Influência da férula na resistência à fratura de restaurações com utilização ou não de retentores intrarradiculares em dentes tratados endodonticamente: uma revisão da literatura / Influence of the ferrule on the fracture resistance of restorations with or without the use of intraradicular posts in endodontically treated teeth: a literature review

Objetivo: realizar uma revisão de literatura narrativa sobre a importância e a influência do efeito férula na resistência à fratura de restaurações em dentes tratados endodonticamente com utilização ou não de retentores intrarradiculares. Metodologia: Foram utilizados os seguintes descritores indexados no DeCS (Descritores em Ciências da Saúde): "Férula", Prótese Dentária", "Falha da Restauração Dentária", "Técnica de Retentor Intrarradicular" e "Pinos de Retenção Dentária" para busca nas bases de dados PubMed, Embase, Lilacs, Web of Science, Scopus e Cochrane Library. Resultados: Os dados da maioria dos estudos in vitro ou in vivo incluídos nesta revisão sugerem o uso da férula para aumento da resistência à fratura e longevidade dos dentes tratados endodonticamente. Tem sido recomendada a confecção de uma férula com altura uniforme de 2 mm e espessura superior a 1,5 mm. Conclusão: O uso de retentores radiculares foi indicado pela maioria dos trabalhos, sendo geralmente recomendados os pinos de fibra de vidro ao invés de núcleos metálicos fundidos para minimizar os riscos de fratura radicular em razão do módulo de elasticidade semelhante à dentina, além de possibilidade de retratamentos em casos de falhas adesivas. Apesar disso, ainda são necessários estudos clínicos com acompanhamento a longo prazo para avaliar a longevidade das restaurações de dentes tratados endodonticamente utilizando pinos de fibra de vidro sem ou com a presença de férula em diferentes espessuras e alturas.

Objective: This study aimed to conduct a narrative literature review on the importance and influence of the ferrule effect on the fracture resistance of restorations in endodon-tically treated teeth with or without the use of intraradicular posts. Methodology: The following descriptors indexed in the DeCS (Health Sciences Descriptors) were used: "Ferrule", Dental Prosthesis", "Dental Restoration Failure", "Post and Core Technique", and "Dental Posts", to search on the databases of PubMed, Embase, Lilacs, Web of Science, Scopus, and Cochrane Library data. Results: Data from most of the in vitro or in vivo studies included in this review suggest the use of the ferrule to increase fracture resistance and longevity of endodontically treated teeth. It has been recommended to make a ferrule with a uniform height of 2 mm and a thickness greater than 1.5 mm. Conclusion: The use of intraradicular posts was indicated by most studies, and fiberglass posts are generally recommended instead of cast metal cores to minimize the risk of root fracture due to the modulus of elasticity similar to dentin, in addition to the possibility of retreatments in ad-hesive failure cases. Despite this, clinical studies with a long-term follow-up are essential to evaluating the longevity of restorations of endodontically treated teeth using fiberglass posts without or with the presence of ferrule in different thicknesses and heights.

Tratamiento con férula dental en bruxismo inducido por antoconvulsivo: Reporte de caso / Dental splint treatment in bruxism induced by anti-seizure drug. Case report

Los signos de desgaste y rechinamiento de los dientes están asociados con el bruxismo y se observan comúnmente en los consultorios dentales. En este reporte, las autoras describen un caso de bruxismo probablemente inducido por el medicamento anticonvulsivo Valpromed®, que fue tratado con éxito mediante una férula dental. El paciente llegó a la clínica declarando que deseaba mejorar su estética. En el examen clínico, se observó un desgaste moderado de las superficies oclusales de los molares asociado con antecedentes de rechinamiento nocturno, característico del bruxismo del sueño. Hace aproximadamente 5 meses, el paciente comenzó la terapia con Valpromed® por orden del neurólogo, debido a episodios de migraña. El medicamento se prescribió para evitar el riesgo de convulsiones ya que el paciente había sufrido de neurocisticercosis durante la infancia. Según los consejos del especialista en rehabilitación oral y la literatura revisada, las autoras concluyeron que el bruxismo podía atribuirse a la terapia con el medicamento anticonvulsivo. Para el tratamiento, se escogió una técnica mínimamente invasiva. Aunque el paciente todavía está en controles, la férula dental parece ser un enfoque prometedor para el tratamiento de esta afección. (AU)

