Upper Right Central Incisor Research Articles

Dental avulsion of a maxillary central incisor: a case report

Introduction: The avulsion of a tooth is defined as a complete displacement from its alveolus.[1] Dental avulsion of permanent teeth is considered one of the most severe and aggressive dental injuries. According to dental trauma studies in different populations, it comprises from about 0.5-7.75% of the total of dental injuries, being more frequent between 9 and 10 years of age [2–6]. The purpose of this study was to evaluate the success of existing protocols when dealing with dental avulsion. Materials and methods: The informed consent in use was signed at the pediatric service of Clinica Universitária Egas Moniz. A 7-year-old female patient suffered craniofacial trauma with avulsion of the upper right central incisor (URCI) and enamel-dentin coronary fracture of the upper left central incisor (ULCI). The avulsed tooth, with open apex, was transported in milk and reimplanted after 16 hours. At Clinica Universitária Egas Moniz pediatric emergency service, the URCI was carefully cleaned from non-viable tissue. It underwent extra-oral endodontic treatment with an apical MTA plug, filled with thermoplastic gutta-percha and later closed with composite resin. Subsequently, under local anesthesia, the clot was removed from the alveolus and irrigated with saline solution. The tooth was reimplanted into the socket and stabilized with semi-rigid splint to adjacent teeth for 4 weeks. The ULCI was sealed with glass ionomer and later restored with composite resin. The patient was medicated with amoxicillin and clavulanic acid for 8 days, being instructed to a soft diet and to avoid sports practice. Follow-up appointments at 7 days, 4 weeks with splint removal, 3, 6 and 9 months. At 3 months, the ULCI presented with necrosis, so endodontic treatment was performed. Last follow-up was at 18 months. Results: Clinical evaluation after more than one year showed absence of clinical symptoms and radiographic images compatible with periapical health. Discussion and conclusions: The URCI suffered ankylosis with radiographic loss of periodontal ligament space, and slight root resorption. These findings are in agreement with the expected complications in the literature. Similar studies agree that the prognosis of the treatment of this trauma is deeply influenced by on-site actions and care taken shortly after the accident [1–8]. However, the patient was allowed to maintain aesthetic, functional and physiological function, as well as preservation of the alveolar contour. Figure 1. vulsion of the URCI; non-complicated fracture the ULCI. Figure 2. Removal of the cloth and cleaning of the alveolus; pulpal aspect of the URCI before endodontic treatment. Figure 3. Reimplantation of the URCI and splinting. Figure 4. Endodontic treatment of the ULCI. Figure 5. Follow-up at 18 months.

Audit of Crowns and Fixed Partial Dentures in a Nigerian Teaching Hospital

Aim: The purpose of this investigation was to document the reasons for placement, and replacement of crowns and fixed partial denture in a Nigerian Teaching Hospital. Methods: a retrospective review of patients that had advanced conservative procedures. A data collection form was used to gather the relevant information from the patients’ case notes. Section A sought information on age, gender, educational level, patients’ occupation etc. Section B recorded information on tooth/teeth involved, reason for fabrication of prosthesis and material used. Results: Three hundred and twenty six had 398 crowns while 23 patients received bridges. Patients’ ages ranged from 16-85 years with a mean of 47.7 ± 17.2 years and a male to female ratio of 1:1.3. Thirty five percent of the crowned teeth were in the upper right quadrant, followed by the upper left quadrant with 29.4%. Upper right central incisors were the most frequently (15.6%) crowned teeth. Endodontics and esthetics were the most common reasons for initial crown placement and replacement respectively. About 60% of bridges fabricated were new, while 22.2% of replaced bridges were due to fracture of porcelain and unacceptable marginal adaptation. Conclusion: Endodontics and esthetics were the most common reasons for initial crown placement and replacement

Measurement of orthodontic forces exerted on the upper right central incisor with the increase of the distance of tooth movement and thickness of the aligner

To measure the orthodontic forces exerted on the upper right central incisor with the increase of the distance of tooth movement and the thickness of the aligner. The labial movement of upper right central incisor at various distances (0.3, 0.6, 0.9, 1.2, 1.5, 1.8 mm) was designed and the stereolithography model (2 times bigger than the original model) was created with 3-D scanning and tomography output. These models were used to fabricate the aligners with different thicknesses (0.8, 1.0, 1.5 and 2.0 mm) of the thermoplastic materials (6 samples for various distances of tooth movement and thicknesses). Orthodontic forces exerted on the upper right central incisor were measured with the micro-stress sensor measurement system. The orthodontic forces increased with the increase of the thickness of the aligner at the same distance of tooth movement (P < 0.05). The orthodontic force was (1.237 ± 0.082), (1.543 ± 0.059), (3.602 ± 0.102), (6.734 ± 0.063) N when the labial movement of upper right central incisor was 0.3 mm with the aligner of 0.8, 1.0, 1.5, 2.0 mm. The orthodontic forces also increased with the increase of the distance of the tooth movement at the same thickness of the aligner(P < 0.05). The orthodontic force of the aligner of 0.8 mm were (1.354 ± 0.039), (1.288 ± 0.037), (1.479 ± 0.031), (1.799 ± 0.039) N when the upper right central tooth labial movement at 0.6, 0.9, 1.2, 1.5 mm. The orthodontic forces increased with the increase of the distance of tooth movement and the thickness of the aligner.