RESUMEN
A 35-year-old man was referred to our hospital for surgical repair of grade IV/IV aortic regurgitation secondary to a congenital unicuspid aortic valve accompanied by aneurysm of the ascending aorta. The aortic valve was the unicuspid unicommissural type and a fully developed commissure was located in the left lateral position (left coronary/right coronary). The anterior (non-coronary/right coronary) and posterior (non-coronary/left coronary) borders were rudimentary with calcified raphe. We performed aortic valve repair in combination with valve sparing root replacement (reimplantation) and partial arch replacement. We converted the unicuspid into a bicuspid aortic valve by preserving his own free margin tissue and creating a neocommissure to the 180 degrees opposite side of the left lateral commissure at the same height by enlarging the cusp with a glutaraldehyde-treated autologous pericardium patch to the cusp belly. The patient was discharged on the 17th postoperative day with trace aortic regurgitation. We successfully repaired the unicuspid aortic valve by augmenting the cusp size using a pericardium patch in order to preserve the free margin of the cusp.
RESUMEN
Infections of periodontal or endodontic origin may result in increased periodontal probing depths with attachment loss adjacent to the root surface, bleeding on probing, suppuration, swelling, tooth mobility, angular bone loss, and pain on percussion. These signs and symptoms may be caused by plaque-associated periodontitis which begins at the margin of the gingiva and proceeds apically or by endodontic infections that enter the periodontal ligament at the apical foramen or through lateral or accessory canals and proceed coronally. The loss of posterior molars as a result of periodontal or endodontic infection leads to migration of teeth, supra-eruption of opposing teeth, loss of supporting alveolar bone and a decrease in masticatory efficiency. The unrestorable teeth can be replaced by removable partial dentures or fixed partial dentures or the recent treatment modality, dental implants. This case report presents one treatment option available to save the molars affected by extensive periodontal lesions, and thereby prevent the undesirable consequences of tooth loss. Hemisection refers to the sectioning of a molar tooth with the removal of an unrestorable root which may be affected by periodontal or endodontic infection or carious lesion. Careful case selection is necessary for long-term success.
RESUMEN
In dentistry, the term 'fusion' is used to describe a developmental disorder of dental hard tissues. In the permanent dentition, fusion of a normal tooth and a supernumerary tooth usually involves the incisors or canines. However, a few cases of fusion involving premolars have also been reported to date. We present a rare case in which fusion of the maxillary left second premolar and a supernumerary tooth in a 13-year-old girl was diagnosed using cone beam computed tomography (CBCT, Alphard-3030, Asahi Roentgen Ind. Co., Ltd.). The tooth was bicuspidized after routine nonsurgical root canal treatment, and the separated teeth underwent appropriate restoration procedures. The second premolar and supernumerary tooth remained asymptomatic without any signs of inflammation after a follow-up period of 9 years. Identification of anatomical anomalies is important for treatment in cases involving fusion with supernumerary tooth, and therefore the microscopic examinations and CBCT are essential for the diagnosis. Fused teeth can be effectively managed by the comprehensive treatment which includes both endodontic and periodontal procedures.