-2d]. Written post-operative instructions were given, antibiotics and analgesics were prescribed for one week. Patient was monitored on weekly schedule post-operatively, to ensure good oral hygiene. Sutures were removed after 10 days and tooth was restored with fiber post and nano-hybrid composite (Coltene Whaledent) [Table/Fig-3a-3e]. Oral hygiene instructions were reinforced, and patient was kept on maintenance for 3 months to re-evaluate this area. At subsequent follow-up examinations tooth was asymptomatic and post-operative radiograph after one year revealed complete healing in peri-radicular region [Table/Fig-3f,g].

Replacement of missing central incisor with single implant-supported fixed prosthesis

Loss of a single anterior tooth causes a major functional and aesthetic concern to the patient. There are different treatment options available for replacing a missing incisor. If the economic status of the patient permits, it is the responsibility of the clinician to explain the benefits of dental implant to replace a single missing tooth. This case report describes the replacement of a missing maxillary left central incisor tooth of a patient with dental implants for better function and esthtics.

Replantation of an avulsed permanent anterior tooth

This case report describes a case of avulsed left maxillary central incisor tooth which was replanted in the dental office. The tooth was gently rinsed of any debris and placed in normal saline during the examination and preparation of the replantation socket. The tooth was replanted and functionally splinted. The following week the tooth was opened for pulp extirpation and placement of calcium hydroxide. Two weeks later, the root canal was filled with gutta-percha and zinc oxide eugenol sealer, and the access cavity was restored with a bonded composite restoration; the splint was removed. Two year clinical and radiological follow up of the case showed ankylosis and infraocclusion of the replanted toothUpdate Dent. Coll. j: 2015; 5 (1): 30-34

An Unusual Case of Feline Bite Induced Odontome in a Four Year Child

A four year old male child presented with a history of cat bite induced dental trauma. This resulted in loss of primary maxillary left central incisor, intrusion of primary maxillary right central incisor and hard swelling in the labial gingiva in the region of primary maxillary right lateral incisor and canine. Routine radiographs revealed the presence of multiple calcified masses in relation to the primary maxillary right lateral incisor and canine. The treatment included surgical removal of the tooth like structures under local anaesthesia to prevent any further harm to the growing tooth bud. Histopathology confirmed the presence of compound odontome. There has been no episode of recurrence at one year follow up period. The most damaging sequel of injuries to primary teeth is their effects on the developing permanent teeth. Therefore the management of injuries to primary teeth should aim for minimizing harm to the permanent tooth buds.

Contouring the Emergence Profile of Peri-implant Soft Tissue by Provisionals on Implants – Case Report

Summary Aesthetic outcome of implant therapy involves the appropriate architecture of peri-implant soft tissue and interdental papilla. The dynamic compression technique of soft tissue is mentioned in contemporary literature as one of the methods for achieving optimal emergence profile. The aim of this case report was to present soft tissue prosthetic modeling with temporary crowns on implants for obtaining an emergence profile of final restoration. A 25-year-old female patient with missing left maxillary central incisor was referred to the Department of Oral Surgery School of Dental Medicine University in Belgrade for dental implant placement. After detailed planning, implant placement of Straumann Bone level implant NC Ø 3, 3×12 mm (Straumann® Bone Level NC), in the position of 21 was performed. Upon completion of osseointegration period, screw retained laboratory temporary crown was fabricated. During the next 3 months emergence profile was scalloped by creating additional pressure on the soft tissue with periodic adding the composite resin material to a temporary crown. The created emergence profile was transferred to the master cast by using customized impression coping, making possible fabrication of the final implant restoration according to the design made with provisional restoration. Soft tissue conditioning using temporary dental restorations on implants presents a non-invasive method with predictable aesthetic result.

