Dilaceration: review of an endodontic challenge.

Department of Endodontics, Faculty of Dentistry and Dental Research Center, Mashhad University of Medical Sciences, Vakilabad Boulevard, Mashhad, Iran.
Journal of Endodontics (Impact Factor: 2.79). 10/2007; 33(9):1025-30. DOI: 10.1016/j.joen.2007.04.013
Source: PubMed

ABSTRACT Dilaceration is the result of a developmental anomaly in which there has been an abrupt change in the axial inclination between the crown and the root of a tooth, but the criteria in the literature for recognizing root dilaceration vary. Two possible causes of dilaceration are trauma and developmental disturbances, and it has also been proposed that it might be associated with some developmental syndromes. Dilaceration can be seen in both the permanent and deciduous dentitions, and it is more commonly found in posterior teeth and in the maxilla. Periapical radiographs are the most appropriate way to diagnose the presence of root dilacerations. Diagnosis, endodontic access cavity preparation, root canal preparation and filling, and other related treatments might be complicated by the presence of a dilaceration. A review of the literature and a discussion of the options for managing this condition are presented.

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    ABSTRACT: Radicular dilaceration is a dental anomaly in which the longitudinal axis of the dental root shows a sudden deviation forming a 90o angle or greater. When this aberration is located in the apical portion of the root and it is not detected until the application of orthodontic movements, it may lead to fenestration of the buccal cortical bone, as well as generation of aesthetic, eruption and dental pulp problems. The treatment of these cases is very complex and usually involves surgical removal of the affected tooth. Case presentation, this article presents the surgical and non-surgical endodontic management of a maxillary central incisor with radicular dilaceration of the apical portion that fenestrated the buccal cortical bone. Additionally, it presents three and a half years of clinical and radiographic follow-up of the case. Discussion, radicular dilaceration is a rare finding that must be detected in order to prevent undesirable surgical mishaps. However, when this anomaly fenestrates the buccal cortical bone like we report in this work, an alternative treatment is the application of both surgical and non-surgical endodontic management on the affected tooth. The purpose of this is to avoid a more invasive and noxious intervention such as a dental extraction.
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