Esthetic treatment of an avulsed maxillary central incisor: report of case

An 11-year-old patient was treated for functional and esthetic dental problems. A multidisciplinary approach was chosen that combined replantation, habit control, orthodontics, and restoration of fractured and nonvital anterior teeth with porcelain veneers.     

Immediate self‐replantation of an avulsed permanent mandibular incisor – a case report

Abstract – Background: Approximately 50% of children under the age of 15 years are subjected to various kinds of injuries in the orofacial region. In the permanent dentition, the most severe dental injury affects the surrounding alveolar bone structure and leads to loss of the tooth. The current literature emphasizes that the awareness of appropriate triage procedures following dental trauma is unsatisfactory and that delay in treatment is the single most influential factor affecting prognosis. Results: This case report presents the immediate self‐replantation of a right lateral mandibular incisor of a 12‐year‐old male patient following a traumatic avulsion. The same patient had earlier, aged 10 years, experienced a trauma leading to the loss of all four maxillary incisors. The missing incisors were replaced by a removable acrylic denture. Having the requisite experience from the earlier accident, the child performed on himself an immediate replantation of the tooth at the site of the accident. After avulsion, the tooth was not splinted timely nor was an endodontic procedure carried out and no antibiotics were prescribed. The first dental examination after the trauma was performed 6 months later and since then, radiographic follow‐up has been introduced. One year after the trauma, following the late endodontic treatment performed 6 months after reimplantation, the tooth is asymptomatic and stable. Conclusions: Immediate self‐replantation of an avulsed tooth is the best treatment choice, even without any other proceeding treatment. However, the healing process should be followed up to allow for the treatment of the early signs of pulpal necrosis and/or root resorption.     

Replantation of an avulsed incisor after prolonged dry storage: a case report

Management of tooth avulsion in the permanent dentition often presents a challenge. Definitive treatment planning and consultation with specialists is seldom possible at the time of emergency treatment. Replantation of the avulsed tooth can restore esthetic appearance and occlusal function shortly after the injury. This article describes the management of a child with an avulsed maxillary permanent incisor that had been air-dried for about 18 hours. The replanted incisor retained its esthetic appearance and functionality 2 years after replantation, yet the long-term prognosis is not good because of progressive replacement root resorption.     

Delayed replantation of an avulsed tooth after 5 hours of storage in saliva: a case report

Abstract – This article reports a clinical case of a 8‐year‐old boy, who underwent an avulsion of the upper left central incisor. The avulsed tooth was kept in the oral cavity in direct contact with saliva for 5 h from the moment of trauma until its replantation. Treatment guidelines for avulsed mature permanent teeth were followed. The clinical and radiographic findings after 2 years revealed absence of root resorption, ankylosis or mobility of the replanted tooth.     

Kostmann syndrome: oral aspects and 10‐year follow‐up case report

Kostmann syndrome (KS) is an autosomal recessive disorder characterized by a low neutrophil count and recurrent bacterial infections, including periodontal disease. This report describes the case of a 5‐year‐old female KS patient treated with regular infusions of granulocyte stimulating factor (granulokine), with primary complaint of gingival bleeding and tooth mobility, and followed up for 10 years. Conventional periodontal treatment and some extractions were performed, after neutrophil function tests using flow cytometry. The invasive procedures were carried out at an outpatient clinic under antibiotic prophylaxis due to a low neutrophil count and an impaired neutrophil function presented. During the 10‐year follow‐up period, despite episodes of recurrent gingivitis and periodontitis the present report describes the positive outcome of dental treatment of a patient with KS.     

Management of root dilaceration of an impacted maxillary central incisor following orthodontic treatment: an unusual therapeutic outcome

Abstract – There are rare cases of impacted permanent central incisors with dilaceration, a dental deformity characterized by pronounced angulation of the longitudinal tooth axis. This paper presents the orthodontic alignment of a permanent maxillary left central incisor in a 7.5‐year‐old boy, which appeared impacted radiologically and displayed root dilaceration. Following surgical exposure with the closed‐eruption technique and appropriate orthodontic traction, the tooth was successfully aligned into the dental arch and the root was radiologically shown to be straightened and relatively well developed.     

