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Prasad P, Galani M, Nawal RR, Talwar S, Kumar G. Three-dimensional Assessment of Two-rooted Maxillary Central Incisor with Labiogingival Groove: Endodontic and Periodontal Surgical Management. Int J Clin Pediatr Dent 2023; 16:528-533. [PMID: 37496939 PMCID: PMC10367301 DOI: 10.5005/jp-journals-10005-2616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
Understanding the diversity of root canal systems and their anatomical/morphological variations helps in achieving improved outcomes of root canal treatment. The outcome of endodontic treatment depends on a thorough knowledge of dental anatomy and its variations. Maxillary central incisor with two roots is a rare entity, so a complete clinical and radiological examination is important before initiating the treatment. Recently, three-dimensional (3D) radiography has improved the diagnosis and treatment planning in endodontics. So, the current report describes the endodontic and periodontal surgical management of traumatized discolored maxillary central incisors with two separated roots and root canals identified by two-dimensional (2D) and 3D radiographic examination. How to cite this article Prasad P, Galani M, Nawal RR, et al. Three-dimensional Assessment of Two-rooted Maxillary Central Incisor with Labiogingival Groove: Endodontic and Periodontal Surgical Management. Int J Clin Pediatr Dent 2023;16(3):528-533.
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Affiliation(s)
- Pankaj Prasad
- Department of Conservative Dentistry & Endodontics, Maulana Azad Institute of Dental Sciences, Delhi, India
| | - Mohit Galani
- Department of Conservative Dentistry & Endodontics, Maulana Azad Institute of Dental Sciences, Delhi, India
| | - Ruchika R Nawal
- Department of Conservative Dentistry & Endodontics, Maulana Azad Institute of Dental Sciences, Delhi, India
| | - Sangeeta Talwar
- Department of Conservative Dentistry & Endodontics, Maulana Azad Institute of Dental Sciences, Delhi, India
| | - Gyanendra Kumar
- Department of Pediatric Dentistry, Maulana Azad Institute of Dental Sciences, Delhi, India
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Li T, He W, Jiang W, Wang X, Nie M, Wang S. Interdisciplinary management of combined periodontal-endodontic lesions with palatogingival grooves of the maxillary lateral incisors: a case report. Br Dent J 2023; 234:27-33. [PMID: 36639473 DOI: 10.1038/s41415-022-5370-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 07/26/2022] [Indexed: 01/15/2023]
Abstract
A palatogingival groove of the maxillary lateral incisor is an anatomic malformation, which always predisposes the tooth to pulpal and periodontal disease. The diagnosis and treatment planning become complicated, with uncertain prognosis. Herein, we present an effective interdisciplinary management of a case of combined periodontal-endodontic lesions caused by palatogingival grooves. A series of treatment modalities were undertaken to preserve the two teeth, including root canal treatment, periodontal initial therapy, splinting the mobile teeth, occlusal adjustment, apical microsurgery, grinding and sealing grooves, and guided tissue regeneration. An apparent healing of the lesions was visible after 12 months. Therefore, interdisciplinary management of combined periodontal-endodontic lesions with palatogingival grooves of the maxillary lateral incisors is necessary for a favourable long-term outcome.
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Affiliation(s)
- Tong Li
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi´an 710032, Shaanxi, People's Republic Of China
| | - Wenxi He
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi´an 710032, Shaanxi, People's Republic Of China
| | - Wenkai Jiang
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi´an 710032, Shaanxi, People's Republic Of China
| | - Xiaoli Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi´an 710032, Shaanxi, People's Republic Of China
| | - Min Nie
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, Department of Endodontics, School and Hospital of Stomatology, Wuhan University, 237 Luo-yu Road, Wuhan, 430079, Hubei, People's Republic Of China
| | - Shengchao Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Centre for Oral Diseases and Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, 145 West Chang-le Road, Xi´an 710032, Shaanxi, People's Republic Of China.
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Ling DH, Shi WP, Wang YH, Lai DP, Zhang YZ. Management of the palato-radicular groove with a periodontal regenerative procedure and prosthodontic treatment: A case report. World J Clin Cases 2022; 10:5732-5740. [PMID: 35979126 PMCID: PMC9258384 DOI: 10.12998/wjcc.v10.i17.5732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/09/2022] [Accepted: 04/09/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Palato-radicular groove (PRG) is defined as an anomalous formation of teeth. The etiology of PRG remains unclear. The prognosis of a tooth with a PRG is unfavorable. The treatment of combined periodontal-endodontic lesions requires multidisciplinary management to control the progression of bone defects. Some researchers reported cases that had short-term observations. The management of teeth with PRGs is of great clinical significance. However, to date, no case reports have been documented on the use of bone regeneration and prosthodontic treatment for PRGs.
