Orthodontic treatment of an impacted dilacerated maxillary incisor: a case report

Dilaceration is one of the causes of permanent maxillary incisor eruption failure. It is a developmental distortion of the form of a tooth that commonly occurs in permanent incisors as result of trauma to the primary predecessors whose apices lie close to the permanent tooth germ. We present a case of post-traumatic impaction of a dilacerated central maxillary left incisor in a young patient with a class II malocclusion.     

Unusual maxillary second premolar morphology: a case report.

This case report presents the relatively uncommon occurrence of a maxillary second premolar with 3 root canals. The possibility of additional root canals should be considered even in teeth with a low frequency of abnormal root canal anatomy. Sound knowledge of root canal anatomy, critical interpretation of radiographs, and high-magnification examination are essential elements of success in complicated root canal therapy.     

Endodontic treatment of a radiculous maxillary premolar: a case report

We report the diagnosis and successful clinical management of three patients with anatomical variation in the maxillary first premolars. Maxillary first premolars have highly variable root canal morphology, but the presence of three canals is rare. This article describes the diagnosis and clinical management of first maxillary premolars with three canals and three separate roots, with special reference to radiographic interpretation and access refinements.     

数字化技术辅助异位阻生尖牙自体牙移植1例

自体牙移植术是指将天然牙从一个位置移植到同一个体的另一位置的手术过程,可有效恢复患者的美观和咀嚼功能,是替代缺牙的可行方法。但因缺乏技术规范,成功率不易保障。不同牙位自体牙移植的存活率与成功率存在差异,尖牙的自体牙移植预后最差。应用数字化技术辅助自体牙移植术,可降低手术难度,减少牙周膜损伤,提高移植牙的成功率。本文报告1例牙瘤导致下颌尖牙异位阻生的自体移植病例。     

Endodontic treatment of a three-rooted maxillary first premolar: a case report

Identifying and accessing all pulp canals is particularly challenging in the endodontic treatment of teeth with atypical canal configurations. This report describes the nonsurgical endodontic treatment of a maxillary first premolar with three root canals. The prevalence of this unusual morphology is reviewed and suggestions are offered to help dentists identify and treat such teeth. This case reminds dentists to be alert for variations in the root canal anatomy of maxillary first premolars.     

Orthodontic-surgical management of an impacted dilacerated maxillary central incisor: a clinical case report

Dilaceration is one of the causes of maxillary central incisor eruption failure. Surgical excision is frequently the first choice of treatment for a severely dilacerated incisor. In this article, the case of a horizontally impacted and dilacerated maxillary central incisor was diagnosed and treated by surgical exposure using the apically repositioned flap technique combined with orthodontic traction. The dilacerated incisor was successfully moved into alignment, with pulpal vitality and periodontal health present 2 years following treatment.     

Periosteal connective tissue grafting or root coverage with enamel matrix derivative: a case report

A 24-year-old female patient presented for the resolution of esthetic concerns associated with wide gingival recession facial to the maxillary left central incisor before orthodontic treatment. A periosteal connective tissue graft in conjunction with an enamel matrix derivative was used to achieve root coverage. This technique achieved healthy thick keratinized tissue coverage of the root surfaces and effectively improved the esthetics. These satisfactory clinical results have been maintained for 18 months, even through active orthodontic treatment.
CLINICAL SIGNIFICANCE
This case report demonstrates an innovative approach to root coverage that uses an enamel matrix derivative in conjunction with periosteal connective tissue grafting. Although there is no absolute clinical evidence that the enamel matrix derivative contributed to the final outcome, the results are encouraging and should be pursued through case-controlled clinical trials.     

Root resorption of a maxillary permanent first molar by an impacted second premolar

This case report highlights the importance of careful clinical and radiographic examination to identify developmental abnormalities before commencing orthodontic treatment.     

Two patterns of histologic healing in an intrabony defect following treatment with enamel matrix derivative: a human case report

Human histologic evidence of periodontal regeneration following treatment of intrabony defects with enamel matrix derivative has yielded inconsistent results in recent case reports. A 46-year-old woman presenting one deep intrabony defect at the distal root of a mandibular first molar scheduled for extraction was selected for enamel matrix derivative therapy. During surgery, a notch was placed at the most apical level of calculus on the experimental root. Nine months postsurgery, a block section including the distal root and surrounding periodontal tissues was obtained and processed in a mesiodistal plane. Histologic analysis demonstrated two different patterns of healing along the proximal and furcal surfaces. Regeneration with new cellular cementum, bone, and periodontal ligament with functional fiber orientation was observed on the distal aspect of the root, whereas the furcal surface healed through ankylosis. This report underlines the biologic variability in wound healing following enamel matrix derivative therapy in periodontal intrabony defects and within the same defect. Host-specific intrinsic and/or extrinsic factors accounting for this variability remain to be investigated.     