Repositioning an inverted maxillary central incisor using a combination of replantation and orthodontic movement: a clinical case report

In some patients, the permanent central incisors fail to erupt and become impacted within the alveolus. In individuals with unfavorable impactions, surgical replantation may be considered to be a reasonable solution before orthodontic repositioning. In this clinical case report, a 9-year-old male patient presented with the permanent maxillary left central incisor in an inverted position high in the vestibule. He was treated with replantation and orthodontic repositioning with fixed appliances. Radiographic review 2 years post-treatment showed an intact lamina dura consistent with a healthy tooth. It is concluded that orthodontic repositioning in combination with surgical replantation can be an optimal treatment choice for impacted teeth, assuming the anatomic location of the tooth is favorable.     

Implant‐Retained Removable Partial Dentures: An 8‐Year Retrospective Study

Purpose: To evaluate the long‐term outcomes of removable partial dentures (RPDs) retained (but not supported) by dental implants. Materials and Methods: We retrospectively evaluated 32 consecutive patients who received implant‐retained RPDs. Each patient received one to four endosseus implants; the sample included a total of 64 implants. Follow‐up was conducted for a minimum of 8 years, during which satisfaction, implant survival, and prosthetic success were evaluated. Results: Patient satisfaction systematically increased. The implant success rate was 93.75%, and 100% of the prostheses were successful. Conclusion: Implant‐retained RPDs are a reliable intermediate solution that can reduce biological and economic costs while maintaining implant treatment benefits and the ease of RPD procedures.     

Spontaneous re‐eruption of a permanent maxillary central incisor after 15 years of ankylosis – a case report

Abstract – Intrusion injuries are considered among the most severe forms of dental trauma, potentially leading to ankylosis as a late consequence. In 1991, a 7‐year‐old boy suffered a traumatic intrusion leading to an infraposition of tooth 21 along with its immobility. Based on the clinical findings, including bright‐sounding percussion testing, disappearance of the periodontal space and a failed attempt at orthodontic movement, a diagnosis of ankylosis was made. Following prosthetic restoration of the infrapositioned tooth, spontaneous re‐eruption occurred 15 years later. With the help of a partial multibracket appliance, the tooth could be adjusted to occlusal level and was then restored to the patient’s satisfaction. Radiographically, it was demonstrated that extrusion of the tooth had been accompanied by a significant gain in local alveolar bone volume. While a wait‐and‐see strategy cannot be recommended as a treatment option following ankylosis, considering that spontaneous re‐eruption after several years is an extremely rare finding, elucidating the mechanisms at work in spontaneous re‐eruption at a cellular level might create an opportunity for iatrogenic triggering of re‐eruption, thus paving the way to new forms of therapy.     

Management of an unerupted dilacerated maxillary central incisor: a case report

Abstract –  A case with a dilacerated maxillary permanent central incisor, treated with forced eruption technique is illustrated and the results of the 4-year follow up are presented. After the successful eruption of the tooth, the root development was completed and the root canal was obliterated. The 4-year follow-up results revealed the tooth to be still functional and the radiographic evaluation showed that the periodontal and periapical tissues were intact and healthy. In conclusion, the impacted dilacerated incisor diagnosed in the early mixed dentition should be treated with the aid of orthodontic traction. The long-term follow up showed that once the tooth is placed in the occlusion properly, it may function well esthetically and preserve its periodontal and periapical health.     

Long‐term retention of avulsed maxillary permanent incisors replanted after prolonged non‐physiological storage

Ankylosis and external replacement resorption (ERR) are two typical biological responses to delayed replantation of avulsed teeth in cases where adequate root canal treatment is performed. The patient's growth stage affects the progression of root resorption and the long‐term outcome of the affected teeth. This case report describes the long‐term outcome of an 18.5‐year‐old patient following an accident in which both of his maxillary central incisors were avulsed and replanted after four hours of non‐physiological storage. ERR and ankylosis of teeth 11 and 21 were detected clinically and radiographically during the second year of follow‐up. Sixteen years after replantation, replacement resorption was progressing very slowly, enabling functional tooth retention with favorable esthetics. Young adults, with delayed replantation of avulsed teeth, may benefit from tooth retention with slow ERR.     

