A novel management of vertical root fracture in an endodontically treated mandibular premolar with titanium screw: A case report.

Introduction: Vertical root fracture is one of the conditions prevalent in endodontically treated teeth. The treatment options include extraction of the fracture fragment or the affected tooth as a whole. This case report highlights the successful management of vertical root fracture in an endodontically treated mandibular first premolar. Method: Surgical intervention was initiated, and a full-thickness flap was elevated. The separated fracture segment was safely retrieved, and the existing caries were removed and then reattached to the main fragment with the help of a titanium screw. The tooth was rehabilitated with a composite resin core followed by a porcelain-fused metal crown and the patient was followed up for 7 years. Result: The tooth was functional with evidence of new bone formation. Conclusion: Reattachment of the fracture fragments with a titanium screw might be considered as an option for managing vertical root fracture cases with poor prognosis.

Novel management of internal root resorption with vertical root fracture using mineral trioxide aggregate - A case report.

Introduction: This case report presents the diagnosis and management of extensive internal root resorption (IRR) in a 17-year-old male patient, with a 9-year-old history of trauma. Method: The affected tooth 21 was associated with vertical root fracture (VRF) and incomplete apex closure with a substantial loss of tooth structure, including dentin and cementum. Encouraged by a healthy periodontal condition, the choice was made to use mineral trioxide aggregate (MTA) to reconstruct and reinforce the resorptive defect and the fractured segment. A composite veneer was placed to enhance the aesthetics. Result: A follow-up of the patient after 2 years revealed healing with a resolution of the lesion. Conclusion: This case report highlights the use of MTA as a lone-standing filling material for the treatment of IRR with VRF in a non-vital immature tooth.

Chronic sinusitis of odontogenic origin due to an undiagnosed displaced root fragment in the maxillary sinus and the role of cone beam computed tomography in successful management.

Radiographic imaging is an important criteria in diagnosis, treatment planning, and follow-up of an endodontic treatment. When clinicians encounter with diagnostic difficulties and persistent symptoms, the need for advanced diagnostic aids, especially imaging methods, become imperative and essential. This paper reports a case, in which primary endodontic therapy having failed, the patient had persisting symptoms such as pain, swelling, and draining sinus along with signs and symptoms of maxillary sinusitis. Advanced diagnostic aids such as Cone Beam Computed Tomography was useful in accurate identification of the etiology, which was a fractured mesiobuccal root tip of maxillary molar. This is the first reported case, in which the fractured root tip has migrated to the maxillary sinus, during primary endodontic treatment, through the perforated antral floor causing odontogenic sinusitis. The operating microscope helped in the successful completion of endodontic retreatment along with fractured root fragment retrieval.

The effect of two bleaching agents on the phosphate concentration of the enamel evaluated by Raman spectroscopy: An ex vivo study.

AIM: The aim of this ex vivo study was to evaluate the effect of in-office bleaching agents,-35% and 38% hydrogen peroxide containing bleaching agents, on the phosphate concentration of the enamel evaluated by Raman spectroscopy. MATERIALS AND METHODS: Forty noncarious, craze-free human maxillary incisors, extracted for periodontal reasons, were used in this study. Baseline Raman spectra from each specimen were obtained before the application of the bleaching agent to assess the phosphate content present in the teeth. The teeth were divided into two groups: Group A - bleached with pola office bleach (35% hydrogen peroxide, potassium nitrate) (light activated). Group B - bleached with opalescence Xtra bleach (38% hydrogen peroxide potassium nitrate and fluoride) (chemical activated). After the bleaching procedure, the treated specimens were taken to obtain Raman spectra to assess the phosphate loss after bleaching treatment. RESULTS: The results showed that the chemically activated bleaching agent showed less phosphate loss when compared with the light activated bleaching agent. CONCLUSION: Within the limitations of this study, it can be concluded that the chemically activated bleaching agent showed minimal phosphate loss when compared to light activated bleaching agent. The chemically activated bleaching agent was better than the light activated bleaching agent when values were evaluated statistically.