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A conservative bioadhesive approach to the reattachment of complicated crown fractures in permanent first molars: a case report with a 2-year followup.

Mirikar P - Case Rep Med (2012)

Bottom Line: To restore the coronal fracture with invasion of biologic width, flap surgery with osteotomy and osteoplasty localized on the fractured teeth was performed, and the tooth remnant was reattached to the crown with a self-etch adhesive system.Frank pulp exposure was treated by self-etch dentin adhesive after surface disinfection prior to sealing of the wound site.At 2-year recall, the teeth continue to be aesthetically and functionally stable with a favourable pulpal and periapical environment.

View Article: PubMed Central - PubMed

Affiliation: Department of Conservative Dentistry and Endodontics, Sinhgad Dental College and Hospital, Maharashtra, Pune 411041, India.

ABSTRACT
This paper presents a clinical report demonstrating combined restorative bioadhesive treatment and prosthetic rehabilitation of uncommon type of dental injury in an eighteen-year-old female involving crown fracture of all the permanent first molars and left upper premolars due to a bicycle riding accident. To restore the coronal fracture with invasion of biologic width, flap surgery with osteotomy and osteoplasty localized on the fractured teeth was performed, and the tooth remnant was reattached to the crown with a self-etch adhesive system. Frank pulp exposure was treated by self-etch dentin adhesive after surface disinfection prior to sealing of the wound site. At 2-year recall, the teeth continue to be aesthetically and functionally stable with a favourable pulpal and periapical environment.

No MeSH data available.


Related in: MedlinePlus

Oblique fracture of distofacial cusp with 26, loss of buccal cusp with 25.
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Related In: Results  -  Collection


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fig2: Oblique fracture of distofacial cusp with 26, loss of buccal cusp with 25.

Mentions: The patient reported to the dental clinic with a chief complaint of fractured teeth in upper and lower back region of the jaw due to a bicycle riding accident. The general condition of the patient was assessed and recorded prior to a detailed examination of head, neck, and oral regions for damage of hard and soft tissues. After a thorough evaluation of the periodontal, endodontic, coronal, and occlusal (PECO) status of the teeth [6, 7], a diagnosis of oblique fractures with 16 (Figure 1), 26, 25 (Figure 2), and vertical fracture with 24 extending subcrestally (Figure 3) was made. With respect to the mandibular molars, oblique fracture with 46 involving mesiolingual cusp (Figure 4) and vertical fracture with 36 extending mesiodistally (Figure 4) were diagnosed. In addition to clinical examination for pulpal exposure, the vitality status of all the teeth was recorded as the baseline responses. The clinical diagnosis was confirmed radiographically (Figures 5, 6, 7, and 8), which also suggested the presence of transverse fracture at the level of coronal and middle third of the root with respect to 24 (Figure 6). Patient was informed of the difficulty of the case and was offered with several treatment alternatives and told about the need for exploratory surgery to define the best treatment modality [6, 7]. Consent was secured from the patient who was previously informed about eventual risks such practices involved. The aim was to preserve the greatest amount of supporting bone and to render rational treatment. Surgery was required to access fracture extension and to assert the viability of fragment reattachment. As a first step, antisepsis and anaesthesia of the involved teeth were carried out. Next fragments were tested for adaptation.


A conservative bioadhesive approach to the reattachment of complicated crown fractures in permanent first molars: a case report with a 2-year followup.

Mirikar P - Case Rep Med (2012)

Oblique fracture of distofacial cusp with 26, loss of buccal cusp with 25.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3295587&req=5

fig2: Oblique fracture of distofacial cusp with 26, loss of buccal cusp with 25.
Mentions: The patient reported to the dental clinic with a chief complaint of fractured teeth in upper and lower back region of the jaw due to a bicycle riding accident. The general condition of the patient was assessed and recorded prior to a detailed examination of head, neck, and oral regions for damage of hard and soft tissues. After a thorough evaluation of the periodontal, endodontic, coronal, and occlusal (PECO) status of the teeth [6, 7], a diagnosis of oblique fractures with 16 (Figure 1), 26, 25 (Figure 2), and vertical fracture with 24 extending subcrestally (Figure 3) was made. With respect to the mandibular molars, oblique fracture with 46 involving mesiolingual cusp (Figure 4) and vertical fracture with 36 extending mesiodistally (Figure 4) were diagnosed. In addition to clinical examination for pulpal exposure, the vitality status of all the teeth was recorded as the baseline responses. The clinical diagnosis was confirmed radiographically (Figures 5, 6, 7, and 8), which also suggested the presence of transverse fracture at the level of coronal and middle third of the root with respect to 24 (Figure 6). Patient was informed of the difficulty of the case and was offered with several treatment alternatives and told about the need for exploratory surgery to define the best treatment modality [6, 7]. Consent was secured from the patient who was previously informed about eventual risks such practices involved. The aim was to preserve the greatest amount of supporting bone and to render rational treatment. Surgery was required to access fracture extension and to assert the viability of fragment reattachment. As a first step, antisepsis and anaesthesia of the involved teeth were carried out. Next fragments were tested for adaptation.

Bottom Line: To restore the coronal fracture with invasion of biologic width, flap surgery with osteotomy and osteoplasty localized on the fractured teeth was performed, and the tooth remnant was reattached to the crown with a self-etch adhesive system.Frank pulp exposure was treated by self-etch dentin adhesive after surface disinfection prior to sealing of the wound site.At 2-year recall, the teeth continue to be aesthetically and functionally stable with a favourable pulpal and periapical environment.

View Article: PubMed Central - PubMed

Affiliation: Department of Conservative Dentistry and Endodontics, Sinhgad Dental College and Hospital, Maharashtra, Pune 411041, India.

ABSTRACT
This paper presents a clinical report demonstrating combined restorative bioadhesive treatment and prosthetic rehabilitation of uncommon type of dental injury in an eighteen-year-old female involving crown fracture of all the permanent first molars and left upper premolars due to a bicycle riding accident. To restore the coronal fracture with invasion of biologic width, flap surgery with osteotomy and osteoplasty localized on the fractured teeth was performed, and the tooth remnant was reattached to the crown with a self-etch adhesive system. Frank pulp exposure was treated by self-etch dentin adhesive after surface disinfection prior to sealing of the wound site. At 2-year recall, the teeth continue to be aesthetically and functionally stable with a favourable pulpal and periapical environment.

No MeSH data available.


Related in: MedlinePlus