Long‐term implant survival and success: a 10–16‐year follow‐up of non‐submerged dental implants

Objectives: The aim of the present study was to evaluate the long‐term results of dental implants using implant survival and implant success as outcome variables. Methods: Of the 76 patients who received 162 implants of the Straumann Dental Implant System during the years 1990–1997, 55 patients with 131 implants were recalled 10–16 years after implant placement for a complete clinical and radiographic examination, followed by a questionnaire that examined the degree of satisfaction. The incidence of biological and technical complications has been carefully analysed for each implant. Success was defined as being free of all these complications over the entire observation period. Associated factors related to peri‐implant lesions were analysed for each implant. Results: The long‐term implant cumulative survival rate up to 16 years was 82.94%. The prevalence of biological complications was 16.94% and the prevalence of technical complications was 31.09%. The cumulative complication rate after an observation period of 10–16 years was 48.03%, which meant that substantial amounts of chair time were necessary following implant placement. The majority of implant losses and biological complications were concentrated in a relatively small number of patients. Conclusion: Despite a relatively high long‐term survival rate, biological and technical complications were frequent. Patients with a history of periodontitis may have lower implant survival rates than patients without a history of periodontitis and were more prone to biological complications such as peri‐implant mucositis and peri‐implantitis. To cite this article :
Simonis P, Dufour T, Tenenbaum H. Long‐term implant survival and success: a 10–16‐year follow‐up of non‐submerged dental implants.
Clin. Oral Impl. Res. 21 , 2010; 772–777
doi: 10.1111/j.1600‐0501.2010.01912.x     

Management of cervical root fracture injury in a patient with epilepsy: Case report with 5‐year follow‐up

The difficulty in providing stability to the coronal segment makes cervical root fracture one of the most challenging dental traumatic injury. This type of injury is less frequent in children. However, due to their serious consequences and poor prognosis, tooth loss may occur. This report presents the management of a case of cervical root fracture in an 11‐year‐old patient with epilepsy. The stabilization of the root‐fractured tooth with a splint failed due to the recurrent seizures the patient had. Coronal fragment was removed and vital root submergence was performed in order to support the alveolar growth. The natural tooth crown was incorporated into a modified Nance appliance to meet the esthetic and functional requirements of the patient. After 5‐year follow‐up, this treatment approach has seemed to offer a long‐term provisional and satisfactory solution to the consequences of a cervical root fracture injury.     

Root canal therapy of an anomalous maxillary central incisor: a case report

Abstract A case of endodontic conservative treatment of a maxillary central incisor with an atypical crown and Type III dens invaginatus is presented. The greatest difficulty was to locate the root canals due to the atypical internal anatomy. There were not two clear canals, but the coronal pulp chamber showed two entrances to the root canal. The tooth presented a distal periodontal pocket and various lingual radicular grooves. The appearance of the crown was improved by alteration of its dimension using diamond rotary instruments and correction with photopolymerized resin.     

A 22‐year follow‐up of an endodontic implant

Root fractures in the middle and apical thirds of the root are treated by repositioning and for approximately 6 weeks of immobilization while those in the cervical third are immobilized for 3 months. Even though the results are good, some root‐fractured teeth are lost and replaced by dental implants or fixed partial dentures. One historic but effective treatment option for those root fractures with unfavorable crown to root ratios is an endodontic implant in middle and apical third root fractures. This method offers immediate stable fixation of a crown and its coronal root segment to the underlying alveolar bone. This report documents the long‐term survival of a tooth treated with an endodontic implant. A 25‐year‐old male patient presented following a bicycle accident with a dislocated unfavorable root fracture in the middle third. The crown with the coronal root segment was secured to the bone using a commercially available endodontic implant. The apical part of the root was removed. Although the clinical and radiological follow‐up results of the endodontic implant demonstrated a good clinical function and little bone loss, the implant ultimately had to be removed after 22 years of service due to pain and increasing mobility.