Article

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: 2.93). 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: PURPOSE: To describe the management and six-year follow-up of a patient who suffered trauma in primary dentition and, as a consequence, presented root malformation in permanent tooth. CASE DESCRIPTION: A 5-years-old boy sustained trauma in primary maxillary anterior teeth due to a bicycle fall. As consequence of avulsion of left central incisor, the boy presented root dilaceration of the permanent successor. Radiography and clinical monitoring of the case were regularly performed. The tooth completed its eruption one year after sequel was detected and is currently successfully functional in the arch, despite the malformation. CONCLUSION: This case reinforces the need of long term follow-up in order to avoid any risks of further tooth damage, intervening only when necessary.
    Revista Odonto Ciência. 12/2010; 26(4):355-358.
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    ABSTRACT: A 19-year-old female reported to the Department of Conservative Dentistry and Endodontics, with pain in relation to upper right posterior teeth. Clinical examination revealed maxillary right first and second premolars having temporary restoration, which was placed in a private clinic two months back. Both the teeth were tender on percussion. Medical history was non-contributory. Radiographic examination revealed that the temporary restorations were extending into the pulp chamber of the involved teeth. The roots of 14 were doubly curved (Bayonet or 'S' shaped) and that of 15 showed a sharp curvature at middle third [Table/Fig-1]. From the clinical and radiographic findings, a diagnosis of previously initiated therapy associated with symptomatic apical periodontitis was made in relation to 14 and 15. Prior to the formulation of endodontic therapy the degree of curvature was determined by using Schneider method and it showed severely curved canals in relation to both the teeth. With informed consent, local anesthesia was administered using 2% lignocaine and 1:100000 Adrenaline and Endodontic therapy was initiated under rubber dam isolation. Temporary restoration was removed and the access cavity of 14 and 15 were modified. The pulp chamber was irrigated by following standardized irrigation regimen using 5.25% of sodium hypochlorite (NaOCl), 17% ethylene diamine tetraacetic acid (EDTA) and physiological saline. For verifying the patency of the root canals, No.8 and 10 stainless steel K-files (Mani, Inc, Japan) were used. No.15 K file glide path was ascertained up to the radiographic working length [Table/Fig-2]. The estimated length till the curvature was marked on the engine-driven instrument and coronal flaring was done. Gate-Glidden (GG) drills were used for orifice enlargement up to size No 3. Working length was then confirmed using an apex locator (Root ZX, J. Morita, Japan) in both the teeth. Sequential filing of the curved canals was done using nickel titanium (NiTi) hand files No. 15, 20, and 25 (Mani, Inc, Japan) to the working length. The apical portions of the canals were prepared using short amplitude filing. Special emphasis was placed on frequent irrigation of the root canal and recapitulation was done to avoid blockage by dentinal debris and to remove the necrotic remnants of the pulp tissue. Final cleaning and shaping was carried out using Hyflex CM rotary files up to 4% 40 size of the instrument. Calcium hydroxide was used as an intracanal medicament and closed dressing was given for six days.
    Journal of clinical and diagnostic research : JCDR. 06/2014; 8(6).
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    ABSTRACT: Statement of Problem: Dilaceration is defined as a sudden change in the axial inclination of root or between the crown and the root of a tooth. There is no previous study evaluating its prevalence in south of Iran. Purpose: This study evaluates the prevalence of root dilaceration on the basis of its location in dental arch in a sample of dental patients referring to Shiraz dental school, Iran. Materials and Method: This retrospective study was performed using full mouth periapical radiographs of 250 patients who were referred to Shiraz dental school. Buccal and lingual dilaceration was determined by its known" bull's eye" appearance in the radiographs or if the deviation was in the mesial or distal directions; the angle of 90 degree or greater between the deviation and the axis of root was the inclusion criteria. Results: Root dilaceration was detected in 0.3% of teeth and 7.2% of patients. It was distributed equally between the maxilla and mandible. Mandibular second molar was the most frequent dilacerated tooth (1.6%) followed by maxillary first molar (1.3%) and mandibular first molar (0.6%). The alveolar nerve was the most common anatomic structure near dilacerated teeth. Conclusion: According to this study, root dilaceration is an uncommon developmental anomaly which occurs mostly in the posterior teeth.
    Journal of dentistry (Shīrāz, Iran). 12/2013; 14(4):160-4.

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