Signs of tooth wear and grinding are associated with bruxism, which is commonly observed in dental offices. Here, the authors describe a case of bruxism probably induced by the anti-seizure drug Valpromed®, that was successfully treated with a dental splint. A man was attended in the dental clinic for improvement of dental aesthetics. On clinical examination moderate overwear of the occlusal surfaces of molars was observed associated with a history of nightly grinding, characteristic of sleep bruxism. Approximately 5 months previously, the patient had started therapy with Valpromed® due to episodes of migraine. The drug had been prescribed by a neurologist to prevent convulsions since the patient had had neurocysticercosis during childhood. Based on the advice of an oral rehabilitation specialist and the literature reviewed, it was concluded that the presence of bruxism in this patient may be attributed to the therapy with the anti-seizure medication. Although the patient is still under controls, the dental splint seems to be a promising approach for the treatment of this condition. The patient was treated with a minimally invasive dental splint and is monitored periodically, showing good results. (AU)

Immunological and Morphological substantiation of the use of dental stick with biopharmaceuticals in the complex therapy of inflammatory periodontal diseases

Aim of the study: clinical, immunological and morphological substantiation of the use of a dental stick with biopharmaceuticals in the complex therapy of inflammatory periodontal diseases. Research methods: leukocyte migration test, cytograms, the study of quantitative and qualitative content of spontaneously released mixed saliva, measurement of the total content of protein, the content of secretory immunoglobulin A (sIgA) and lysozyme in it. Clinical improvement of the periodontal tissues condition after treatment by 77% was registered. OHI-S (hygienic index), PI (periodontal disease index), PMA (papillary-marginal-alveolar index) were 7.5, 3.4, and 8.7 times lower, respectively, compared to the pre-treatment group. The depth of periodontal pockets decreased 2.6-3.4 times, the number of sessions per treatment course was reduced to 3-8 visits to the doctor. The amount of mixed saliva (in comparison with the initial data) increased 2.7 times, normal levels were restored and were 1.2 ml higher than control indicators. Protein levels, lysozyme and sIgA concentrations increased and exceeded the pre-treatment level 1.8 times and by 44.5%, respectively. Cytograms data revealed that the number of red blood cells (in one field of view) in the gingiva specimens in inflammatory periodontal diseases (IPD) patients was 2.3 times lower, count of leukocytes with signs of destruction was 13.4 lower and intact leukocyte count was 3.8 times lower. Lymphocyte count was 2 times lower, indicating that the inflammatory process in periodontal tissues was reduced as a re sult of the reduction of the microbial burden: staphylococci and actinomycetes were detected 3 times less often, diplococci ­ 3.5 times less often, filamentous bacteria and streptococci ­ 4 times less often, protists ­ 5 times less often, respectively. The number of cocci microcolonies was 2.7 times higher. The number of fibroblasts (in one field of view) increased threefold, the content of collagen filaments of the normally oriented structure increased 1.4 times, compared to the original data, which indicated the formation of favorable conditions for healing and reparative regeneration processes. The results of the study showed that the use of a dental stick during local IPD therapy is an effective way of correcting changes in clinical and laboratory indicators of local immunity and that dental stick is a promising new dosage form in practical periodontology.