Accidental displacement of impacted maxillary third molar: a case report

An unusual case of an impacted right maxillary third molar that was accidentally displaced into the maxillary sinus during exodontia and was surgically retrieved almost 2 years later is described. The tooth was removed under general anesthesia, after maxillary sinus exposure through Caldwell-Luc approach. Postoperative recovery was uneventful. Six months after the retrieval surgery, the maxillary sinus was completely healed and the patient did not present any complaint.     

Surgical intervention of mucosal fenestration in a maxillary premolar: a case report.

Labial mucosal fenestration of the root apex is an uncommon occurrence. An unusual case involving a maxillary right first premolar is described. When presented, the tooth was nonvital with the buccal root apex readily seen through a soft tissue and bone fenestration. Conventional endodontic treatment with gutta percha failed to resolve the problem. Periodontal surgery with a laterally positioned pedicle flap was thus scheduled. At the 1-month recall, complete healing was evident in the surgical site, and the fenestrated area of the maxillary right first premolar was filled with healthy mucosal tissue. One-year postoperatively, the mucosa remained covered, and there was radiographic evidence of bone infilling in the periapical region.     

Traumatic hemisection and restoration of a maxillary first premolar: a case report

Surgical hemisection of a tooth involves the deliberate excision of one or more roots and their associated coronal structure. This procedure generally is performed as an alternative to complete extraction on molars when their prognosis can be improved by removing roots that are significantly compromised. Traumatic hemisection is nondeliberate and describes complete fracture through a furcation, resulting in severance of a fragment from the tooth. The case presented here involves traumatic hemisection and represents the first documented report to detail the restoration of a hemisectioned maxillary first premolar, the only nonmolar, multi-rooted tooth.     

Orthodontic treatment of a patient with an impacted maxillary second premolar and odontogenic keratocyst in the maxillary sinus

An eight-year-, four-month-old girl was brought to the orthodontic clinic of Okayama University Medical and Dental Hospital. The patient had an impacted upper left second premolar because of an odontogenic keratocyst and showed a skeletal Class II jaw base relationship. At the age of six years four months, marsupialization of a cyst was performed at the Okayama University Medical and Dental Hospital because the patient had shown a swelling of the left cheek because of the cyst. The upper left second premolar was located in the roof of the maxillary sinus. The cyst was histopathologically diagnosed as an odontogenic keratocyst. At the age of nine years 10 months and after regaining the space for eruption of the premolar, the impacted premolar erupted without traction. At the age of 12 years five months, edgewise treatment was initiated, which continued for three years. After removing the edgewise appliance, an optimum occlusion was achieved. The occlusion was maintained without recurrence of the keratocyst after a retention period of five years.     

双根三根管上颌第一前磨牙根管治疗1例

上颌第一前磨牙三根管的发生率为0.5%~7.5%,目前国内报道的多为三根三根管型,尚未见双根三根管型的病例报告。本病例介绍1例双根三根管型上颌第一前磨牙的根管治疗。     

Spontaneously healed horizontal root fracture in maxillary first premolar: report of a case

Abstract –  Root fractures of the posterior teeth are rare and occur as a result of severe trauma. This study describes the horizontal root fracture of a maxillary first premolar. The fractured roots were discovered during a routine radiographic examination. The tooth was asymptomatic and responded positively to electric pulp testing. The patient reported accidental trauma, which occurred 14 years before. Our case is an example of spontaneously healed fractured roots. The interesting findings were that the healing was observed even in the presence of two roots, including preservation of the vitality of the pulp.     

Endodontic treatment of three-rooted maxillary first premolar: A case report

A meticulous knowledge of the tooth morphology, careful interpretation of angled radiographs, proper access preparation and a detailed exploration of the interior of the tooth are prerequisites for a successful treatment outcome. False assumption about root canal morphology may lead to incomplete debridement and obturation of root canal space eventually leading to endodontic failures.Maxillary first premolar is known for the greatest variations in root anatomy and root canal morphology, while presence of two roots with two canals is quite common and is considered normal. The incidence of first maxillary premolar with three roots & three canals is quite rare and has been reported to 0–6% by Carns and Skid.This case report discusses the diagnosis and treatment of a maxillary first premolar with three canals and three separate roots. The presence of three roots with three canals was detected by radiographic interpretation, access refinements and confirmed by using spiral computed tomography.