CASE SUMMARY This case reported the management of a 40-year-old male patient with the chief complaint of slight mobility and abscess in the upper right anterior tooth for 15 d and was diagnosed with type II PRG of tooth 12 with combined endodontic-periodontal lesions. The accumulation of plaque and calculus caused primary periodontitis and a secondary endodontic infection. A multidisciplinary management approach was designed that included root canal therapy, groove sealing, a periodontal regenerative procedure, and prosthodontic treatment. During a 2-year follow-up period, a good prognosis was observed.
CONCLUSION This report indicates that bone regeneration and prosthodontic treatment may contribute to the long-term favorable prognosis of teeth with PRGs.
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Affiliation(s)
- Dan-Hua Ling
- Department of Comprehensive Dentistry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310052, Zhejiang Province, China
| | - Wei-Ping Shi
- Department of Comprehensive Dentistry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310052, Zhejiang Province, China
| | - Yan-Hong Wang
- Department of Comprehensive Dentistry, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 311221, Zhejiang Province, China
| | - Dan-Ping Lai
- Department of Comprehensive Dentistry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310052, Zhejiang Province, China
| | - Yan-Zhen Zhang
- Department of Comprehensive Dentistry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310052, Zhejiang Province, China
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Makeeva MK, Daurova FY, Byakova SF, Turkina AY. Treatment of an Endo-Perio Lesion with Ozone Gas in a Patient with Aggressive Periodontitis: A Clinical Case Report and Literature Review. Clin Cosmet Investig Dent 2020; 12:447-464. [PMID: 33149696 PMCID: PMC7604462 DOI: 10.2147/ccide.s267933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/16/2020] [Indexed: 01/29/2023] Open
Abstract
The pulp and periodontium have obvious relationships that have been described in many studies. Pulp infections may affect periodontal tissues and vice versa. Teeth with endo-perio lesions have a worse prognosis than isolated endodontic or periodontal lesions. Elimination of endodontic and periodontal infections is essential for successful treatment, so co-operation between endodontists and periodontists is necessary. In this clinical case, a 44-year-old male presented with primary periodontal disease with secondary endodontic involvement in his lower right canine because of aggressive periodontitis. There was 10 mm of clinical attachment loss and 8 mm periodontal pocket mesial from the tooth and bone radiolucency periapical and lateral from the root. Periodontal therapy was followed by endodontic treatment. Periodontal therapy included root scaling and planing, treatment of the periodontal pocket with ozone gas, systemic antibiotics, oral hygiene instructions, and chlorhexidine rinsing. Endodontic therapy included root canal instrumentation with rotary endodontic files, irrigation, root canal treatment with ozone gas, and obturation with lateral compaction. Radiographs at a 6-month follow-up appointment showed complete healing of the periapical lesion and alveolar bone lateral to the root. Using an interdisciplinary approach to treat endo-perio lesions provides favorable clinical outcomes. Ozone therapy is beneficial for the successful treatment of endo-perio lesions with narrow periodontal pockets in patients with aggressive periodontitis and poor prognosis.
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Affiliation(s)
- Maria K Makeeva
- Conservative Dentistry Department, People's Friendship University of Russia (RUDN University), Moscow, Russia.,Therapeutic Dentistry Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Fatima Yu Daurova
- Conservative Dentistry Department, People's Friendship University of Russia (RUDN University), Moscow, Russia
| | - Svetlana F Byakova
- Therapeutic Dentistry Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Anna Yu Turkina
- Therapeutic Dentistry Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Giner-Lluesma T, Micó-Muñoz P, Prada I, Micó-Martínez P, Collado-Castellanos N, Manzano-Saiz A, Albero-Monteagudo A. Role of cone-beam computed tomography (CBCT) in diagnosis and treatment planning of two-rooted maxillary lateral incisor with palatogingival groove. Case report. J Clin Exp Dent 2020; 12:e704-e707. [PMID: 32905137 PMCID: PMC7462372 DOI: 10.4317/jced.57092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/26/2020] [Indexed: 11/09/2022] Open
Abstract
Background The embryonic root groove is an anatomical abnormality that starts in the cingulum and extends longitudinally down the long axis root towards the apex. This developmental anomaly is more frequently reported in maxillary lateral incisors. Gu YC in 2011 established three types of radicular grooves depending on its severity. According to this classification, type III presents a greater diagnostic and therapeutic complexity. The prevalence of palatogingival grooves in maxillary lateral incisors ranges from 1.9 to 14%. This case report provides valuable information about the diagnosis and treatment plan of palatogingival grooves with Cone-beam computed tomography (CBCT) scan.
