Restoration of an intruded maxillary central incisor with a uniquely designed dowel and core restoration: a case report

This article describes the restoration of an intruded root using a custom-made metal dowel and metal-ceramic veneer core restoration. The treatment plan for this patient consisted of restoring the missing esthetics and eliminating psychological trauma by utilizing the root of the intruded maxillary left central incisor to replace both missing central incisor crowns. This treatment will preserve space and bone until the patient is old enough for another prosthodontic restoration to be considered. CLINICAL SIGNIFICANCE: As the lost fragments were not recovered, we considered this restoration of the intruded root to be the best therapeutic option, considering the effect on the patient's psyche. The patient was satisfied with the final result.     

种植体颈部裂开致即刻种植即刻负重修复失败1例

即刻种植即刻负重修复具有早期恢复患者美观和功能，缩短种植周期，减少手术次数、手术创伤小、患者痛苦小等优点。本文报道1例种植体颈部裂开致即刻种植即刻负重修复失败的病例。     

Physiotherapy in the management of temporomandibular disorders

A bstract :  Physiotherapy is concerned with the relief of pain and the restoration of function in the musculoskeletal system following trauma, disease, and dysfunction. This paper presents a review of the different forms of physiotherapy and their application to temporomandibular problems.     

The combination of a surgical and adhesive restorative approach to treat a deep crown-root fracture: a case report.

Most dental trauma requires immediate action to preserve the affected teeth. Furthermore, the trauma has often a great impact on the appearance and well being of the patient. In this case trauma resulted in a very deep complicated crown-root fracture of one incisor and a complicated crown fracture in another incisor of a 47-year-old woman. A combination of surgical extrusion and adhesive restoration was chosen to provide good prognosis for the teeth as well as an instant esthetic result that was well accepted by the patient. Eleven months after trauma, the treated teeth exhibited good healing and normal function.     

Restoration of severely decayed primary incisors using indirect composite resin restoration technique

Caries of primary incisors is a common problem in paediatric dentistry in some countries. The restoration of primary incisors which have been severely damaged by early childhood caries or trauma is also a difficult challenge for clinicians. This case report describes an indirect technique for the restoration of primary anterior teeth using composite resin reinforced with a fibre-glass post. Over a one-year period, the crowns have demonstrated good retention and aesthetic results. The restorations were provided in two short chair-side sections, with satisfactory patient cooperation.     

Restoring of traumatized anterior teeth: a case report

Abstract –  The fracture of anterior teeth in children creates psychological impact on both the parents and the child especially if the injury affects the permanent dentition and involves the loss of extensive tooth structure. Besides the pain and discomfort from the injury, the child's changed appearance may make him the target for teasing and even ridicule by other children. Traumatic teeth can be treated in different ways, in the WHO system, eight groups were classified according to the anatomical structure involved, and treatment planning depends on the type of the injuries to the teeth and their supporting structures. This article describes the restoration of smile of the patients after fractured of teeth by different treatment options available. Because of the fact that lost fragmans were not recovered, and bearing in mind the patient age, we considered composite-veneered amalgam restoration of the fractured teeth as the best therapeutic option. The patient was satisfied with the final result.     

A simple technique to fabricate a surgical obturator restoring the defect in original anatomical form

Oral cancer treatment involves the surgical removal of all or part of the maxilla, leaving the patient with a defect that compromises the integrity and function of the oral cavity. The postoperative restoration of esthetics, deglutition, and speech shortens recovery time in the hospital and expedites the patient's return to the community as a functioning member. The surgical obturator is the proven treatment option in such situations. This article describes a simple technique to fabricate a surgical obturator that restores patient's original dentition and facial and palatal tissue form. The obturator fabricated with this technique utilizes the vacuum formed index of patient's original tissue form and duplicated partly in heat and partly in auto polymerizing acrylic resin. Duplication of the original tissue form helps patient to minimize the immense physiological trauma immediately after the surgical resection. The obturator fabricated with this technique supports soft tissues after surgery and minimizes scar contracture and disfigurement, and thus may have a positive effect on the patients' psychology.     

Use of a two-piece Gunning splint as a mandibular guide appliance for a patient treated for ameloblastoma

Prosthodontic restoration in edentulous patients who have undergone hemisection of the mandible is difficult because of the instability of the mandible after resection and the lack of teeth necessary for successful retention of a guidance appliance. Successful prosthodontic restoration was accomplished through the use of a two-piece Gunning splint both for intermaxillary fixation and as a guidance appliance in an edentulous patient who underwent a hemisection of the mandible subsequent to treatment for an ameloblastoma. Because mandibular guidance therapy is most successful in patients whose resection involves only bony structures with minimal loss of soft tissue and no radical neck dissection or radiation therapy, the patient treated for ameloblastoma is an ideal candidate for the use of a two-piece Gunning splint for intermaxillary fixation and mandibular guidance therapy.     