Side effects of mandibular advancement splints for the treatment of snoring and obstructive sleep apnea: a systematic review

ABSTRACT Introduction: Occlusal side effects or development of pain and/or functional impairment of the temporomandibular complex are potential reasons for poor compliance or abandonment of mandibular advancement splints treatment for snoring and obstructive sleep apnea. Objective: This study aimed at providing a comprehensive review evaluating the craniofacial side effects of oral appliance therapy for snoring and obstructive sleep apnea. Methods: An electronic search was systematically conducted in PubMed and Virtual Health Library from their inception until October 2016. Only Randomized Controlled Trials whose primary aim was to measure objectively identified side effects on craniofacial complex of a custom-made oral appliance for treating primary snoring or obstructive sleep apnea were included. Studied patients should be aged 20 or older. The risk of bias in the trials was assessed in accordance with the recommendations of The Cochrane Risk of Bias criteria. Results: A total of 62 full-text articles were assessed for eligibility. After the review process, only 6 met all the inclusion criteria. All studies were rated as having a high risk of bias. The most uniformly reported mandibular advancement splint side effects were predominantly of dental nature and included a decrease in overjet and overbite. The risk of developing pain and function impairment of the temporomandibular complex appeared limited with long-term mandibular advancement splint use. Conclusion: The limited available evidence suggests that mandibular advancement splint therapy for snoring and obstructive sleep apnea results in changes in craniofacial morphology that are predominantly dental in nature, specially on a long-term basis. Considering the chronic nature of obstructive sleep apnea and that oral appliance use might be a lifelong treatment, a thorough customized follow-up should therefore be undertaken to detect possible side effects on craniofacial complex. It is also important to provide adequate information to the patients regarding these possible changes, especially to those in whom larger occlusal changes are to be expected or in whom they are unfavorable. Long-term assessments of adverse effects of oral appliance therapy, with larger study samples and recruitment of homogenous patient population are still required.

RESUMO Introdução: efeitos colaterais oclusais e o desenvolvimento de dor e/ou disfunção do complexo temporomandibular podem levar à baixa adesão ou ao abandono do tratamento do ronco e da apneia obstrutiva do sono com aparelhos de avanço mandibular. Objetivo: fornecer uma revisão abrangente da literatura sobre os efeitos colaterais craniofaciais do tratamento do ronco e da apneia obstrutiva do sono com aparelhos de avanço mandibular. Métodos: foram realizadas buscas eletrônicas sistematicamente no PubMed e na Biblioteca Virtual em Saúde até outubro de 2016. Foram incluídos apenas Ensaios Controlados Randomizados, com o objetivo primário de mensurar objetivamente os efeitos colaterais no complexo craniofacial associados ao uso de aparelhos de avanço mandibular no tratamento do ronco e da apneia obstrutiva do sono. Os pacientes estudados deveriam ter 20 anos de idade ou mais. A avaliação do risco de viés dos trabalhos selecionados seguiu as recomendações do The Cochrane Risk of Bias. Resultados: no total, 62 artigos completos foram avaliados em relação à elegibilidade. Após o processo de revisão, apenas 6 atenderam aos critérios de inclusão. Todos os estudos foram julgados como tendo alto risco de viés. Os efeitos colaterais mais frequentemente encontrados foram de natureza dentária e incluíram uma diminuição do overjet e do overbite. O risco de desenvolvimento de dor ou disfunção do complexo temporomandibular pareceu limitado na avaliação de longo prazo do uso do aparelho de avanço mandibular. Conclusão: as evidências disponíveis são limitadas e sugerem que o tratamento do ronco e da apneia obstrutiva do sono com aparelhos de avanço mandibular resulta em alterações craniofaciais predominantemente dentárias, especialmente nas avaliações de longo prazo. Considerando-se que a apneia obstrutiva do sono é crônica e que os aparelho intrabucais se constituem em uma forma de tratamento contínuo e por tempo indefinido, é necessário um acompanhamento individualizado para monitorar possíveis efeitos colaterais no complexo craniofacial. Também é importante informar aos pacientes sobre esses possíveis efeitos, especialmente àqueles nos quais são esperadas maiores alterações oclusais ou nos quais elas sejam desfavoráveis. Ainda são necessárias avaliações de longo prazo dos efeitos colaterais do tratamento com aparelhos intrabucais, com amostras maiores e mais homogêneas.