Case Report The patient was referred to the University Dental Clinic of European University of Valencia, with recurrent abscesses at the upper right lateral incisor region for the last two years. Palpation and percussion tests were positive for tooth 1.2. There was no clinical history of caries or previous trauma. Periapical radiography showed periapical radiolucent lesions located, not only in the apical area of tooth 1.2, but also in tooth 1.3. Both teeth had previously been endodontically treated. Periodontal probing showed normal values. CBCT scan was perfomed in order to establish a definitive diagnosis and appropriate treatment plan.
Discussion The complex anatomy of the palatal root groove requires detailed knowledge of the internal root morphology for endodontic treatment success. This complementary tool allows a more accurate image of hard tissue structures, such as palatal grooves and/or accessory roots, in comparison to conventional periapical radiography. The treatment plan of this primary periodontal lesion with secondary endodontic involvement was as follows: periapical surgery combined with root amputation and sealing with MTA, and guided bone regeneration. Key words:Palatal radicular groove, palatogingival groove, maxillary lateral incisor, cone-beam computed tomography, endodontic-periodontal lesion, guided bone regeneration.
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Affiliation(s)
- Teresa Giner-Lluesma
- Prof. Asociado de Endodoncia y Odontología Restauradora, Universidad Europea de Valencia, España
| | - Pedro Micó-Muñoz
- Prof. Titular de Endodoncia y Odontología Restauradora, Universidad Europea de Valencia, España
| | - Ilaria Prada
- Graduada en Odontología por la Universidad Europea de Valencia, Master Universitario en Odontopediatría Universidad Católica de Valencia, España
| | - Pablo Micó-Martínez
- Graduado en Odontología por la Universidad Europea de Valencia. Máster en Periodoncia y Osteintegración por la Universidad de Valencia, España
| | | | - Alberto Manzano-Saiz
- Prof. Asociado de Endodoncia y Odontología Restauradora, Universidad Europea de Valencia, España
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Herrera D, Retamal-Valdes B, Alonso B, Feres M. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Periodontol 2018; 89 Suppl 1:S85-S102. [DOI: 10.1002/jper.16-0642] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 06/29/2017] [Accepted: 07/30/2017] [Indexed: 12/16/2022]
Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Belén Retamal-Valdes
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
| | - Bettina Alonso
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Magda Feres
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
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Herrera D, Retamal-Valdes B, Alonso B, Feres M. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Clin Periodontol 2018; 45 Suppl 20:S78-S94. [DOI: 10.1111/jcpe.12941] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 06/29/2017] [Accepted: 07/30/2017] [Indexed: 01/29/2023]
Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Belén Retamal-Valdes
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
| | - Bettina Alonso
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Magda Feres
- Department of Periodontology; Dental Research Division; Guarulhos University; Guarulhos São Paulo Brazil
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Shubbar A, Bolhari B, Fakhari N, Alemi P, Nosrat A. Non-Surgical Retreatment of Maxillary Lateral Incisor with Unusual Anatomy: A Case Report and Mini Review. IRANIAN ENDODONTIC JOURNAL 2017; 12:381-385. [PMID: 28808470 PMCID: PMC5527219 DOI: 10.22037/iej.v12i3.16607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Knowledge about internal anatomy plays a crucial role in the success of the root canal treatment. Many studies on internal anatomy have repeatedly reported that maxillary lateral incisors have only one canal. The primary aim of this article was to describe successful non-surgical retreatment of a permanent maxillary lateral incisor with two root canals and open apices. The treatment was carried out using dental operating microscope and the canals were obturated with mineral trioxide aggregate (MTA) as an apical plug. A review of literature was also conducted to evaluate the anatomical variations of maxillary lateral incisors.
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Affiliation(s)
- Ashraf Shubbar
- Department of Endodontics, Dental School, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Bolhari
- Department of Endodontics, Dental School, Tehran University of Medical Sciences, Tehran, Iran
| | - Nooshin Fakhari
- Department of Endodontics, Dental School, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvin Alemi
- Department of Endodontics, Dental School, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Nosrat
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Endodontics, Periodontics, and Prosthodontics, Dental School, University of Maryland Baltimore, Baltimore, Maryland, USA
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Xuelian T, Lan Z, Dingming H. [Intentional replantation for the treatment of palatal radicular groove with endo-periodontal lesion in the maxillary lateral incisor: a case report]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2017; 35:448-452. [PMID: 28853516 DOI: 10.7518/hxkq.2017.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Palatal radicular groove leads to severe endo-periodontal lesion in lateral incisors. The groove occurs on the labial and lingual root surfaces, while the localized periodontal pocket develops along the lingual groove length. The complicated root canal system, extensively destroyed bone lamella, and persistent fistula pose a challenge for root canal therapy, tooth retention, and thorough infection control inside and outside of the root canal. Combining microscopic root canal therapy with intentional replantation and nano-biomaterial application facilitates infection control, tooth retention, and formation of newly periodontal attachment.
