ABSTRACT
The sequelae associated with anterior oral trauma during childhood growth may require a protracted period of clinical management to achieve an optimal foundation for future prosthetic therapy. This article presents two case examples of long-term ridge development and preservation in children after anterior dental and alveolar trauma. These two patients were managed for periods of 11 years, one from age 8 to 19 and the other from age 9 to 20, until they were old enough to receive implantsupported restorations. Two different treatment plans were prescribed based on whether or not the teeth in question were ankylosed. In one case, fractured roots that were not ankylosed were retained; in the other, decoronation of an ankylosed tooth was performed.
Subject(s)
Tooth Ankylosis , Tooth Avulsion , Tooth Injuries , Alveolar Process , Child , Humans , Tooth CrownSubject(s)
Incisor/injuries , Tooth Avulsion/surgery , Tooth Replantation/methods , Adolescent , Alveolar Bone Loss/prevention & control , Alveolar Process/growth & development , Bone Development/physiology , Child , Humans , Isotonic Solutions/therapeutic use , Maxilla , Organ Preservation Solutions/therapeutic use , Periodontal Ligament/physiology , Root Resorption/physiopathology , Root Resorption/prevention & control , Time Factors , Tooth/transplantation , Tooth Ankylosis/prevention & control , Tooth Crown/surgery , Transplantation, Autologous , Treatment OutcomeABSTRACT
Published reports claim that implants can fail from endodontic pathosis involving teeth adjacent to an implant, from preexisting bacteria in an extraction site that had a history of a tooth having a periradicular lesion, and even from an asymptomatic endodontically treated tooth with no clinical or radiographic evidence of pathosis. This report considers the support offered for an endodontic connection to implant failure, and it presents a case that conflicts with the premise that endodontic involvement causes implant failure. The diagnosis and treatment of a radiolucent lesion associated with an implant is described. Although initially interpreted as indicating a failing implant, the etiology of the radiolucency was a necrotic pulp in a maxillary lateral incisor with resorption. Nonsurgical endodontic treatment that combined Ca(OH)2 for interim treatment and mineral trioxide aggregate for final obturation completely resolved the periradicular lesion abutting the implant and successfully retained both the implant and the resorbed lateral incisor.
Subject(s)
Dental Implants , Dental Restoration Failure , Periapical Periodontitis/complications , Periapical Periodontitis/therapy , Root Canal Therapy , Adolescent , Dental Implantation, Endosseous , Female , Humans , Incisor , MaxillaABSTRACT
Diagnosis and treatment of chronic apical periodontitis associated with an abutment tooth in an extensive tooth-implant-supported fixed prosthesis is reported. Careful, complete interpretation of clinical data was imperative because the periapical radiolucency presented around the apex of a vital tooth. A retrograde endodontic approach was used to prevent an adverse outcome to the complex rehabilitative treatment that had been performed over many years.
