The conservative approach in the treatment of maxillofacial trauma in children has been widely adopted. The type of fracture and its presence within the growing facial skeleton along with the presence of tooth buds may result in different management strategies to that employed in adults. An understanding of conservative treatment options is essential to make informed choices which will best manage these injuries, and an example is presented in this paper. This case report describes a 14-year-old boy who sustained trauma to the chin as a result of a fall, causing a mandibular symphyseal fracture. He was successfully treated by the means of applying direct interdental wiring combined with an acrylic splint.
The introduction of an intraradicular composite reinforcing technique, in conjunction with the reestablishment of matching post canal spaces, has allowed compromised, root-filled teeth to be restored with functional, esthetic post crowns. This clinical case report suggests that reconstituted post canals, in accurately adapting to passive, parallel-sided, matching, and well-fitting posts, can enhance the retention of post crowns. Other factors of clinical importance relating to the resin-reinforced technique are discussed, including fracture resistance, depth of polymerization, dentin adhesion, polymerization shrinkage, and coronal microleakage.
The composite reinforcement technique has been used clinically to salvage damaged root-filled teeth compromised by caries, trauma, developmental abnormalities, internal resorption and iatrogenic causes. This clinical case report describes the use of the technique to reattach a fractured fragment in a compromised endodontically treated root besides reinforcing it for continued function in the mouth. Factors of clinical importance related to this additional application; including reattachment of tooth fragments, post crown retention, coronal microleakage and fracture resistance and strength, are also briefly discussed.
The objectives of this Malaysian study were to investigate the relationship between severity of trauma and interval before treatment, and the effect of delayed treatment on prognosis. A total of 123 traumatized permanent incisors were observed over a 24-month period. Results of this study suggest that the interval between trauma and emergency treatment is directly related to the severity of injury and the level of dental awareness of the patients. However, prognosis of these teeth is greatly influenced by the interval between trauma and initial treatment. Pathological pulp changes in these teeth can occur as late as two years after injury and this justifies the necessity for a long observation period following treatment.
A method of treating an apical root fracture with accompanying resorption at the junction of the fracture fragments using glass-cermet cement is described. Endodontically, the material had previously been used for repair of lateral resorptive root defects and retrograde root fillings. Complete bone regeneration was observed three years post-operatively following treatment of the root fracture in the conventional manner. The various advantages of glass-cermet cement as a root filling material used in the technique described are discussed.
This case report demonstrates sequential periodontic, orthodontic and prosthodontic treatment modalities to save and restore deep horizontally fractured maxillary central incisor. The location of fracture was deep in the mucosa which reveals less than 2 mm of tooth structure to receive the crown. The procedures like surgical crown lengthening, endodontic post placement, orthodontic forced eruption, core build-up and metal-ceramic crown restoration were sequentially performed to conserve the fractured tooth. Forced eruption is preferred to surgical removal of supporting alveolar bone, since forced eruption preserves the biologic width, maintains esthetics, and at the same time exposes sound tooth structure for the placement of restorative margins.