Custom ocular prosthetics

The rehabilitation of a patient who has suffered the psychologic trauma of an ocular loss requires a prosthesis that will provide the optimum cosmetic and functional result. Refinement in the details of custom ocular construction has produced a superior restoration delivered more readily.     

Abnormal reaction to subgingivally placed dental amalgam studied by transmission electron microscopy and microprobe analysis. Case report

An abnormal clinical response to dental amalgam is reported. The patient presented with a generalized burning sensation having a focus of pain in a region approximating a subgingivally placed dental amalgam restoration. Replacement of the amalgam restoration with glass ionomer cement relieved the pain and burning. Gingival tissue associated with the amalgam, excised to render the new restoration supragingivally, displayed ultrastructural changes in both the epithelium and connective tissue, with mercury demonstrated in the connective tissue and the epithelium by electron microprobe analysis. The significance of the presence of mercury and absence of the other constituents of dental amalgam are discussed.     

Allergic contact stomatitis from a gold alloy--fixed partial denture

Allergic contact stomatitis to gold is rare. To our knowledge, seven cases caused by dental restorations have been previously reported. Each of the patients was female. This report documents an allergic reaction to gold in a fixed prosthesis. A female patient, previously sensitized to gold earrings, experienced an itching and burning pain sensation and ulceration of the oral tissues adjacent to the gold restoration. Patch tests confirmed the allergy to gold. The dentist needs to be aware of the symptoms that are characteristic of the allergic manifestations of gold. Inquiries about allergies to metals and jewelry should be a part of the medical history. Any patient experiencing pain, itching, burning, and ulceration of the mucosa adjacent to a cast gold restoration should be suspected of an allergic contact stomatitis.     

Trauma to an implant‐supported crown that was saved by the fixation screw: a case report

Abstract – A traumatic impact to an implant‐supported crown might damage the implant, restoration and peri‐implant tissues. Ideally, only a small prosthetic retreatment is needed for restoration, as complicated prosthetic retreatments or surgical retreatments in particular, could be very inconvenient for the patient. However, there is a deficiency in literature on how the implant, restoration and surrounding tissues generally react to impact forces. This report demonstrates a case of trauma to an implant‐supported crown in the maxillary anterior zone resulting in a displacement of the implant crown. After careful examination and follow‐up, it appeared that only the fixation screw was damaged, whereas the implant, restoration and peri‐implant tissues remained unharmed. Thanks to the protective qualities of the implant system, an easy prosthetic retreatment could restore the implant‐supported crown and a surgical retreatment was prevented.     

The relationship between chronic facial pain and a history of trauma and surgery.

OBJECTIVE: Because pain is the most commonly reported symptom of patients presenting to temporomandibular disorders clinics, it is important to identify factors that modify the perception or reality of such pain. The purpose of this study was to investigate the hypothesis that a patient with a history of trauma and/or non-temporomandibular joint surgery might be sensitized to pain and might report increased pain levels if a temporomandibular disorder later developed. STUDY DESIGN: This was a retrospective study of 778 consecutive patients seen over a 1-year period in an Orofacial Pain Clinic. Study parameters included gender, lifetime number of self-reported traumas, lifetime number of non-temporomandibular joint operations, and location, intensity, frequency, and type of temporomandibular disorder-related pain. RESULTS: There were significantly more women than men in the study (609 to 169). There was no relationship between numbers of previous traumas and non-temporomandibular joint operations and types of temporomandibular disorder. However, there were statistically significant relationships between the severity of facial pain and the frequency of facial pain as well as between the severity and frequency of joint pain and the number of traumas. There were also statistically significant associations between the severity and frequency of facial pain and the number of non-temporomandibular joint-related surgical procedures that the patient had undergone. CONCLUSIONS: There is a relationship between a patient's reported history of trauma and/or non-temporomandibular joint-related operations and the severity and frequency of facial and temporomandibular joint pain, should it develop. It is possible that such traumas and operations sensitize the patient in such a way that the pain of subsequent temporomandibular joint disorders is heightened.     

