Intentional replantation for the treatment of a double-rooted maxillary lateral incisor with periodontal-endodontic lesions: a case report and literature review / 口腔疾病防治

Objective@#To investigate the clinical characteristics, diagnosis and treatment of severe combined periodontal-endodontic lesions in a double-rooted maxillary lateral incisor with a palatal radicular groove and to provide a reference for clinical diagnosis and treatment.@*Methods@#A patient with a double-rooted left maxillary lateral incisor with a palatal radicular groove and severe combined periodontal-endodontic lesions underwent complete root canal therapy and intentional replantation, and a retrospective analysis of the management of this type of patient was performed based on the literature.@*Results@#The 3-year follow-up examination revealed no discomfort, good healing of the upper left lateral incisor, no pathological loosening, and a palatal gingival sulcus was found at a depth of approximately 1 mm. Review of the literature showed that the prognosis of the affected tooth and the choice of treatment plan were correlated with the length and depth of extension of the lingual groove toward the root, the periodontal condition and the pulpal status of the affected tooth. For minor PRGs or for affected teeth with no loss of pulpal viability, flap surgery and odontoplasty can be used to avoid endodontic treatment or retreatment. For deep or long lingual grooves that result in significant loss of periodontal tissue, endodontic treatment, odontoplasty, or closure of the grooves and guided tissue regeneration are needed. In the case of PRGs with double root formation, the affected tooth can be preserved via root canal therapy, removal of the small root and filling with apical restorative material, and intentional replantation.@*Conclusion@#In cases of severe combined periodontal-endodontic lesions due to palatal radicular grooves occurring in double-rooted maxillary lateral incisors, clinical presentation and imaging can prevent missed diagnoses, and appropriate treatment should be based on the length and depth of lingual grooves extending toward the roots, periodontal conditions, and pulpal status of the affected teeth.

Summary of combined orthodontic and implant treatment in the patients with the congenital absence of maxillary lateral incisors / 口腔疾病防治

Objective@#To summarize the treatment options for congenital maxillary lateral incisor agenesis (MLIA).@*Methods @#Review the literature, summarize the current treatment options and advantages and disadvantages of various methods of MLIA, and analyze cases. @*Results @#When a patient′s occlusion and other conditions are suitable for space closure and canine substitution, closure of the gap is the recommended method, as it has good aesthetic results and leads to good periodontal health. However, when closure cannot be performed, a dental implant has a strong advantage compared with other restoration methods. When planning implants for MLIA patients, doctors should carefully select the correct surgery time and take care with the implant position to obtain good results.@* Conclusion@#In the choice of a treatment plan for MLIA, we need to use the concept of multidisciplinary combined treatment to obtain a more satisfactory treatment effect with regard to aesthetics and function.

Non-syndromic Supplemental Permanent Maxillary Lateral Incisor: A Rare Case Series.

Supernumerary teeth, or hyperdontia, are the additional teeth to the normal series and are seen in all quadrants of the jaw. They have been reported to occur in both primary and permanent dentition. The supplemental supernumerary refers to duplication of teeth in the normal series and is found at the end of the tooth series. The majority of supernumeraries found in primary dentition are of the supplemental type. It is rare and was overlooked because of their normal size and shape. Hereby, we report three cases of supplemental maxillary permanent lateral incisor which resulted in crowding and poor esthetics. This case series reports unilateral supplemental teeth and its management.

Management of apicomarginal defect in esthetic region associated with a tooth with anomalies

Tooth related factors such as palatoradicular groove can be one of the causes for localized periodontal destruction. Such pathological process may result in apicomarginal defect along with inflammation of pulp. This creates challenging situation which clinician must be capable of performing advanced periodontal regenerative procedures for the successful management. This case report discusses clinical management of apicomarginal defect associated with extensive periradicular destruction in a maxillary lateral incisor, along with histopathologic aspect of the lesion.

Palatogingival Groove - Cause of Root - Canal Failure - A Case Report.

Morphological defects occurring in dental structure can be sometimes predisposing factors for the onset of inflammatory processes in the periodontal and/or pulpal tissues. Palatogingival groove is one such defect, most frequently found on the lingual surface of maxillary laterals. They are easily overlooked as aetiologic factors, as these grooves are covered by periodontal tissues. This case report discusses successful management of a root-canal treated maxillary lateral incisor with an associated radicular lingual groove having persisting inflammatory condition. The management included a combination of endodontic therapy and periodontal regenerative techniques.

Endodontic treatment of maxillary lateral incisors with anatomical variations

Maxillary lateral incisors usually exhibit a single root with a single canal. However, maxillary lateral incisor teeth with unusual morphology of root canal system are frequently reported. These cases of variable root canal anatomy can be treated well by nonsurgical endodontic methods. A detailed description of root canal morphology is fundamental for successful endodontic treatment. Treatment using an operating microscope, radiographs from different angles, and cone-beam computerized tomography (CBCT) can produce more predictable endodontic outcomes.

Retreatment Of A Maxillary Lateral Incisor With Two Canals Associated With Bony Dehiscence : An Endo- Perio Case Report.

A 25-year old female was referred with gingival recession and pus discharge associated with bony dehiscence in relation to previously root canal treated maxillary left lateral incisor. Radiographic examination revealed presence of a second canal which was left untreated in the previous treatment which could be the possible cause of treatment failure and development of bony dehiscence. During re-treatment, the second canal was located, cleaned and shaped and obturated and the bony defect was treated with free gingival graft. This case report demonstrates the need for greater attention in treating the root canal of maxillary lateral incisors due to its variations in root canal morphology and also the need for thorough evaluation of good quality pre-operative radiographs taken in different angulations to avoid such mishaps. This case is unusual because considerable research has reported that these teeth can only have a single canal.

An Endodontic Mishap In Maxillary Lateral Incisor With Two Roots : A Case Report.

A 24 year old male was referred with pain and swelling in relation to a previously root canal treated maxillary left lateral incisor. Radiographic examination revealed presence of a second root which was left untreated in the previous treatment. This endodontic mishap had led to the failure of the case. During the retreatment the second canal was detected and cleaned, however considering the amount of bone loss around the second root, it was resected. This case report demonstrates the need for greater attention in treating the root canal of maxillary lateral incisors due to its anomalies, and also the need for thorough evaluation of good quality preoperative radiograph to avoid such mishaps.

Management of lateral incisor with palatal radicular groove.

Palatal radicular grooves are developmental anomalies of maxillary incisors, which contribute to localized periodontitis resulting in loss of anterior teeth. Palatal radicular grooves, when present, act as a site for plaque accumulation and periodontal infection. They are easily overlooked as etiologic factors, as these grooves are covered by periodontal tissues. The clinician has to be alert and check for variations in the anatomy of the tooth as a cause of pulp necrosis in the anterior segment of the tooth, when other causes are ruled out. Recognition of palatal radicular grooves is critical, especially because of its diagnostic complexity and the problems that may arise if it is not properly interpreted and treated. This case report describes the diagnosis and management of a maxillary lateral incisor with necrotic pulp and localized periodontal destruction, associated with a palatal radicular groove.