The endodontic management of traumatized permanent anterior teeth: A review

Australian Dental Journal (Impact Factor: 1.1). 04/2007; 52(1 Suppl):S122-37. DOI: 10.1111/j.1834-7819.2007.tb00520.x
Source: PubMed


Despite the many journal articles and reviews that have been published regarding the treatment of trauma to teeth, the endodontic management of these injuries is often still not fully understood. The purpose of this review is to establish clear and up-to-date guidelines for practitioners who are faced with treating dental injuries on a day-to-day basis, based on an assessment of current available scientific information relating to the endodontic management of these injuries.
Treatment is discussed under the headings: infractions, uncomplicated crown fractures, complicated crown fractures, crown-root fractures, root fractures, luxation injuries, avulsion, root resorption, pulp canal obliteration and open-apex teeth. Emphasis is placed on the treatment of traumatized immature teeth where maintenance of pulp blood supply is important to encourage continued development of the root system. Only the treatment of traumatized permanent anterior teeth is reviewed.
Information contained in this article is based on a review of the literature on dental trauma which involved a MEDLINE search using the key words “dental trauma” and the individual topics listed above. The guidelines produced by the International Association of Dental Traumatology, the American Academy of Pediatric Dentistry and the American Association of Endodontists were also reviewed and the recommendations contained in this paper are in concert with the major recommendations of these bodies.

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Available from: Alex Moule, Oct 29, 2014
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    • "A periapical lesion may be associated with such an open apex tooth having blunderbuss canal, as it is more prone to bacterial infection leading to necrosis of the pulp tissue and an inflammatory response in the periapical tissues.5,6 It presents with various clinical and radiographic signs and symptoms such as pain, swelling, discoloration of the tooth, draining sinus tracts and periapical radiolucency.7 Its management involves non-surgical endodontic therapy with complete disinfection and obturation of the root canal. "
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    ABSTRACT: Cone beam computed tomography (CBCT) is a recent three-dimensional (3D) radiographic imaging modality used for the accurate diagnosis, management and follow-up of endodontic problems. In tooth with open apex and periapical lesion, the use of new obturation material such as white mineral trioxide aggregate (wMTA) facilitates faster and more predictable closure of root apex and periapical healing. The objective of this case report was to evaluate the role of CBCT and wMTA obturation in management of a permanent anterior tooth with open apex and periapical lesion. After CBCT evaluation of maxillary left central incisor with open apex and periapical lesion, it was endodontically treated with wMTA obturation. The patient was recalled regularly for 6 months. CBCT was found to be a useful tool for the diagnosis and post-operative evaluation of this case. The wMTA used for obturation in two visit endodontic treatment resulted in successful outcome, both clinically and radiographically.
    07/2014; 6(4):68-72.
    • "Phase I therapy was performed and patient was posted for endodontic treatment. Calcium hydroxide dressing was given for 2 weeks followed by obturation with Gutta percha.[10] Surgery was planned 1 week after completion of endodontic treatment. "
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    ABSTRACT: Traumatic injuries are the most studied yet most challenging for a dentist. Extrusive luxation injuries are usually managed by repositioning tooth in the original position and pulp sensibility is evaluated at regular periodic intervals. However, when injuries are chronic, tooth is necrotic with compromised periodontal support, treatment is a challenge. Intentional replantation utilizing growth factors in fibrin rich network of platelet rich fibrin can be a treatment modality in such patients where other restorative modalities to establish function-esthetics rehabilitation is not possible.
    Journal of Indian Society of Periodontology 09/2013; 17(5):670-5. DOI:10.4103/0972-124X.119292
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    ABSTRACT: A case is presented of an 11-year-old boy who was diagnosed with a horizontal radicular fracture located in the middle third of a maxillary right central incisor that was immediately managed conservatively. Subsequent to the injury, the patient complained of inability to bite, a swollen upper lip and pain on palpation in the periapical region of the tooth. Clinically the tooth appeared extruded. Radiographic examination revealed a root fracture. The extruded tooth was repositioned and immobilised with a wire-composite splint, under a suitable prophylactic antibiotic and anti- inflammatory analgesic coverage for one week. Two years after trauma, the treated tooth was firm and healthy with good aesthetics and normal function.
    East African medical journal 05/2008; 84(12):599-602. DOI:10.4314/eamj.v84i12.9598
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