Adhesive fragment reattachment after orthodontic extrusion: a case report

The importance of soft tissue examination in post-traumatic decision-making: a case report

Dental and facial traumas involving teeth and supporting tissues are common sports-related injuries. In this case report treatment of a 23-year-old student who had been elbowed by an opponent player during a basketball game, which caused oblique fractures on both maxillary incisor teeth is presented. The patient presented 17 days following trauma having completed full recovery of soft tissues. A fragment of upper incisor tooth had been embedded in lower lip at the time of trauma, which was covered by healing tissues. At the 1 month control the patient complained of a hard structure in his lower lip. The elusive broken fragment was revealed by a radiograph and then removed surgically. This case report is a good example of the importance of the training of general dentists about sports-related traumatic injuries as well as emphasising the importance of the use of mouthguards during contact sports.

Periodontal healing of a horizontal root fracture: a case report with a two-year follow-up

BACKGROUND

For traumatized teeth exhibiting crown-root fractures, there is a growing body of evidence that re-fastening the coronal part may result in successful treatment. However, data on the long-term impact of these bonding procedures on the periodontium are scarce. A case report of a young female patient presenting with an isogingivally- and horizontally-fractured lower incisor with a two-year follow-up is presented.

METHODS

The tooth fragment was reattached to the remaining root using an adhesive technique after flap elevation and endodontic therapy. No attempt was made to splint the coronal fragment to the neighboring teeth.

RESULTS

Despite the subgingival location of the bonding surface, uneventful periodontal healing was clinically monitored during the observation period. The coronal fragment was retained successfully for a period of more than two years.

CONCLUSIONS

Even for tooth fractures below the gingival margin, the combined approach of surgery and adhesive techniques can be used successfully to restore a severely traumatized tooth.

Reattachment of a fractured permanent molar cusp: a 12-month follow-up

A posterior crown fracture due to acute trauma is an uncommon type of dental injury. This case report presents combined endodontic-bioadhesive treatment of a complicated crown fracture of a permanent molar due to a horse riding accident. Endodontic therapy was initiated following surgical removal of the fractured mesiolingual cusp, which was stored frozen until bonding procedures could be carried out. Subgingival and proximal contours of the missing cusp were maintained by an interim glass-ionomer restoration during endodontic therapy. Following root-canal obturation, the fractured cusp was reattached using a total-etch adhesive and composite resin system. The patient was recalled at 1, 3, 6 and 12 months, demonstrating excellent clinical and radiographic findings.

A conservative multidisciplinary approach for improved aesthetic results with traumatised anterior teeth

A subgingival crown-root fracture presents a restorative problem to the clinician because restoration is complicated by the need to maintain the health of the periodontal tissues. If the remaining portion of the root is thought to be enough to support a definitive restoration, the root may be extruded by orthodontic forced eruption after root canal treatment. Extrusion enables the remaining root portion to be elevated above the epithelial attachment. Endodontic posts may be useful in exerting vertical forces to the root for extrusion without buccal tipping. The following case shows multidisciplinary management of a case of dental trauma. Orthodontic forced eruption is incorporated using endodontic posts and restoration with porcelain fused to metal crowns--leading to successful restoration of the traumatised teeth.