Repercusiones del uso de Dispositivos de Avance Mandibular como Terapia para el Síndrome de Apnea Obstructiva del Sueño en el Complejo Temporomandibular. Revisión Narrativa / Repercussions of the use of Mandibular Advancement Devices as Therapy for Obstructive Sleep Apnea Syndrome in the Temporomandibular Complex. Narrative Review

RESUMEN: El objetivo de este trabajo fue escribir, según la literatura científica disponible más actual, los efectos que inducen el uso de dispositivos de avance mandibular, como terapia para el SAHOS, en el sistema temporomandibular de los pacientes. Se realizó una revisión de la literatura más actual (últimos 10 años; 2006-2016) a partir de la búsqueda electrónica en las bases de datos PubMed, TripData Base, Epistemonikos, The Cochrane Library y las revistas especializadas Journal of Clinical Sleep Medicine y SLEEP. Con el uso de las palabras clave: "Mandibular advancement device", "orthodonthic appliances", "sleep apnea syndroms", "sleep apnea obstructive", "Temporomandibular joints disorder", los operadores booleanos AND y OR. Se realizó un análisis crítico de la literatura evaluando nivel de evidencia, grado de recomendación y riesgo de sesgo de cada publicación. La búsqueda en las distintas bases de datos arrojó un total de 242 documentos, de los cuales 60 fueron seleccionados por título y abstract. Luego 8 estudios fueron descartados por estar repetidos. Se aplicaron los criterios de inclusión y exclusión quedando un total de 20 artículos; se eliminaron 8 por no responder a la pregunta de investigación y se añadió 1 título mediante la búsqueda manual. Finalmente, se analizaron 13 artículos; 2 revisiones sistemáticas, 2 ensayos clínicos aleatorizados y 6 series de casos. La mayoría de los documentos incluidos concuerda en que los efectos inducidos por los DAM, sobre el complejo temporomandibular son mínimos y reversibles, sin explicitar ningún diagnóstico de TTM en particular. Sin embargo, esta evidencia viene en su mayoría de estudios recomendables, pero no concluyentes. Se necesitan más y mejores estudios para realizar un análisis y abstraer conclusiones más certeras. Estos deben ser homogéneos a la hora de clasificar TTM y definir un protocolo óptimo de avance mandibular.

ABSTRACT: The aim of this study was to describe, based on the most recent scientific literature available, the effects produced by the mandibular advance appliances (MAA) as a therapy for obstructive sleep apnea-hypopnea syndrome (OSAHS) in the temporomandibular system. We carried out a review of the most current literature published in the last 10 years, based on an electronic search in PubMed, TripData Base, Epistemonikos, The Cochrane Library and the specialized magazines Journal of Clinical Sleep Medicine and SLEEP. The key words used for each search were "MANDIBULAR ADVANCEMENT DEVICE", "ORTHODONTIC APPLIANCES", "SLEEP APNEA SYNDROMS", "SLEEP APNEA, OBSTRUCTIVE", and "TEMPOROMANDIBULAR JOINT DISORDERS" combined with boolean operators AND and OR. A critical analysis of the literature was evaluated based on the level of evidence, degree of recommendation and risk of bias of each publication. We obtained 242 articles and 60 of these were selected by title and abstract. Inclusion and exclusion criteria were applied, obtaining 20 articles of which 8 were excluded because they did not answer the investigation question. One article was obtained by manual search. Of this number, 13 articles, 2 systematic reviews, 2 randomized clinical trial and 6 cases series were analyzed. Most of the articles analyzed agreed that the effects produced by the MAA in the temporomandibular complex are minimal and reversible, and they did not specify any TMD diagnosis in particular. However, this evidence comes mostly from recommended but inconclusive studies. More and better designed studies are needed, with homogeneous classification of TMD diagnostic criteria that allows to define an optimal protocol for mandibular advancement as a therapy.