Effect of gingival displacement cord and cordless systems on the closure, displacement, and inflammation of the gingival crevice

Statement of problemThe gingival sulcus should remain open long enough for the impression material to flow into it and completely fill the space provided by the gingival displacement. Impressions with less sulcal width have a higher incidence of voids, tearing of impression materials, and reduction in marginal accuracy. PurposeThe purpose of this clinical study was to investigate the closure, gingival displacement, and gingival inflammation of the gingival crevice after the use of medicated gingival displacement cord and cordless systems. Material and methodsGingival sulcus closure was studied in 40 participants. They were divided into 4 groups: 2 cord (Ultrapack, SilTrax AS) and 2 cordless (Expasyl, Traxodent Hemodent paste) methods. The labial surfaces of the maxillary right and left central incisors were evaluated. Gingival sulcus was photographed every 20 seconds from 0 to 180 seconds after the removal of the cord or cordless system. The bleeding index (BI) and gingival index (GI) were measured at day 0, day 1, and day 7. The width of the sulcal orifice was measured at the mid-buccal (MB) and transitional line angle (TLA) on a digital image, using computer software (Photoshop version 7.0; Adobe). Data were analyzed with ANOVA, Tukey honest significant difference (HSD), Kruskal-Wallis, and Mann-Whitney U tests (α=.05). ResultsAll groups showed a sulcal width greater than 0.22 mm up to 60 seconds after the removal of the displacement materials at the MB and up to 40 seconds at the TLA. Among all groups, Expasyl showed the fastest closure. Gingival displacement in the MB area for the cord group was greater than for the cordless groups. GI and BI indices were larger for the cord group than for the cordless group at days 0 and 1. ConclusionsAt up to 60 seconds, the cord and cordless techniques were equally effective. The cord group showed a greater amount of displacement than the cordless group. However, the cordless materials showed reduced frequency of changes to the gingival index.

Epidemiological study of traumatic dental injuries in 5- to 6-year-old Brazilian children.

Monitoring traumatic dental injury (TDI) in primary teeth through epidemiological cross-sectional surveys provides descriptive information relevant to the development of public policies focused on the prevention of such injuries for the target population. The aim of this study was to assess the prevalence of TDI in 5- to 6-year-old Brazilian children and its association with biological and socioeconomic factors. A total of 684 children aged 5 to 6 years old, from 11 public schools in the city of Barueri (Brazil) were evaluated. Clinical examinations were carried out in the schools, by two trained and calibrated examiners. Gauze and a mouth mirror were used for the examinations. The reported TDIs were classified according to the Andreasen (2007) criteria for primary teeth. The results showed that 52.3% of the children had TDI. Enamel fracture (63.4%) was the most frequently observed sign of TDI, and the most affected teeth were the primary maxillary central incisors (26.9% maxillary right central incisor and 24% maxillary left central incisor). There was no association between the presence of TDI and biological or socioeconomic factors. In conclusion, the prevalence of TDI was high and had no statistically significant association with biological and socioeconomic factors.

