ABSTRACT
Smiling is not a simple option in those patients who have a severe aesthetic deformity. Many definitions of aesthetics were introduced in dentistry but according to Young, beauty, harmony, naturalness and individuality are the major qualities of aesthetics. The dentist must visualize aesthetics in relation to the patient and then translate that visualization into an acceptable aesthetic result. The success of his efforts depends upon his artistic ability, his powers of observation and experience. Many treatment options are available to achieve aesthetics in compromised anterior teeth but in recent era with the introduction of advanced material (new ceramic and composite materials) has increased the demand of conservative treatment options. Porcelain laminate Veneers (PLVs) were introduced in the 1980s as an alternative to full-coverage crowns. The present case report describes the treatment of fracture & diastema in the anterior dentition with thin ceramic veneers, to restore esthetics and function.
ABSTRACT
Bilateral inverted impacted third molar is a very rare incidence. Dearth of dental arch length and space are also considered as the chief cause for tooth impaction. Reviewing the literatures, mandibular third molar was the most frequently impacted tooth, followed by the maxillary third molars, the maxillary canines and the mandibular premolars.
ABSTRACT
Aims: Management of vertically fractured mandibular first molar by intra coronal splinting applying the finite centre of rotation effect of Pythagorus theorem. Case Presentations: A 28 year old male patient presented at the Department of Conservative Dentistry and Endodontics with the chief complaint of pain in the lower right back region of the mouth since last the 10 days. Past dental history revealed that affected tooth had root canal treatment done two years ago. History of present illness was that pain was elicited on chewing, and applying pressure on that area, with occasional bleeding from the same region. Intraoral examination revealed that tooth 46 was tender on percussion with vertically fractured crown in mesiodistal direction. Periapical Radiograph revealed that tooth was endodontically treated, with radiolucencies at apical and furcal area, and visible fracture line in mesiodistal direction at CEJ level. Technique Used in the Study: The tooth was endodontically retreated and Pythagorus theorem was used to locate the centres of rotation on both buccal and lingual sides of tooth 46 coronally. The technique was followed by drilling a vent at the same position approximating a fibre post (3M, Relyxfibre post). The centres were different both for buccal and lingual aspects which when approximated will provide antirotation. The post was placed in the buccolingual direction and the tooth was restored with posterior composites after which the restoration was checked for any high points. Follow up of the case was done for the period of one year. Discussion: The concept of the estimation of the finite centre of rotation is like the primary objective in tightening a screw joint to generate an optimum preload that will maximize the fatigue life of the screw while offering a reasonable degree of protection against loosening. The major advantage of this approach is that the fragment was stabilized properly and there was healthy development of periodontium over the year. Conclusion: Usually the vertically fractured tooth have poor prognosis and may likely be referred for extraction if not stabilized properly. This case report emphasizes the basic concept of stabilization and preventing rotation around an axis which will give the fractured tooth a better longevity and avoid the vibrations during crown preparation. The combined effect will restore the patient’s own natural tooth back and minimizes the chances of periodontal complication.
ABSTRACT
Aims: To use platelet rich fibrin (PRF), which is an autologous platelet concentrate, along with nanocrystalline hydroxyapatite with collagen for treatment of periapical lesion and negotiation of calcified canal of adjacent tooth. Case Presentation: A 19-year-old female reported to the Department of Conservative Dentistry and Endodontics with chief complaint of pain in maxillary right central incisor. Past dental history revealed trauma which she sustained 10 yrs back in the same region. On intraoral examination, there was a draining sinus, in relation to the apex of 11. Also discolouration and crown fracture was found in relation to 11. Periapical radiograph revealed a large diffused periapical radiolucency in relation to 11 and 12, open apex of 11 and calcified root canal in relation to 12. Technique Used in the Study: A periapical surgery under local anaesthesia was planned in the region of maxillary right anterior region in relation to tooth no 11 and 12. Before surgery calcified canal of tooth no 12 was negotiated. PRF and nanocrystalline hydroxyapatite with collagen combination were placed in bony cavity. Follow up of the case was done for period of 6 months. Discussion: In present case combination of nanocrystalline hydroxyapatite with collagen and PRF is used, as it helps in faster bone regeneration. Graft material is osteoconductive and collagen network provides a better scaffold for clot formation and bone regeneration. Conclusion: The combination of PRF and nanocrystalline hydroxyapatite with collagen has been demonstrated to be an effective approach to induce faster periapical healing in present case with large periapical lesion.