Stability of periodontally compromised teeth after splint and non-surgical therapy: two cases followed-up for 1 to 3 years

This article describes cases of applying non-surgical treatment including scaling and root planing, occlusal adjustment and tooth splinting of periodontally compromised lower anterior incisors Clinical and radiographic evaluations were performed over a 1–3-year period. All clinical parameters and radiographic bone levels improved in both cases. Dramatic regeneration of alveolar bone and lamina dura were observed on radiographic images, and no specific complications occurred during the follow-up period. Within the limitations of this study, these cases demonstrated the possibility of tooth rescue through non-surgical treatment and splinting of periodontally compromised teeth typically considered for extraction.

Systematic development of esthetics and function in a young patient with maxillary dental aplasia

Objectives: Full-arch rehabilitations in young patients suffering from dental agenesis should compensate for the reduced vertical dimension of occlusion and restore both esthetics and function at minimal biological cost. This requires precise planning and maximum patient compliance during the preprosthetic phase. The pretreatment period with tooth-colored splints promotes a predictable outcome of the final restorations. Clinical considerations: Thanks to better restorative materials and adhesive techniques and increased knowledge of how to preserve sound tooth structures, prosthetic dentistry has increasingly turned toward minimally invasive procedures. The present clinical case documents a minimally/non-invasive maxillary full-arch rehabilitation of an agenesis patient with multiple dental aplasia, primary tooth persistence, and deficits in bone growth. The patient was pretreated with a tooth-colored CAD/CAM polycarbonate splint. Adequate esthetics and function were achieved by two zirconia-based single-wing adhesive fixed dental prostheses to replace the upper lateral incisors, lithium disilicate ceramic partial crowns for the posterior regions, and two feldspathic veneers for the upper central incisors

Conclusions: Non-invasive pretreatment with a removable tooth-colored splint realizes the treatment goal simply and safely, reduces treatment time, increases predictability, and facilitates the transfer of the prototype to the final restorations. New restorative options permit the minimally invasive treatment of such patients

Clinical Significance: A pretreatment with a removable tooth-colored splint offers a simple and safe way to define the treatment goal, reduces treatment time, increases predictability, and facilitates the transfer of the results to the final restorations even in complex cases. New restorative options permit minimally invasive treatments of young patients with multiple dental agenesis?

Four year's clinical evaluation of glass fiber reinforced resin-bonded fixed partial denture as a periodontal splint to replace lost anterior teeth / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical performance of glass fiber reinforced resin-bonded fixed partial denture(GFR-RBFPD) as a periodontal splint on abutment teeth with reduced periodontal support.</p><p><b>METHODS</b>Thirty fixed-fixed GFR-RBFPD were delivered to restore anterior partial edentulous dentitions. The adjacent abutment teeth had severely reduced periodontal support and were not indicated for full crown retained FPD. The success rate and functional survival rate had been recorded and the periodontal condition had been evaluated for 4 years. The results were statistically analyzed with single factor variance analysis and chi square test(α=0.05).</p><p><b>RESULTS</b>In the first, second, and third year following restoration, one connector fractured in each year and they were repaired with adhesive resin and the pontics were kept in place for function. In the third and fourth years after restoration, there was one pontic displacement with fracture of connectors. The total survive rate was 83%(25/30) and the functional survival rate was 93% (28/30) at the end of the fourth year. The main reason of failure was fracture of connector. About 22%(13/60) of the adjacent teeth showed marginal bone height decrease, while the other 78% (47/60) increased with statistic significant difference from one year after the restoration to the end of the observation term(P<0.05). The periodontal condition of the adjacent teeth was improved after the restoration.</p><p><b>CONCLUSIONS</b>The four years clinical evaluation indicates that the GFR-RBFPD may be used as fixed prostheses to replace lost one to three anterior teeth with reduced periodontal support of abutment teeth.</p>

Periodoncia e implantes: evaluación clínica y radiográfica durante 30 años / Periodontics and implants: a 30-year clinical and radiographic evaluation

Caso clínico que muestra tratamiento periodontal evaluado durante 30 años e implantes colocados hace 13 años...