ANTERİOR ÇAPRAZ KAPANIŞLI OLGUDA ÇOKLU DENTAL TRAVMA: İKİ YIL TAKİPLİ OLGU RAPORU

OZET Amac: Bu olgu raporunda; anterior capraz kapanisi bulunan hastada intruzyon ve ekstruzyonun birlikte goruldugu travmanin tedavisi sunulmaktadir. Olgu Raporu: 8 yasinda kiz hasta, Gazi Universitesi Dis Hekimligi Fakultesi Pedodonti Klinigi’ne kaydiraktan dusmeye bagli travma hikayesi ile basvurdu. Hastanin 11 numarali disinde intruzyon, 21 numarali disinde ekstruzyon ve on capraz kapanis varligi tespit edildi. Coklu travmanin tedavi planlamasinda kok uclari acik olan 11’in re-erupsuyonu, 21’in yerine yerlestirilmesi ve 3 hafta splint yapilmasina karar verildi. 21 numarali disin 6. Ay kontrolunde vitalite kaybi ve renklesmeye bagli apeksifikasyon tedavisi yapilmasina karar verildi. Hastanin 3 aylik periodlarla 24 ay takibi yapildi. Bulgular: Intruze dis, 12. ay kontrolunde vitalitesini koruyup capraz kapanistan cikarak re-erupte oldu. Ekstruze disin apeksifikasyon sonrasinda 12, 18 ve 24 aylik kontrollerinde klinik ve radyografik olumsuz bir semptom gozlenmedi. Sonuc: Bu olgu raporunda coklu travma olgularinda tedavi planlamasi ve takibinin buyuk oneme sahip oldugu vurgulanmistir. Anahtar sozcukler: Anterior capraz kapanis, intruzyon, ekstruzyon MULTIPLE DENTAL TRAUMA IN CASE ANTERIOR CROSSBITE: TWO YEARS FOLLOW-UP IN CASE REPORT ABSTRACT Purpose: The purpose of this case report is to present a case of a patient who had anterior cross-bite and suffered from intrusion and extrusion of maxillary central incisors at the same trauma. Case Report: An 8-year-old girl was referred to Gazi University Faculty of Dentistry, Department of Pediatric Dentistry, who suffered from slide accident within 1 hours. During clinical examination intrusion of maxillary right central incisor(#11), extrusion of maxillary left central incisor(#21) and anterior cross-bite were detected. While considering the multiple trauma, it was decided that repositioning of #21 and waiting for the spontaneous re-eruption of #11 that has open apices, would be the best choice. In addition, teeth were splinted with non-rigid splint. At the 6th month follow-up, loss of vitality and discoloration of #21 was determined. Apexification was indicated. The patient was followed-up for 24 months. Results: The intruded tooth was re-erupted spontaneously in 12 months. Moreover anterior cross-bite was also corrected without any intervention. Apexification of the #21 was shown no symptoms radiographically or clinically throughout the 12th, 18th and 24th month follow-ups. Conclusion: This case report features that the treatment planning of multiple trauma patients and follow-ups should be highlighted to have great importance. Key words: Anterior cross-bite, intrusion, extrusion

Periapical healing by non-surgical intervention : A case report

Abstract The rationale behind endodontics is to thoroughly disinfect the root canal system, and to provide hermetic seal which in turn ceases the progress of the periapical infection. Most of these periapical infections attributed directly or indirectly to oral microbes. Surgical interventions in larger periapical infection are sometimes accompanied by certain complications. Hence, non-surgical approach can be considered. This article presents non-surgical healing of a periapical lesion of endodontic origin associated with maxillary left central and lateral incisors, observed over a period of 6 months, using calcium hydroxide as an intracanal medicament. How to cite this article Shukla R, Hiremath NV, Lalwani P, Suma R. Periapical healing by non-surgical intervention: A case report. CODS J Dent 2015;7:42-44.

Reconstruction of the Alveolar Buccal Bone Plate in Compromised Fresh Socket after Immediate Implant Placement Followed by Immediate Provisionalization.

The aim of this clinical report was to reestablish the buccal bone wall after immediate implant placement. The socket defect was corrected with autogenous bone, and a connective tissue graft was removed from the maxillary tuberosity to increase the thickness, height, and width of the buccal bone and gingival tissue followed by immediate provisionalization of the crown during the same operation. A 66-year-old patient presented with a hopeless maxillary left central incisor with loss of the buccal bone wall. Atraumatic, flapless extraction was performed, and an immediate implant was placed in the extraction socket followed by preparation of an immediate provisional restoration. Subsequently, immediate reconstruction of the buccal bone plate was performed, using the tuberosity as the donor site, to obtain block bone and connective tissue grafts, as well as particulate bone. Finally, immediate provisionalization of the crown followed by simple sutures was performed. Cone-beam computed tomography and periapical radiographs were taken before and after surgery. After 4 months, the final prosthetic crown was made. After a 2-year follow-up, a satisfactory aesthetic result was achieved with lower treatment time and morbidity. This case demonstrates the effective use of immediate reconstruction of the buccal bone wall for the treatment of a hopeless tooth in the maxillary aesthetic area. This procedure efficiently promoted harmonious gingival and bone architecture, recovered lost anatomical structures with sufficient width and thickness, and maintained the stability of the alveolar bone crest in a single procedure. If appropriate clinical conditions exist, immediate dentoalveolar restoration may be the most conservative means of reconstructing the buccal bone wall after immediate implant placement followed by immediate provisionalization with predictable healing and lower treatment time.