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Affiliation(s)
- Tan Xuelian
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Conservative Dentistry and Endodontics, West China Hospitalof Stomatology, Sichuan University, Chengdu 610041, China
| | - Zhang Lan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Conservative Dentistry and Endodontics, West China Hospitalof Stomatology, Sichuan University, Chengdu 610041, China
| | - Huang Dingming
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Conservative Dentistry and Endodontics, West China Hospitalof Stomatology, Sichuan University, Chengdu 610041, China
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Ahmed HMA, Hashem AA. Accessory roots and root canals in human anterior teeth: a review and clinical considerations. Int Endod J 2015; 49:724-36. [DOI: 10.1111/iej.12508] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 07/09/2015] [Indexed: 01/14/2023]
Affiliation(s)
- H. M. A. Ahmed
- Department of Conservative Dentistry; School of Dental Sciences; Universiti Sains Malaysia; Kelantan Malaysia
| | - A. A. Hashem
- Department of Endodontics; Faculty of Dentistry; Ain Shams University; Cairo Egypt
- Department of Endodontics; Faculty of Dentistry; Future University; Cairo Egypt
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Forero-López J, Gamboa-Martínez L, Pico-Porras L, Niño-Barrera JL. Surgical management with intentional replantation on a tooth with palato-radicular groove. Restor Dent Endod 2014; 40:166-71. [PMID: 25984480 PMCID: PMC4432261 DOI: 10.5395/rde.2015.40.2.166] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 11/07/2014] [Indexed: 02/07/2023] Open
Abstract
A palato-radicular groove (PRG) is a developmental anomaly primarily found in the maxillary lateral incisors. It is a potential communication path between the root canal and the periodontium that decreases the survival prognosis of the affected tooth, therefore compromising the stability of the dental structure in the oral cavity. The aim of this case report is to present an original technique where a PRG was treated by means of intracanal disinfection, PRG sealing with glass ionomer, replantation with intentional horizontal 180 degree rotation of the tooth, and an aesthetic veneer placed to provide adequate tooth morphology. The clinical and biological benefits of this novel technique are presented and discussed.
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Affiliation(s)
- Jorge Forero-López
- Department of Endodontics, Universidad El Bosque School of Dentistry, Bogotá, Colombia
| | - Luis Gamboa-Martínez
- Department of Endodontics, Universidad El Bosque School of Dentistry, Bogotá, Colombia
| | - Laura Pico-Porras
- Department of Endodontics, Universidad El Bosque School of Dentistry, Bogotá, Colombia
| | - Javier Laureano Niño-Barrera
- Department of Endodontics, Universidad El Bosque School of Dentistry, Bogotá, Colombia. ; Universidad Nacional de Colombia School of Dentistry, Bogotá, Colombia
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Gupta R, Prakash V. Non-Surgical Management of Mandibular Molar with Multiple Intra-oral Sinus Tracts: A Case Report. J Clin Diagn Res 2013; 7:2392-3. [PMID: 24298540 DOI: 10.7860/jcdr/2013/5953.3535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 07/10/2013] [Indexed: 11/24/2022]
Abstract
Multiple intra-oral sinus tracts of dental origin are an uncommon condition. Patients with this condition may undergo surgical extraction, biopsies and antibiotic regimens, but all of them fail with the recurrence of the sinus tract. A proper diagnosis and management are important, to avoid any complications. This case report has described the conventional root canal treatment of a patient who had three distant intra-oral sinuses which had occurred due to an intact tooth with pulp necrosis, who had a history of accidentally biting on a hard food object and having a periapical radiolucency which indicated a chronic periradicular abscess. At follow up examination, the tooth was found to be asymptomatic and radiographically, it showed repair of the lesion.
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Affiliation(s)
- Ruchi Gupta
- Reader, Department of Conservative Dentistry & Endodontics, Institute of Dental Studies & Technologies , Delhi-Meerut Road, Kadrabad, Modinagar, Uttar Pradesh-201201 (India)
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