Immediate tooth extraction,placement of a Tapered Screw-Vent implant,and provisionalization in the esthetic zone: a case report

PURPOSE: This clinical report describes an immediate tooth extraction, followed by placement and provisional restoration of a dental implant in the prepared socket of a right maxillary central incisor. MATERIALS AND METHODS: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. A flapless, transmucosal surgical approach was used to prepare the socket and insert a tapered implant. The implant was immediately restored with a provisional abutment and crown without occlusal contacts. An impression was made 22 days after implant insertion, and a definitive, all-ceramic restoration was placed 3 days later. RESULTS: During the period of provisional progressive loading, no significant soft tissue contraction was observed related to noninvasive operating techniques and the immediate insertion of the provisional restoration. The patient exhibited no clinical or radiologic complications through 8 months of clinical monitoring after loading. CONCLUSION: The Tapered Screw-Vent implant and all-ceramic restoration provided the patient with immediate esthetics, function, and comfort without any complications during the postloading follow-up period.     

Contemporary aesthetic care for nonvital teeth: conservative treatment options

This article presents a series of considerations for the adhesive restoration of the nonvital tooth. Although ensuring the marginal integrity of all elements is critical to the final restoration, the most important parameter in the restoration of an endodontically treated tooth is the evaluation of the loss of substance in volume, architecture, and location. It is also important for the dentist to consider other clinical parameters (eg, the age of the patient, the length of time since trauma, even the occlusal scheme) prior to initiating care for these teeth. Learning Objectives: This article advocates the clinician's conservation of natural tooth structure when providing care to preserve the root anchorage due to repeated and invasive work that can result in microfractures or loss of tooth. Upon reading this article, the reader should: * Understand the need to preserve tooth structure by performing partial-coverage restorations. * Become more familiar with the indications for resin-bonded restoration for a devital tooth.     

Postoperative pain after apicectomy. A clinical investigation

Summary. The present study investigated the magnitude and duration of postoperative pain after apicectomy under local anaesthesia in 80 patients. Multiple regression analysis was used to determine the relationship between certain preoperative and operative variables with both the pain experience on the day of surgery and the overall pain experience throughout the 7-day investigation period. The results showed that postoperative pain after apicectomy is of short duration and reaches its maximum intensity in the early postoperative period. The magnitude of pain does not appear to be dependent upon the operator, sex of the patient or surgical trauma. However, a previous history of acute periapical infection is an important determinant of the postoperative pain experience.     

Atypical odontalgia--a form of neuropathic pain that emulates dental pain

In order for the neuropathic pain associated with AO to occur in the oral or facial area, a deafferentation process must be initiated as previously explained. Deafferentation happens when there is a trauma to tissues including, but not limited to, endodontic therapy, a surgical extraction or even a simple one, a deep scaling, an injurious dental injection, and even the placement of a crown. Thankfully, most patients heal uneventfully. Apparently a small percentage of patients have a genetic predisposition to deafferentation pain. In reviewing articles on this subject, there is often material about the inadvertent dental treatment of patients with AO. Many patients often have undergone numerous invasive procedures in an effort to ameliorate pain. It is not possible to read a research paper about AO without reading about the recurrent theme of either overtreatment or unnecessary treatment. Caution should be exercised when performing endodontic therapy solely for the relief of pain without objective need for such therapy. It is common for the AO patient to undergo many other irreversible dental treatments with no resolution of pain symptoms. When the dentist encounters a patient in pain for which there is no dental connection, he or she should strongly consider referring the patient to a facility or practitioner who has expertise in dealing with the non-dental source of dental pain.     

Immediately loaded fixed maxillary implant treatment for a patient with advanced periodontal disease: a clinical report

Patients with a failing maxillary dentition typically require an extended treatment sequence that involves extractions, interim prosthesis wear, grafting and subsequent implant placement, and restoration with an implant-supported fixed or bar-retained prosthesis. Established maxillary implant protocols can take up to 15 or more months to complete. The purpose of this report is to describe a treatment sequence using zygomatic implants in a patient with advanced periodontal disease. A fixed prosthesis was fabricated without grafting, resulting in a shortened treatment time.     

The role of sexual trauma as a cause of orofacial symptoms. Case report

Authors describe a 58-sitting psychotherapy of a 46-year-old female patient with psychogenic atypical facial pain. Sexual trauma in the childhood was found as a cause of the psychogenic pain symptoms, leading to series of unnecessary extraction of teeth in this case. Psychotherapeutic treatment led to the recovery of the somatic symptoms, and a moderate improvement of the behaviour related to men of this patient.