English

In this study, a patient with a large periapical lesion related to the maxillary left central incisor and two canalled lateral incisors was presented. A single visit non-surgical root canal treatment was performed for both teeth. A three-year follow-up radiograph revealed complete healing of the periapical lesion. This report confirms that the large size of a periapical lesion neither mandates surgical removal nor the placement of intra-canal dressing and that such a lesion can heal following a conservative single visit endodontic treatment. Furthermore, familiarity with the variations of root canal morphology is essential for successful endodontic treatment. Maxillary lateral incisors usually have a single canal; however, this case report describes endodontic treatment of maxillary lateral incisor with two buccopalatal root canals. Key words: Healing of large periapical lesion, single visit root canal treatment, two canalled maxillary lateral incisor.

Identifying the tooth shade in group of patients using Vita Easyshade

Objective:The aim of the present investigation is to identify tooth shade among a group of Sudanese patients.Materials and Methods:Total number of patients was 227. Participant's age ranged from 15 to 72 years, which, was divided into four groups. The tooth included in the study was either right or left sounds maxillary central incisor. Vita Easyshade was used to select the tooth shade. Investigation of the differences of Commission International de l’Eclairage (CIELab) coordinates among gender and state of origin was conducted together with an examination of the relationship between CIELab coordinates and age. One-way analysis of variance was used to test the differences in L*, a* and b* according to state of origin.Results:Results showed that A3 was the most common classical tooth shade respectively. There was highly significant difference in L* between males and females (P = 0.002). There was a significant relation between tooth shade and age (P = 0.026). There was a high significant association between classical tooth shade and Sudan regions (P = 0.00).Conclusion:In conclusion, most common classical shade was A3, women's teeth were lighter than men's. There was a relation between ethnic background and tooth shade.

In vivo Scanning Electron Microscope Assessment of Enamel Permeability in Primary Teeth with and without Early Childhood Caries

Background: Over the years, certain primary teeth have been shown to be highly sensitive to dental caries, while others have remained caries-free. It has been hypothesized that this may be attributed to differences in the permeability of the enamel surface. Aim: The aim of the study was to evaluate the hypothesized differences in the permeability of primary tooth enamel in children with and those without Severe Early Childhood Caries (S-ECC) using scanning electron microscopy. Materials and Methods: Sixteen children between 3 and 6 years of age were randomly selected and divided into two groups: Group 1, children without S-ECC (n = 8), and Group 2, children with S-ECC (n = 8). In each child, 4 teeth (the maxillary right and left central and lateral incisors) were subjected to evaluation. An impression was made with polyvinylsiloxane impression material, and scanning electron microscopy was used to inspect the negative replicas for droplets. Results: The results indicated higher significance when individual regions (cervical, middle, and incisal thirds) in the two groups were evaluated and compared. Similarly, the overall results showed high statistical significance between S-ECC and non-S-ECC teeth. Conclusion: There could be a positive relationship between the permeability of tooth enamel and the development of caries, which needs further research.