A novel approach in treating horizontally fractured canine using RIBBOND splint and MTA as an obturating material and intra-radicular splint: A case report.

Radicular fractures in permanent teeth are uncommon injuries among dental traumas, being only 0.5-7% of the cases. Management of horizontal root fractures presents a formidable challenge for clinicians because of the difficulty of achieving a stable reunion of fracture fragments. This case report presents the management of horizontally fractured canine by approximation of fracture fragments, fiber splinting, and use of MTA - both as an obturating material and intra-radicular splint. Short-term follow-up of the case showed promising results both clinically and radiographically.

Clinical effect of sequential therapy for maxillary central incisor with horizontal mid-root fracture / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical effect of sequential therapy for traumatized maxillary central incisor with horizontal mid-root fracture.</p><p><b>METHODS</b>Twenty maxillary central incisors with horizontal mid-root fracture following dental trauma were included in our study. The distance between root fracture plane and root apical segment was more than 5 mm. The sequential therapy included stabilizing the traumatized incisor with a flexible splint after repositioning the coronal segment of the tooth, temporarily filling with calcium hydroxide after root preparation, sealing the root apex with warm gutta-percha obturation technique and internal fixation with fiber post combined with composite resin adhesion. The patients were followed for 6 to 24 months.</p><p><b>RESULTS</b>Two cases healed without sign of fracture line and eighteen cases healed with sign of fracture line. No case failed. Abnormal mobility and translocation, percussion pain, gingival swelling, sinus tract and periodontal pocket were not observed in all the traumatized teeth.Radiology showed normal root apex and periodontium.</p><p><b>CONCLUSIONS</b>Sequential therapy for maxillary central incisor with horizontal mid-root fracture could acquire a satisfactory therapeutic effect.</p>

The use of silane-coated industrial glass fibers in splinting periodontally mobile teeth.

In the past, direct stabilization and splinting of teeth using an adhesive technique required the use of wires, pins, or mesh grids. Problems with the current fiber reinforcement materials are their inherent thickness when embedded within composite resin, their availability in fixed widths and their high cost. This paper discusses the use of silane-coated industrial grade glass fibers, which can be bundled in the form of ribbon according to the required thickness and length. Of the three patients discussed in this paper, none has exhibited debonding or recurrent caries over 1-year period. By reinforcing composite splints with these industrial grade glass fibers, dentists can provide patients with restorations and splints that are economical, fracture resistant, and more durable than most alternative splinting materials of the past.

Férula de acrílico y alambres circunmandibulares para el tratamiento de una fractura de mandíbula / Splint made from acrylic and circummandibular wires for treatment of mandible fracture

Se presenta el caso de una niña que sufrió una caída desde una altura de varios metros y presentó una fractura en el fémur izquierdo y en el cuerpo mandibular del lado izquierdo. Como tratamiento se empleó una férula de acrílico y alambres circunmandibulares para reducir y estabilizar la fractura de la mandíbula; la fractura del fémur fue reducida por método abierto con placa y tornillos. La férula se retiró a las semanas de la fractura. Se le realizó un seguimiento clínico y radiográfico durante 3 meses, y se constató una excelente evolución, con excelente consolidación ósea y oclusión. Los resultados demostraron la utilidad de este medio de fijación de fracturas, sobre todo porque es poco agresivo para los niños y con él se evitan muchas complicaciones(AU)

This is the case of a girl fell from some meters height and had a fracture of left femur and in the left side of mandibular body. As treatment we used an acrylic and circummandibular wires to reduce the mandible fracture; the femur's fracture was reduced by open method using plates and screws. A few weeks later splint was removed. A clinical and radiographic follow-up was made over three months, confirming an excellent course, bone consolidation and occlusion. Results showed the usefulness of this method of fracture's fixation mainly because it is not much aggressive for children avoiding in this way many complications(AU)

Functional diagnostics and aquasplint therapy, a novel procedure for simple diagnosis and effective therapy of the TMJ/TMD during orthodontic treatment

Temporomandibular joint screening prior to orthodontic rehabilitation is indispensable for preventive, therapeutic, and forensic reasons. Daily practice calls for a simple and effective concept in order to treat TMD patients, and to avoid iatrogenic mishaps during orthodontic therapy. Furthermore, planning and prognosis may be improved in many cases. This article presents one of the new approaches to manage the malocclusion-related TMD, using the AquaSplint which is a self,adjusting, customisable, prefabricated splint

Management of a complex dentoalveolar trauma: a case report

This paper describes the case of a 12-year-old male patient who presented a severe lateral luxation of the maxillary central incisors due to a bicycle fall. Treatment involved suture of the soft tissues lacerations, and repositioning and splinting of the injured teeth, followed by endodontic treatment and periodontal surgery. After a 2-year follow-up, clinical and radiographic evaluation revealed that the incisors presented satisfactory esthetic and functional demands.

Este artigo apresenta o caso de um paciente de 12 anos de idade que apresentou uma luxação lateral severa dos incisivos centrais superiores decorrente de uma queda de bicicleta. O tratamento envolveu a sutura dos tecidos moles dilacerados e reposicionamento e fixação dos dentes traumatizados, seguidos por tratamento endodôntico e cirurgia periodontal. Após um acompanhamento de 2 anos, a avaliação clinica e radiográfica revelou que os incisivos apresentavam exigências estéticas e funcionais satisfatórias.

El uso racional de la ferulización en periodoncia: reporte de una técnica simplificada y funcional / The rationale use of splinting in periodontics: report of a simplified and functional technique

la ferulización es uno de los procedimientos más antiguos de la odontología, sin embargo, aun en la actualidad, la ferulización periodontal continúa siendo una valiosa herramienta para el control de la hipermovilidad dentaria. Hoy en día, la utilización de las técnicas de ferulización debe estar fundamentada en sólidos conocimientos sobre la etiopatogenia de la enfermedad periodontal y trauma oclusal. Este artículo presenta una situación bastante común en la clínica odontológica que es la enfermedad periodontal avanzada en los dientes anteriores-inferiores, causando al paciente gran incomodidad masticatoria y hasta inseguridad para actividades funcionales básicas como la propia habla. Para la resolución de este cuadro clínico, se propone una ferulización definitiva por medio de una técnica alternativa, simplificada y funcional apuntando la manutención de los dientes periodontalmente debilitados. Este recurso es especialmente valioso para pacientes que no tienen condiciones financieras de recibir prótesis convencionales o soportadas por implantes.

Surgical repositioning of intruded immature permanent incisor: an updated treatment concept.

Intrusion of immature permanent anterior teeth presents a great dilemma due to variety of treatment options. The ideal treatment option is the one with least probability of developing complications like external root resorption, obliteration of pulp canal, marginal bone loss etc. This paper presents a case report with treatment strategy of repositioning, splinting, successfully attempted apexification and obturation of a completely intruded immature permanent central incisor. Excellent healing with no post-operative complications even after 10 months of follow up.

Restoring biological width in crown-root fracture: a periodontal concern.

A 10-year-old male child reported to J.S.S. Dental College and Hospital presenting with a vertical crown-root fracture of maxillary central incisor with a history of fall 10 days back. A new treatment protocol was attempted in contrary to various schools of thoughts of coronal fragment removal wherein fractured fragments were approximated and internally reinforced with latest technologies in adhesive dentistry, the goal was to save the tooth, restore its function and esthetics. This case presents the above mentioned philosophy.

Management of a rare combination of dental trauma: a case report.

The occurrence of combined injury of intrusion, avulsion and lateral luxation is rare and the mechanism responsible for this is intriguing. This case report describes such a combined injury and its management. The rationale behind the treatment modalities is discussed.