Prevalence of traumadic dental Injuries among new orthodondic patients seen at the University of Benin Teaching Hospital, Nigeria

Objective: The aim of this study was to determine the prevalence of traumatic dental injuries among new orthodontic patients.
 Method: The dental records of 150 patients consisting of 57 males (38%) and 93 females (62%) with a mean age of 18.4 ± 7.6 years who presented for orthodontic treatment at the University of Benin Teaching Hospital Dental Centre were assessed for data relating to traumatic Injuries to the permanent anterior teeth. The causes and types of dental trauma, type of tooth involved and number of affected teeth were evaluated with patients' histories, study casts and pretreatment radiographs. Descriptive statistics were performed for the study variables, age and gender differences In the frequency of traumatized teeth were evaluated with the chi-square test.
 Result: The results revealed dental trauma prevalence of 21.3% among the new patients before the onset of their orthodontic treatment. The prevalence of dental trauma was significantly higher in males (p<0.05) and most frequently observed In patients aged 6 to 10 years. Falls was the commonest cause of dental traumatic Injuries among the patients (37.5%). The most common type of trauma to the teeth was enamel fracture (46. 9%) followed by avulslon (28.1 %). Most traumatic Injuries affected the right and left maxillary central Incisors. Frequency of trauma to only one tooth was observed in 68.8% of the patients and multiple teeth Involvement seen In 31.2%.
 Conclusion: This study revealed a high prevalence of traumatic dental injuries among new patients seeking orthodontic treatment at Benin City, Nigeria. An early orthodontic evaluation and interceptive therapy where appropriate is recommended to reduce risk of dental trauma in Nigerian young population.

Age estimation of adults using dental pulp: A cross-sectional radiographic study

Background: Age estimation from teeth is frequently used because teeth may be preserved for a long time after all tissues have disintegrated. Dental pulp is a well‑protected structure. With progressing age, the size of the dental pulp chamber is reduced vertically and horizontally as a result of secondary dentin deposition. Thus, assessment of these radiographic measurements can be used as an indicator of age estimation. Aim: Estimation of the chronological age of an adult from dental pulp size using conventional intraoral periapical radiograph. Materials and Methods: The study group consisted of 100 subjects inclusive of both the genders aged between 16 and 50 years. The tooth selected was maxillary left central incisor. Intraoral periapical radiographs were taken by following paralleling cone technique. Total pulp length and cervical pulp width of the root canal were measured. To compensate for the differences in magnification and angulation on the radio graph, ratio between total pulp length, and cervical pulp width was calculated (P/A). Results: A gradual reduction in pulp size was observed with respect total pulp length and cervical pulp width with an increase in age and this showed a significant correlation with the chronological age. Conclusion: Dental age prediction is useful in routine and mass fatalities as teeth can be preserved for a long time. The clinical significance is that, it can be used in anthropology, forensic science, on both living and dead. The results confirm that there is horizontal and vertical reduction in pulp size with an increase in age due to secondary dentin formation. This radiographic morphometric pulp reduction can be used to estimate the nearest chronological age of an adult.

Systemic effects of fluoxetine on the amount of tooth movement, root resorption, and alveolar bone remodeling during orthodontic force application in rat

Antidepressant drugs such as fluoxetine are of the most commonly used drugs among the public. These drugs may impact the regulation of bone cell functioning, and thus affect orthodontic tooth movement. The aim of this study was to determine the effect of fluoxetine on tooth movements during orthodontic treatment in rats. In this study, 30 male rats were randomly assigned into two groups and injected with fluoxetine 10 mg/kg (experimental group) and normal saline (control group) for a period of 1-month intraperitoneally 5 times/week. Then, the rats were anesthetized and a nickel-titanium closed-coil spring was placed between the left maxillary first molar and left maxillary central incisors of all samples, and then fluoxetine (experimental group) and normal saline (control group) were injected for another 3 weeks by the same method. After measuring tooth movements, rats were sacrificed, and histomorphometric analyses were conducted and the obtained data were statistically analyzed using independent t-test and the significance was set at 0.05. Following the fluoxetine injection, the mean amount of tooth movements in the experimental group was reduced compared to the control group, which was not statistically significant (P = 0.14). There was no significant difference between the two groups regarding bone apposition rate (P = 0.83), external root resorption rate (P = 0.1), and mean number of root resorption lacunae (P = 0.16). Within the limitations of this study, systemic use of fluoxetine may cause insignificant reduction of tooth movement rate in rats; however, this subject needs more evaluations.